December 2005
What is integrated treatment, and what makes it effective in treating youth with co-occurring disorders?
Integrated treatment is a collaborative approach to providing treatment for co-occurring disorders. One clinician or treatment team provides both mental health and substance abuse treatment services, with each applied at appropriate times and situations according to the client’s needs. The ideal provider team consists of individuals from varied clinical backgrounds who have been cross-trained to work together.
Co-occurring disorders are inherently complex, and clients require multiple services across several systems. For this reason, integrated treatment programs are specially designed to take into account the full range of each client’s symptoms and needs. Treatment must also take into account the client’s age, culture, level of severity, and stage of recovery. Treatment plans are customized to individual clients, utilizing the strategies from mental health and substance abuse treatment fields that are most appropriate for each client’s unique situation.
Adolescents with co-occurring disorders must receive services that are appropriate to their developmental stage. In addition, because mental illness and substance-related disorders often disrupt normal adolescent social and emotional development, treatment should include support in developing needed skills and functions. Youth are involved in many different environments (e.g. school, juvenile justice, family, sports, youth activities), and these various roles must also be accounted for during treatment. Evidence also suggests that youth benefit from being included in designing and evaluating their own treatment (Federation of Families, 2000).
A therapeutic relationship between the client and the provider(s) is important for effective treatment of all individuals with co-occurring disorders, but may be particularly crucial in treating adolescents. An effective therapeutic alliance requires the provider to act with empathy and be supportive of the client’s ability to make decisions regarding his or her own change. Adolescents may benefit from this type of client-provider relationship, as they are in a stage of development characterized both by insecurity and a desire to make their own decisions.
Integrated treatment has succeeded in treating adolescents with co-occurring disorder. In fact, the Substance Abuse and Mental Health Services Administration (SAMHSA) regards integrated treatment as an evidence-based practice for treating co-occurring disorders in adults, adolescents, and children (Substance Abuse and Mental Health Services Administration, 2002).
References:
Federation of Families for Children's Mental Health & Keys for Networking, Inc. (2000). Blamed and Ashamed:t he treatment experience of youth with co-occurring substance abuse and mental health disorders and their families. Alexandria, VA: FFCMH.
Substance Abuse and Mental Health Services Administration. (2002) Report to Congress on the Prevention and Treatment of Co-occurring Substance Abuse Disorders and Mental Disorders. Rockville, MD: Substance Abuse and Mental Health Services Administration. http://alt.samhsa.gov/reports/congress2002/index.html