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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

Module 1

Substance Abuse Treatment for Persons with Co-Occurring DisordersInservice Training

Based on A Treatment Improvement Protocol

TIP 42


What is a tip

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

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

Introduction—Module 1

The Evolving Field of

Co-Occurring Disorders


In this module

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

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

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

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

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

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

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 of COD among SMI and SA Adult Populations


Prevalence and other data

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 disorders1

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

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

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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