The following protocol, TIP 48 Managing Depressive Symptoms in Substance Abuse Clients during Early Recovery, will be discussed in conjunct with class notes in order to discern ways to effectively work with clients with co-occurring disorders. Clinicians need to be able to assess accurately for mental health disorders, substance use, and readiness for change.
First, when working with a population with co-occurring disorders it is vital they are able to be accurately assessed quickly so they will be able to be placed into treatment which meets their needs as quickly as possible. Diagnosing clients with depression and substance abuse/dependence, needs to meet the criteria with the current DSM. Substance abuse and dependence in the DSM tends to be confusing due to the clinician making the diagnosis based out of their limited “snap shot” of information and context. The daunting task of assessing as accurately as possible is vital to address the placement criteria.
Working with those with co-occurring diagnosis may require the clinician to have specific training due to the nature of having varying complications. The training may require for those to have a multi-problem view point to cover the multidimensional problems which may or have occurred. Client’s with the diagnosis of depression and substance abuse/dependence need to have a treatment plan which is client-centered. “A client-centered treatment plan is based on a careful assessment inclusive of immediate needs, motivation for change, and readiness to change.” (p 23).
Creating the therapeutic alliance and sustaining it is vital for the client to be able to trust and rely on the clinician for help. “An early and strong therapeutic alliance is critical to successful treatment.” (p 24). Being vulnerable with another individual is difficult and scary, even more so when an individual has encountered shame due to their struggles. Even though using substances does not make sense to some people, it is important to understand that addiction is a genetic disposition. Knowing of the genetic disposition, the clinician is able to become more objective when working with those who struggle with addiction.
Even though it may be difficult to work with co-occurring disorders, it is important to treat substance abuse and depressive symptoms as a primary focus on an individual level. Not everyone who struggles with addiction and depression goes through the same struggles. The clinician needs to be careful not to assume they know the client’s experience due to observing or working with those in a similar situation. Being mindful to respect the client and their history will assist in understanding the client and their worldview.
When working with clients with depression and substance use, it is helpful to utilize active listening. Active listening entails listening attentively to the client’s statements and reflecting them in...