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HFDD 002| Dual Diagnosis (Co-occurring Disorders)

Clinical Dilemmas in Assessment and Treatment

Workshop Overview

The addiction and mental health treatment fields have arisen from very different roots. This has accounted for the ongoing fragmentation that has been aggravated by different training, systems and funding. Clients and clinicians are separated by ideology and treatment orientations that do not serve well the co-occurring disorders client. This workshop will review the obstacles to integrated services and offer solutions to these cultural clashes.

Even though many are committed to best practices in integrated dual disorders treatment, it is difficult to actually change clinician attitudes and skills to provide truly integrated services. This workshop will address clinical dilemmas in treating clients with the dual problems of psychiatric and addiction illness: How to decide whether there is a substance-induced psychiatric disorder or an actual co-occurring mental and substance-related disorder? Is the substance use a result of a psychiatric disorder or an attempt to self-medicate a mental disorder? Are the mental health symptoms a result of substance use problems? Which is primary and which is secondary or doesn't it matter? Should there be a period of abstinence before a mental health evaluation or before medication is given? Or should medication be given regardless of a period of abstinence? 

Workshop Objectives

  • Identify the major ideological differences that divide addiction and mental health systems.
  • Discuss assessment strategies, techniques and priorities to determine treatment options and interventions.
  • Apply treatment and motivational strategies necessary to develop a treatment plan that meets the client's individual multidimensional needs and stage of change.
  • Identify staff, program and systems issues in providing less fragmented services for those with co-occurring mental and substance-related disorders.


New York State should pass legislation to raise the age of adult criminal responsibility from 16 to 18 so that youth who are charged with a crime are treated in more age appropriate manner.


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