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By Rebecca A. Clay
Presenters at a panel on a variety of practices discussed results of their recent
work in the field. From linking falls and depression among older persons to the use
of 12-step approaches with persons with co-occurring disorders, panelists offered the
following challenges and solutions:
Challenge: Substance abuse treatment providers wanted to offer gender-sensitive
treatment to women with a history of sexual abuse; however, providers felt unqualified
to handle discussions of these traumas.
Solution: With funding from SAMHSA's Center for Substance Abuse Treatment,
Deborah Rugs, Ph.D., an associate in research at the University of South Florida’s
Louis de la Parte Florida Mental Health Institute, and colleagues Holly Hills, Ph.D.,
and Roger Peters, Ph.D., identified an a protocol—"Seeking Safety"—and
tested two ways of persuading treatment providers to use it.
One group had a single workshop about how to use the manual; the other identified
"opinion leaders" who would receive intensive training and then train counselors
in turn. Intensive training paid off, with the second group more than twice as likely
as the first group to use the protocol.
Challenge: Visiting nurses noticed that depression and accidental
falls seemed to go hand-in-hand for their older clients.
Solution: To find out, Thomas Sheeran, Ph.D., M.E., a research fellow
in the department of geriatric psychiatry at Weill Medical College of Cornell University
and his team compared older persons who were "fallers" to "non-fallers."
Researchers discovered that depressive symptoms were associated with a nearly three-fold
increase in relative risk of falls, even after control groups were created for certain
medical problems. As a result, the agency plans to institute a protocol for prevention
of falls.
Challenge: Researchers confirmed that the 12-step approach treats
alcoholism and substance abuse effectively. Does it also work for individuals who have
co-occurring mental disorders?
Solution: To find out, Michael P. Bogenschutz, M.D., an associate
professor of psychiatry at the University of New Mexico Health Sciences Center and
his team conducted a literature review. Although researchers did not find sufficient
data to answer the question definitively, they did find evidence suggesting that 12-step
programs—particularly those specially designed for the dually diagnosed, may
help participants recover from both conditions. 
« See Also—Previous
Article
« See Part 1: Complexities
of Co-Occurring Conditions Conference: Experts Identify Problems, Examine Solutions
« See Part 2: Complexities
of Co-Occurring Conditions Conference: Experts Identify Problems, Examine Solutions
« See Part 3: Complexities
of Co-Occurring Conditions Conference: Experts Identify Problems, Examine Solutions
See Also—Conference Panels:
« See Conference Panel:
Improving Outcomes
« See Conference Panel:
Housing and Treatment
Depression and Illness: Coordinating Care »
See Also—Complexities of Co-Occurring Conditions Conference:
4 Million Have Co-Occurring Serious Mental
Illness, Substance Abuse »
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