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Module 1 . Substance Abuse Treatment for Persons with Co-Occurring Disorders Inservice Training Based on A Treatment Improvement Protocol TIP 42. What is a TIP?. Best-practice guidelines for treatment of substance use disorders Developed by Center for Substance Abuse Treatment (CSAT)

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Module 1

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Module 1

Substance Abuse Treatment for Persons with Co-Occurring DisordersInservice Training

Based on A Treatment Improvement Protocol

TIP 42


What is a TIP?

  • Best-practice guidelines for treatment of substance use disorders

  • Developed by Center for Substance Abuse Treatment (CSAT)

  • Draws on experience and knowledge of clinical, research, and administrative experts in a particular topic area

  • Consensus Panel for TIP 42, page xi


ATTC Network 2001-2006

NorthwestFrontierATTC

Prairielands ATTC

ATTC ofNew England

NortheastATTC

Great LakesATTC

ATTC National Office

MountainWestATTC

Central East ATTC

Mid-AmericaATTC

Central EastATTC

Mid-Atlantic ATTC

PacificSouthwestATTC

Southeast ATTC

Gulf Coast ATTC

Southern CoastATTC

NorthwestFrontierATTC

Caribbean Basin, Hispanic/Latino & US Virgin Islands ATTC


Introduction—Module 1

The Evolving Field of

Co-Occurring Disorders


In This Module . . .

  • Overview of the evolving field of Co-Occurring Disorders

  • Understanding of the important developments that led to TIP 42

  • Initial exploration of TIP 42 and how it is organized.


TIP Exercise—Terms

  • Read the left column on Page 27

  • Discuss with your partner:

    • Which of these terms have you ever used or heard?

    • Which of these terms are used in your programs?

    • What advantages does the term “co-occurring disorders” have over “dual diagnosis” and “dual disorder”? Over the other terms?


Co-Occurring Disorders

Co-occurring disorders

  • Refers to co-occurring substance use (abuse or dependence) and mental disorders.

    Clients said to have co-occurring disorders have:

  • one or more disorders relating to the use of alcohol and/or other drugs of abuse and one or more mental disorders.

    Diagnosis of co-occurring disorders (COD) occurs when

  • at least one disorder of each type can be established independent of the other and is not simply a cluster of symptoms resulting from the one disorder.


Co-Occurring Disorders:Your setting

1.Do these definitions describe clients in your practice/program? (Estimate percentage or describe prevalence)

2.How has serving clients with COD affected your practice/program?

3.What challenges do clients with COD present to your clinical knowledge and skills?


Co-Occurring Disorders:Implications

  • Treatment

    • Prevalence of COD, multiple problems they create, impact on treatment and treatment outcome, new models/strategies are receiving attention and encouraging treatment innovation

  • Clinicians & Knowledge Dissemination

    • Knowledge of both mental health and substance abuse is essential and dissemination of knowledge has become widespread


Why a new TIP on Co-Occurring Disorders?

  • Availability of data

  • Treatment innovations for other populations with COD

  • Changes in treatment delivery

  • Advances in treatment

  • Recent developments


Prevalence of COD

  • In 2002, 4 million adults met the criteria for both serious mental illness (SMI) and substance dependence and abuse.

  • An estimated 10 million Americans of all ages and in both institutional and non-institutional settings have COD in any given year.


Prevalence of COD among SMI and SA Adult Populations


Prevalence and Other Data

Data now show:

  • COD are common in general adult population.

  • Increased prevalence of people with COD and programs for people with COD.

  • People with COD are more likely to be hospitalized and the rate may be increasing.

  • Rates of mental disorders increase as the number of substance use disorders increase.


Why a new TIP on Co-Occurring Disorders?

  • Availability of data

  • Treatment innovations for other populations with COD

  • Changes in treatment delivery

  • Advances in treatment

  • Recent developments


Advances in Treatment of COD

  • “No wrong door” policy

  • Mutual self-help for people with COD

  • Integrated care as a priority for people with severe and persistent mental illness

  • Development of effective approaches, models, and strategies

  • Pharmacological advances


Recent Developments

  • National Registry of Effective Programs and Practices (NREPP)

  • Co-Occurring Disorders State Incentive Grants (COSIG)

  • Co-Occurring Center for Excellence (COCE)

  • Report to Congress on the Prevention and Treatment of Co-Occurring Substance Use Disorders and Mental Disorders

  • Co-Occurring Disorders: Integrated Dual Disorders Treatment Implementation Resource Kit


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