Dual Diagnosis: Evaluation, Treatment, Training, and Program Development

Front Cover
Joel Solomon, Sheldon Zimberg, Edward Shollar
Springer Science & Business Media, Dec 31, 1993 - Medical - 322 pages
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.
 

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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
References
305
INDEX
311
Copyright

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