Concurrent Treatment of Severe Mental Illness and Active Substance Use

Although it is well recognized that many patients with severe mental disorders also abuse substances, there are ongoing debates about the proper way to address the issues that arise in these treatments. Some feel that the... [ view full abstract ]

Although it is well recognized that many patients with severe mental disorders also abuse substances, there are ongoing debates about the proper way to address the issues that arise in these treatments. Some feel that the treatments are best handled by experts in their respective areas with the possibility that two treatments can be conducted at the same time. Others feel that it is best to postpone the psychotherapeutic treatment until the substance use issues are resolved in substance use treatment. In either of these two approaches, the additional referrals needed may result in the patient being lost from the treatment system.  But, it is possible for the psychotherapist to successfully treat both problems together.

.In this workshop, we will explore the advantages and issues that arise when treating severe mental illness and substance use together in the same psychotherapy.  Four primary issues will be explored. 1.  Not all substance use may be revealed to the therapist, either at the outset or when it occurs during the course of the treatment. 2. Patient symptoms from substance use and severe mental disorder are often difficult to differentiate from one another. 3. Treatment may be stalled by patient reluctance to engage with the therapist around the issues of substance use or psychological difficulties. 4. The therapist may feel ill equipped to address substance use with a patient if the primary training is the treatment of severe mental disorders.

This workshop will systematically explore each of these clinical difficulties and provide examples of how they may be resolved to lead to a successful therapy. Participants are encouraged to bring clinical examples from their own practice to discuss.