Chapter 8 Article Summary

Mental Health and Substance Abuse: Dual-Diagnoses

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Many problems arise from the complex issue of a dual-diagnosis. This is simply because there is much research that needs to be done in order to better understand the treatment options for these complex cases. An article written by Martin Smith addressed these issues, as well as the many complexities associated with dual-diagnoses.

The work of Smith whole-heartedly agreed with that of Van Wormer and Davis (2008). According to Smith, it is especially difficult to treat adolescents who have a dual diagnosis of mental health problems as well as substance misuse problems (2013). Treating adolescents with these complex issues is even more difficult than treating adults with these complex issues (Smith, 2013). This is because adolescents are already going through a period of many changes that can become very confusing (Smith, 2013). Therefore, they are more likely to turn to substance misuse as a coping mechanism (Smith, 2013).

Since these individuals struggle with addiction at such a young age, it is possible for this addiction to actually re-wire their brains (Smith, 2013). According to Smith, this vulnerability due to age may actually increase the likelihood of these adolescents becoming prone to diseased states, either mental or physical (2013). This is where the dual-diagnosis begins (Smith, 2013).

This brain change may also stunt the adolescent’s emotional growth (Smith, 2013). Therefore, the mental illness will feed off of that. According to Smith, these negative consequences on the brain and memory due to drug use go widely unconsidered among professionals in the field (Smith, 2013). This is why many treatments for individuals suffering from a dual-diagnosis are ineffective.

However, there are a few treatments which seem to work if used properly. The key to their success is the initial engagement of the adolescents (Smith, 2013). The methods that seem to be effective are motivational interviewing and coaching techniques structured by the “cycle of change (Smith, 2013).” Both techniques require a trusting therapeutic alliance between the client and the therapist (Smith, 2013). It is also important that the developmental phases of adolescents is taken into account (Smith, 2013).

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It is sad to me that young individuals have relatively little options when it comes to receiving treatment for a dual-diagnosis of addiction and mental illness. I understand why it is such a difficult problem to treat, but it is unfortunate that they must continue to suffer.

I feel as though it does not really matter which illness is causing which. Addiction should always be the illness that is treated first. Addiction in itself is not a healthy thing, and certainly does not help a mental illness. Therefore, if the client receives treatment for their addiction first, it will become much easier to identify and treat the mental illness.

References

Smith, M. (2013). Care of adolescents who have mental health and substance misuse problems. Mental Health Practice, 16(5), 32-36.

Van Wormer, K. & Davis, D. R. (2008). Addiction treatment: A strengths perspective. California: Brooks/Cole