Dual Diagnosis: Evaluation, Treatment, Training, and Program Development

✍ Scribed by Sheldon Zimberg (auth.), Joel Solomon M.D., Sheldon Zimberg M.D., Edward Shollar Ph.D. (eds.)

• Publisher: Springer US
• Year: 1993
• Tongue: English
• Leaves: 333
• Edition: 1
• Category: Library

✦ Synopsis

Patients who have both a psychiatric disorder and a substance abuse problem cause most clinicians to throw up their hands in despair. The clinical problems that these "dual diagnosis" patients present are enor­ mously complex. Diagnostically, how is one to tell if disorders of mood and thinking, for instance, are signs of a mental illness or consequences of substance abuse? How is one to obtain important historic information when the patient may be unable or unwilling to provide it and there are no readily available collateral sources of information? In any case, why bother? Treatments for dually diagnosed patients are ineffective; patients won't stay in treatment; recidivism occurs at a very high rate. To make matters even more difficult, traditional health care reim­ bursement mechanisms do not provide for the multimodality clinical programs and special services needed by the patient who is both mentally ill and a substance abuser. So the clinician needs an effective bureaucratic strategy as well as a treatment strategy. For the most part, clinicians have handled the problem by ignoring it.

✦ Table of Contents

Front Matter....Pages i-xxiv
Front Matter....Pages 1-1
Introduction and General Concepts of Dual Diagnosis....Pages 3-21
Diagnosis and Differential Diagnosis of Psychiatric and Substance Use Disorders....Pages 23-37
Recognizing Dual Diagnosis Patients in Various Clinical Settings....Pages 39-53
Front Matter....Pages 55-55
Management of Acute Problems in the Dual Diagnosis Patient....Pages 57-76
The Long-Term Treatment of the Dually Diagnosed....Pages 77-104
The Role of Self-Help Groups in the Treatment of the Dual Diagnosis Patient....Pages 105-126
Countertransference and Attitudes in the Context of Clinical Work with Dually Diagnosed Patients....Pages 127-146
Modified Therapeutic Communities for Dual Disorders....Pages 147-170
Inpatient Treatment for the Dually Diagnosed....Pages 171-192
Special Considerations for Dually Diagnosed Schizophrenics and Their Families....Pages 193-214
Adolescent Dual Diagnosis....Pages 215-235
Front Matter....Pages 237-237
Program Development....Pages 239-251
Developing Dual Diagnosis Treatment Services within Existing Outpatient Psychiatric and Addictive Disorder Programs....Pages 253-270
Dual Diagnosis Training....Pages 271-285
Research Issues in Dual Diagnosis....Pages 287-309
Back Matter....Pages 311-322

✦ Subjects

Psychiatry; Public Health; Epidemiology