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Co-Occurring Disorders Treatments Across VA & TN 

Co-Occurring Substance Abuse & Mental Health

Substance Abuse and Mental Health: 

  • It is estimated that 50-75% of individuals with substance use disorders also have a psychiatric disorder. It is more common in adolescents than not. 
  • 30-50% of adolescent patients had co-occurring mood disorders, whereas 10-20% had co-occurring anxiety disorders. 
  • Co-occurring disorders are linked with increased severity of substance use disorders. 

Treatment access for co-occurring issues is lacking: 

  • 20% of individuals suffering from a severe mental health disorder will develop a substance use disorder in their lifetime. 
  • Only 7% of individuals will receive treatment for both disorders. 55% receive no treatment at all. 
  • Those who do receive help for substance abuse often obtain it after their problems are more severe and co-occurring with medical and psychiatric conditions. 

Integrated Treatment for dual diagnoses is paramount: 

  • Multi-disciplinary teams to target multiple issues in an individualized manner. This may include coordinating with an outside psychiatrist to obtain necessary medications. 
  • Bio-psychosocial approach to incorporate many facets of life. 
  • Cognitive Behavioral Therapy to problem-solve around challenges.
  • Motivational Interviewing to approach change with positivity.
Man Drinking

Kemet Health's Approach to Substance Abuse Treatment 

Cognitive Behavioral Therapy (CBT)

CBT focuses on the activities in an individual’s life, rather than the events that lead up to their difficulties. It is based on the following: 

  • Psychological problems are based on faulty or unhelpful ways of thinking. 
  • Psychological problems are based on learned patterns of unhelpful behavior. 
  • Coping skills can be learned to deal with psychological problems. This relieves negative symptoms and allows individuals to lead more effective lives. 

With CBT we identify and change thought patterns that have a negative influence on behavior or emotions.

Raising awareness of negative and often unrealistic thoughts can be effective to help patients overcome a wide variety of maladaptive behaviors. 

Some examples of CBT exercises include: 

  • Develop a better understanding of others’ behavior and motivation
  • Use problem-solving skills to cope with difficult situations 
  • Develop stronger confidence in your abilities 
  • Role play to prepare for potentially difficult interactions with others 
  • Calm your mind, relax your body 
  • Develop coping skills for the difficulties of life
  • Identify and pacify negative thoughts, set new goals and self-monitor

CBT is problem-oriented, short-term and requires less time investment than other forms of therapy. 

CBT is one of the most utilized and studied forms of therapy. Research suggests that CBIT leads to significant improvement in functioning and quality of life – and has been demonstrated to be as effective as, or more effective than other psychological therapy or psychiatric medications. 

Motivational Interviewing (MI) 

MI is non-confrontational. It is used to strengthen personal motivation and foster a commitment to a specific goal. It is a goal-oriented and collaborative style of counseling. 

MI encourages an empathetic and open discussion about an individual’s life, as well as their substance use. The goal is to explore the individual’s interest to change, any potential roadblocks and the path to improve motivation. 

Motivational Interviewing values individual autonomy. It does not require the individual to admit to anything before considering behavioral changes. 

Important exercises to encounter with Motivational Interviewing: 

  • Self-examination: What might be gained through positive change? 
  • Encouraging reflection: Why do you want to make the change? 
  • Looking to the future/past: How might you go about it to succeed? 
  • Examining self-confidence: How confident are you to make this change, and why? 
  • Importance of change: How important is it for you to make this change, and why? 
  • Positivity: Did you feel good about the experience? 

Motivational Interviewing meets the American Psychological Association’s criteria for promising treatments of adolescent substance abuse. Individuals with co-occurring mental health & substance abuse issues can benefit from MI techniques to improve psychiatric outcomes. 

Trauma-Informed Care (TIC)

Trauma is an external event with long-lasting effects on mental well-being - and is highly correlated with mental health outcomes. 

Trauma can negatively affect your well-being, including your physical and mental health. 

Trauma is widespread across society. Many people who seek help for mental health have histories of trauma, but often don’t recognize the effects of trauma in their lives.

Trauma comes in many forms:

  • Childhood physical or sexual abuse, neglect
  • Serious accidents or natural disasters
  • Homelessness
  • Involuntary psychiatric hospitalizations
  • Drug overdoses
  • Interpersonal violence
  • Traumatic Grief

Trauma-informed care is a holistic approach, a change in perspective: the focus shifts from “what is wrong with you?” to “what happened to you?”. 

Practices trained in TIC have many benefits to you:

  • Compassionate witness and acknowledgement to the pain underlying your distress and behaviors
  • Sensitivity to abuse and connecting the individual with the support needed
  • Safe environment that reflects the need for physical and emotional safety
  • Problem Solving. Improve understanding of the past and extract wisdom to better approach the future
  • Cultural Competency ensured across all our interactions
  • Strengths Based. Belief of strength as an individual, to be an expert in their own life and have/develop the resilience to survive difficult circumstances