COSIG CONFERENCE BROCHURE.pdf - Drexel University College ...

COSIG Co-Occurring Disorders Conference, Hershey PA, May 15-17, 2006
Why Focus on Co-Occurring Disorders -Cont.
• A CMHS (2001)national health services study indicated
that 43% of adolescents receiving mental health services
had been diagnosed with a co-occurring SUD.
• SAMSHA 1994-96 National Household Survey found
13% of adolescents with significant emotional and
behavior problems reported alcohol and drug
dependence.
• SAMSHA/CSAT 1997-2002 study found 62% of
adolescent males and 82% of adolescent females
entering SUD treatment had a significant co-occurring
emotional/psychiatric disorder.
Comorbidity is the Norm
• Estimates suggest that >75% have a psychiatric disorder
• Behavioral disorders e.g., Conduct Disorder (CD) = most common (50-
80%)
– negatively correlated with treatment success
• Mood Disorders, esp. Depression= prevalent (24-50%)
• Anxiety Disorders (7-40%)
• High rates of exposure to childhood abuse and other potentially
traumatic events is correlated with substance use
• Many have multiple disorders
– Depression, substance use and conduct disorders
• Acute and chronic effects of psychoactive substances can exacerbate
preexisting psychopathology
Psychiatric Symptom Severity, Youths in
Residential Drug Treatment in New Jersey
60
50
40
30
20
10
0
35
12.2 15.6 33.7 30.9
22.7
33
15.4
28
51
13.3
24.3
Depression Anxiety ADD/ADHD Conduct
Disorder
Acute High Clinical
Source: Hawke, Survey of Adolescent Drug Treatment Programs in New Jersey, 2002
What does Integration mean?
(Drake R., 2001)
• Cross-trained multi-disciplinary staff
• Integrated assessment, treatment planning and
case management
• Coordination with outside caregivers, residential
settings and families
• Continuing psychopharmacologic monitoring
• Utilization of peer recovery supports
• Dual recovery philosophy
Some Basic Assumptions
(Adapted from Minkoff, 2000)
• Heterogeneous population
• Application of Developmental Biopsychosocial
framework
• Complex assessment occurs over time and
begins with need to engagement as many as
possible
• Frequent occurrence of multiple problems and
mental and physical disorders
• Effective interventions and treatment programs
are flexible and occur in stages
Additional Assumptions
• The adolescent sitting before you has a history
before the onset of their presenting symptoms.
• The adolescent’s early developmental history
holds essential information regarding resiliencies
& islands of competencies as well areas of
challenge, deficit and risk potential
G. Benson - 2005
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