Best Practices

Excerpted from the Preface to Treating Concurrent Disorders: A Guide for Counsellors - Approaching Concurrent Disorders

In Best Practices: Concurrent Mental Health and Substance Use Disorders (Health Canada, 2002), experts review and comment on the existing scientific literature, and provide consensus where literature does not exist. The document provides opinions from stakeholders, including clients, and is a summation of what we know and don’t know, with a large nod to what we don’t know.

Constructing a best practice model is an ongoing task of bringing together evidence-based knowledge, and of creating protocols of care that we can justify on the basis of the research and what we know produces better outcomes. That task has begun, and in some areas, such as assessment and screening, there is strong evidence of the best approach. In other areas, however, we don’t yet have the knowledge to be able to say, “Here’s what you should do . . . .” We can talk about what we do; we have materials that we can share; but we can’t say they have been rigorously evaluated. This is not unlike many other domains of health care practice.

There is some crossover between our book and Health Canada’s Best Practices. Some chapters in this book are written by people who also contributed to that document. The goal here, however, is to offer more detailed and practical information, revealing how we work to provide specialized services to clients. Some of what we present here does not yet have a best practice literature to support it, but it is included to encourage dialogue and contribute to knowledge- and skill-building in these practice areas, where clinical services are needed, in spite of the lack of a strong scientific literature.

In the Preface: Approaching Concurrent Disorders:

Best Practices

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