Treating Concurrent Disorders: Preface

Treating Concurrent Disorders: A Guide for Counsellors

Preface - Approaching Concurrent Disorders

Jump to the Introduction of Treating Concurrent Disorders .

A single problem can be difficult enough to address, but when people have more than one, and perhaps many problems, even understanding how these problems relate to and affect each other can be a challenge.

Addiction and mental health workers know that many, if not most, of our clients have problems beyond those that brought them into treatment. Difficulties with interpersonal relationships, employment, finances, housing or the law often go hand-inhand with substance use and mental health problems. We also know that when people present with either a substance use or mental health problem, their risk of having both kinds of problem is increased. Studies show that about half of the people with either a mental health or substance use disorder have had problems in the other domain at some point in their life (Health Canada, 2002; Kessler et al., 1996; Regier et al., 1990).

When people with co-occurring substance use and mental health problems seek help, the treatment they receive is too often directed at only one of these problems. Helping clients to address one key problem can sometimes start a process of change that goes on to have far-reaching positive effects; other times this approach does little to improve clients’ overall situation, and may even make both problems worse. To understand how we can best help a client, we need to look at that person as a whole, and see how that person’s problems overlap, disguise or exaggerate one other. Only then we can begin to offer help that is effective.

Although many people have noted the interdependency of substance use and mental health problems over the years, the notion of integrating the treatment of these co-occurring problems is recent. Clients seeking help for these “concurrent disorders” have almost always had to go one place for mental health treatment and another for substance use treatment, often with little or no connection between the services. Only in the past 20 years have clinicians and researchers begun to develop and implement more comprehensive treatments for these clients.

Now that the need for integrated treatment for concurrent disorders is being more widely recognized, there is much to be done. Some clinical practices have been developed, and some of these practices have been supported by research, but much more needs to be discovered.

In this book, we draw on our understanding of existing research and “expert consensus” literature, and also on what we have learned through our work with clients here at the Centre for Addiction and Mental Health (CAMH). Our goal in sharing our understanding and experience is to allow others to take advantage of the gains that we have made, and to join us in pursuing further knowledge in this area.

If you work with clients who have substance use or mental health problems, you are undoubtedly already working with people who have concurrent disorders. If you are committed to understanding and working with clients as whole persons, then you need to understand what these problems are, how they co-occur and how you can help.

Leaving this work to specialists in concurrent disorders is not enough. People in all kinds of helping roles can provide support—people who work in the addiction and mental health systems, obviously, but also people working in other domains, such as criminal justice and corrections, health care, child welfare and family service, employee assistance programs and education.

With this book, our goal is to take information about concurrent disorders beyond academic and scientific discourse, and to make it accessible to a wider range of readers. We hope that counsellors across a diverse range of services will be better able to work with this client population, and that people with co-occurring substance use and mental health problems will get the comprehensive care they need.

Treating Concurrent Disorders: Preface

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