What Some Rehabs Often Miss: Four Keys to Treating Co-Occurring Disorders

By Johnny Patout 06/03/14

Recovering addicts still affected by their mental health disorder will often return to their addiction at some point.


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Approximately 8.9 million adults who abuse drugs also have a mental health disorder, according to the Substance Abuse and Mental Health Services Administration. However, only 7.4 percent of these individuals receive treatment for both issues. This disparity leaves many addicts struggling to recover even after going to drug rehab.

The assumption is that a drug rehab center will fix all problems. However, abuse is a complex issue with many moving parts. As a patient shows recovery in one area, he or she can still struggle in other areas. These struggles may create a path to relapse.

A holistic, integrated approach is required to treating the whole patient. With this in mind, there are four key factors in treating a patient with both a mental health disorder and a substance abuse disorder.

1. Integrate treatment.

Failing to see the addict as anything more than his or her addiction is a huge problem. Many treatment centers, unfortunately, only focus on the drug abuse. If they can help the patient stay clean for a certain period of time, they consider it a success. For patients with co-existing mental health disorders such as depression, ADHD or bipolar disorder, this kind of faulty treatment will not work.

Recovering addicts still affected by their mental health disorder will often return to their addiction at some point. It is crucial that the treatment center provide aid for all co-occurring disorders. This is the only way to ensure an addict reaches and maintains recovery. Coping with bipolar disorder strengthens his or her ability to cope with addiction and vice versa.

2. Treat trauma.

Mental health disorders and traumatic experiences often walk hand in hand. Childhood trauma has long been known to raise a child’s odds of developing depression and addiction later in life. However, many addiction professionals continue to believe that addicts need to go through a period of abstinence from any substances before they are ready to address their traumatic past experiences. In reality, this is counterintuitive.

Without first confronting their mental health issues and past experiences, most addicts will not be able to recover. Working through such issues early and often in treatment will help set the stage for a smoother recovery process down the road.

3. Focus on the group.

Group therapy has proven to be one of the most important factors in treating patients with co-occurring disorders. Those who suffer from mental health disorders often do so in isolation and fear. Providing a safe, comfortable environment in which addicts can explore their issues with peers is important for recovery. In the group setting, they build the trust and self-confidence necessary to move forward with additional treatment.

Instilling the importance of group therapy while in rehab can increase patients’ chances of maintaining aftercare group therapy once they leave the center. A 2011 study found that those who do not participate in aftercare are ten times more likely to return to seriously harmful behavior within one year. The group therapy model is vital when dealing with complicated, co-occurring disorders.

4. Monitor medications.

Taking the proper medication can be a challenge for any individual suffering from a mental health disorder. Add a substance abuse disorder to the mix and it can be a recipe for disaster. Treatment centers have the unique ability to help these individuals by integrating their medication therapy plans. They can ensure the patients adhere to the recommended dosages.

Doctors and counselors work together to ensure the patient is getting the correct medication. Closely monitoring their medications in conjunction with non-pharmacological therapy can make the process more comfortable for the recovering addict.

A treatment center cannot “fix” any issues that the patient isn’t willing to personally confront. If the patient is willing, then the treatment has a chance. And when a center is able to take an integrated approach towards co-occurring disorders, the patient is in good hands.

Johnny Patout is the CEO of an adolescent treatment center.

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Johnny Patout is the chief operating officer of Seaside Healthcare, responsible for the psychiatric and substance abuse programs. Before joining Seaside, Mr. Patout was president of Psych Management Partners LLC in Lafayette, Louisiana, a provider of management and consulting services for psychiatric and substance abuse programs. A graduate of the University of Southwestern Louisiana, he holds a master’s degree in social work from Louisiana State University. In 2014, Mr. Patout was awarded Behavioral Healthcare magazine’s Champions Award for his leadership and contribution to the behavioral healthcare industry over the past three decades.