By Ann Webb
An integrated approach
Historically, mental health and substance abuse treatment have been seen as separate entities with different procedures, professional orientations and certifications. In recent years there has been a growing realization that co-occurring disorders are more the norm then the exception. The preferred treatment approach, based on both research findings and best practices, is to treat both at the same time in an integrated approach.
Approximately 16% of offenders are estimated to have a severe mental health and substance use disorder diagnosis. Individuals with untreated mental health conditions are often at higher risk for treatment failure and future recidivism. Effective treatment includes educating the participant on the importance of medication compliance in combination with recovery strategies, with the goal of empowering participants to recognize the importance of illness self-management and the role it plays in attaining an alcohol drug and crime-free lifestyle.
Motivational Interviewing-based therapy is a fundamental component of dual diagnosis treatment as it helps develop positive coping patterns and promotes cognitive and behavioral skills. Dual diagnosis treatment is most effective when viewed as a long-term process, with an ongoing community-based component.
Meeting the need
The KPEP Dual Diagnosis program is designed to meet the needs of these individuals. Those receiving dual diagnosis treatment must have evidence of a “severe and persistent” mental illness as determined by an evaluation by a psychiatrist or fully licensed psychologist. The evaluation includes a mental status exam, psychiatric/mental health history, current or past psychotropic medications and diagnosis on Axis I-V.
Severe and persistent mental illness includes schizophrenia, bipolar disorder, schizoaffective disorder, major depressive disorder, psychosis (other than schizophrenia), chronic brain disorder with significant functional impairment, post-traumatic stress disorder, and other conditions considered to be a severe disorder of thought or mood that significantly impairs judgment, behavior, capacity to recognize reality, or ability to cope with ordinary demands of life.
Participants are assessed by a trained treatment staff member for indications of a severe and persistent mental illness as well as a substance use disorder. The preliminary screening for a mental health disorder involves administration of the MCMI, a psychological assessment tool intended to provide information on personality traits and psychopathology, including specific psychiatric disorders outlined in the DSM. If the assessment reveals indications of a severe and persistent mental illness, the client is referred for an evaluation by a psychiatrist or fully licensed psychologist.
Utilizing the manualized and evidence-based curriculum entitled Hazelden Co-Occurring Disorder Program, the KPEP Dual Diagnosis program provides an environment for the client with co-occurring disorders that takes into consideration the needs and the limitations of functionality of the participant. Treatment activities are cognitive-behavioral and skill-based and progress at a slower pace with information provided gradually and with significant repetition.
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