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Models of Treatment for
Co-Occurring Disorders
Dr. Dawn-Elise Snipes PhD, LMHC
Executive Director, AllCEUs.com
Learner Objectives
~ Identify the most common settings for co-occurring disorders treatment
~ Differentiate between the levels of treatment from intervention to residential level IV.
~ Identify specific characteristics of treatment in problem solving courts, jails

Settings
~ Health Departments and Social Services
~ Behavioral Healthcare Centers
~ Private Practice Offices
~ Hospitals
~ Schools
~ Jails

Prevention
~ Averting problems before they begin through modifying risk and protective factors in the following domains:
~ Individual
~ Family
~ School
~ Community
~ Examples
~ Educating children about drugs and their effects
~ Improving communication among families
~ Ensuring children are able to engage in school
~ Improving community stability, organization and attachment.
Intervention
~ Providing resources to prevent worsening of addiction or other biopsychosocial issues that could lead to addiction.
~ Methods
~ Psychoeducational groups and classes
~ Early identification of persons with risk factors for mental health, stress related or substance abuse issues
~ Frequency: Once per week
~ Setting:
~ School
~ Church
~ Community Center
~ Clinic
~ Home
~ Online/phone
Outpatient
~ Individual and group counseling sessions
~ Frequency: 1 to 3 times per week
~ Setting:
~ Clinic
~ School
~ Online/Telephone
~ Home
~ Issues
~ Coping skills
~ Maladaptive emotions/reactions; thoughts and/or behaviors
~ Relationship and interpersonal issues
~ Past traumas and losses

Intensive Outpatient
~ Individual and group counseling sessions
~ Frequency: 3 to 5 times per week for a minimum of 3 hours per day
~ Setting:
~ Clinic
~ Online
~ Issues
~ Coping skills
~ Maladaptive emotions/reactions; thoughts and/or behaviors
~ Relationship and interpersonal issues
~ Past traumas and losses
Partial Hospitalization
~ Individual and group counseling sessions
~ Frequency: Daily
~ Setting: Clinic (Patient sleeps off campus)
~ Issues
~ Coping skills
~ Maladaptive emotions/reactions; thoughts and/or behaviors
~ Relationship and interpersonal issues
~ Past traumas and losses

Short-Term Residential
~ Individual and group counseling sessions
~ Frequency: Daily for up to 60 days
~ Setting: Clinic (Patient sleeps on campus)
~ Issues
~ Coping skills
~ Maladaptive emotions/reactions; thoughts and/or behaviors
~ Relationship and interpersonal issues
~ Past traumas and losses

Long Term Residential
~ Individual and group counseling sessions
~ Frequency: Daily for up to 1 year
~ Setting: Clinic (Patient sleeps on campus)
~ Issues
~ Coping skills
~ Maladaptive emotions/reactions; thoughts and/or behaviors
~ Relationship and interpersonal issues
~ Past traumas and losses
~ Medication management
~ Establishment of wrap around services

Criminal Justice
~ Individual and group counseling sessions
~ Frequency: Daily
~ Setting
~ Jail
~ Intensive outpatient as with problem solving courts
~ Issues
~ Coping skills
~ Maladaptive emotions/reactions; thoughts and/or behaviors
~ Relationship and interpersonal issues
~ Past traumas and losses
~ Changing criminogenic thinking
~ Reintegration services
Case Management and linkages with wrap around services
Job and life skills

Problem Solving Courts
~ Created to assist consumers whose illegal behaviors are thought to be a result of an underlying substance abuse or mental health issue.
~ Involve
~ Weekly monitoring by the court
~ Daily contact with a counselor
~ Provision of sanctions based on noncompliance
~ Progression through phases based on demonstrated improvements in behaviors, reactions and relationships

Summary
~ Consumers should be placed in the least restrictive environment
~ There are benefits and drawbacks to all levels of care
~ Outpatient
~ Intensive outpatient
~ Short term residential
~ Long term residential
~ Problem solving courts have demonstrated much success