Co-Occurring Disorders: A Guide for Service Providers

SAMHSA recently published Treatment Improvement Protocol 42 (TIP 42), Substance Abuse Treatment for Persons With Co-Occurring Disorders, to help addiction counselors and other practitioners treat clients with co-occurring substance abuse and mental disorders.

Often, clients are treated for only one or the other problem in either a substance abuse or mental disorder treatment setting, whereas the use of an integrated approach enhances treatment outcomes. To this end, TIP 42 describes a variety of practical, evidence- and consensus-based approaches that can be used in either setting.

TIP 42 cites data from research over the last decade showing that co-occurring disorders are common, create multiple problems, and have a profound impact on treatment processes and outcomes.

Created by a panel of experts and reviewed by the field, TIP 42 is designed primarily for service providers who treat clients on a regular basis, but also is useful for administrators, primary care providers, criminal justice staff, and other health care and social service personnel who encounter people with co-occurring disorders.

The TIP contains nine chapters and 14 appendices and includes case studies as examples for counselors.

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Highlights

Early chapters cover the treatment of co-occurring disorders as an evolving field, the important developments leading to the creation of TIP 42, the publication’s scope and intended audience, and the criteria used to select the strategies, techniques, and models that are described in subsequent sections.

• Definitions and terms defines, describes, and reviews terms and classification systems for co-occurring disorders as they relate to substance abuse, mental disorders, clients, treatment, programs, and treatment systems.

• Workforce development addresses critical issues in workforce development, including values, competencies, education, and training.

• Assessment includes a review of key principles, highlights of the selected instruments, and a description of the 12 steps in an “ideal” assessment process. TIP 42 encourages counselors to collect patient information on a continuous basis and to revise assessments often as the patient moves through recovery.

• Treatment approaches provides counselors with principles, strategies, and models for treating clients with co-occurring disorders wherever they come for treatment—including facilities for treatment of substance abuse or mental health, or medical offices.

• Traditional settings and models describes practices that have proven effective for treatment of persons with co-occurring disorders in residential and outpatient settings. Several distinctive models are highlighted.

• Special settings and specific populations explores the particular needs of people with co-occurring disorders within three key “special” populations: homeless persons, criminal justice populations, and women. Recommendations cover the means and methods of providing treatment to clients with co-occurring disorders in acute care and other medical settings, and the ways such programs can be sustained. Emerging “dual recovery mutual self-help” programs are also described.

• Mental disorders contains key information about substance abuse and particular mental disorders, highlighting advice to help counselors work effectively with clients who have co-occurring disorders.

To obtain TIP 42, Substance Abuse Treatment for Persons With Co-Occurring Disorders, contact SAMHSA’s National Clearinghouse for Alcohol and Drug Information (NCADI) at P.O. Box 2345, Rockville, MD 20847-2345. Telephone: 1 (800) 729-6686 (English and Spanish) or 1 (800) 487-4889 (TDD). Ask for NCADI No. BKD515.

For more information, visit SAMHSA’s Co-Occurring Center for Excellence at www.coce.samhsa.gov. 

To Find TIPs Online For information and online links to other Treatment Improvement Protocol (TIP) publications, visit www.kap.samhsa.gov/products/manuals/tips/ numerical.htm. You can review the entire TIP series by topic or by number.

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