Dual Diagnosis: Evaluation, Treatment, Training, and Program DevelopmentJoel Solomon, Sheldon Zimberg, Edward Shollar Patients who have both a psychiatric disorder and a substance abuse problem cause most clinicians to throw up their hands in despair. The clinical problems that these "dual diagnosis" patients present are enor mously complex. Diagnostically, how is one to tell if disorders of mood and thinking, for instance, are signs of a mental illness or consequences of substance abuse? How is one to obtain important historic information when the patient may be unable or unwilling to provide it and there are no readily available collateral sources of information? In any case, why bother? Treatments for dually diagnosed patients are ineffective; patients won't stay in treatment; recidivism occurs at a very high rate. To make matters even more difficult, traditional health care reim bursement mechanisms do not provide for the multimodality clinical programs and special services needed by the patient who is both mentally ill and a substance abuser. So the clinician needs an effective bureaucratic strategy as well as a treatment strategy. For the most part, clinicians have handled the problem by ignoring it. |
Contents
INTRODUCTION AND GENERAL CONCEPTS | 3 |
Models of Psychiatric and Addictive Disorder Causality | 9 |
Overcoming the Knowledge and Attitude Gap | 17 |
DIAGNOSIS AND DIFFERENTIAL DIAGNOSIS | 23 |
Dual Primary Primary Psychiatric Disorder and Primary | 32 |
Chapter 3 | 39 |
Substance Abuse Settings | 48 |
Conclusion | 51 |
Modifications and Issues | 163 |
References | 169 |
The Halfway | 180 |
Adaptation of the DrugFree TC in the Hospital Setting | 189 |
Schizophrenia Substance Use Disorders and the Family | 202 |
Conclusion | 212 |
ADOLESCENT DUAL DIAGNOSIS | 215 |
Conclusion | 233 |
Chapter 4 | 57 |
Central Nervous System Depressants | 64 |
Psychotomimetic Drugs | 71 |
THE LONGTERM TREATMENT OF THE DUALLY DIAGNOSED | 77 |
Our Armamentarium | 87 |
Recommendations | 100 |
Overview of AA | 106 |
Emergence of New Groups to Meet the Needs of the Dual | 116 |
Twelve Steps and Specific Diagnosis | 123 |
COUNTERTRANSFERENCE AND ATTITUDES IN THE CONTEXT | 127 |
Conclusion | 143 |
Modified TCs for the Dually Disordered | 152 |
Chapter 12 | 239 |
References | 251 |
DEVELOPING DUAL DIAGNOSIS TREATMENT SERVICES | 253 |
Developing a Psychiatric Treatment Program for Dual Diagnosis | 260 |
Conclusion | 268 |
Evaluation | 282 |
RESEARCH ISSUES IN DUAL DIAGNOSIS | 287 |
Diagnostic Issues | 293 |
Treatment Issues | 299 |
305 | |
311 | |
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Dual Diagnosis: Evaluation, Treatment, Training, and Program Development Joel Solomon,Sheldon Zimberg,Edward Shollar No preview available - 2013 |
Common terms and phrases
abstinence activities acute addiction adolescent alcohol American anxiety approach assessment associated attitudes become begin behavior client clinical clinician cocaine comorbidity considered continued dependence depression described difficult discussed drug drug abuse dual diagnosis patients dually diagnosed effective effort evaluation example existing experience factors feelings functioning goals Hospital identified important increased indicated individual integrated involved issues Journal medication meetings mental health mental illness modified negative occur organization participants period person planning population positive possible present Press prevalence primary problems projective psychiatric disorder psychological psychopathology psychotherapy psychotic recovery relationship reported require response result role schizophrenia settings severe social specific staff step structure studies substance abuse substance use disorders suggests symptoms syndrome therapeutic therapist therapy tion treat treatment types withdrawal York