Complex Issues Require Complex Treatment

I was recently giving a talk about identifying eating disorders in chemically dependent clients and received feedback from members of the audience that made a lot of sense. One woman mentioned she had been in inpatient treatment for alcoholism but remained active in her eating disorder, binging and purging the entire time she was in treatment. She underplayed her eating disorder and her counselors didn’t tackle the problem, as a matter of fact, she felt they avoided it. She quickly relapsed.

She entered another treatment center and the clinical team realized they had to treat both the eating disorder and her substance abuse issues concurrently. Fortunately for her, the team was well trained and developed a complex, individualized treatment plan. She said they were tenacious as far the eating disorder was concerned and she did the work she needed to do. She has been in recovery ever since.

So how do we treat clients who are diagnosed with more than one disorder? For example, someone who is diagnosed as chemically dependent, depressed, a gambling addict and is struggling with significant trauma? Where do you, as a clinician begin after detox? What do you tackle first?

It takes a highly skilled team to work with these issues as a whole and not place clients in “tracks”. I have seen the “non track” approach work very well at several facilities due to the fact that they developed integrated individualized treatment conducted by experienced clinicians.

So many treatment centers claim to work with “dual diagnosis”, but often, their programs do little to address all of their client’s issues or their clinicians are not trained in specific therapeutic modalities that are required for complex clients. If centers claim to treat dual diagnosis, I believe their program schedule and clinicians should reflect a high level of clinical sophistication.

It’s important treatment management understand the need to provide training for clinicians in order to offer a high standard of care. It’s also crucial for Clinical Directors to construct a program that is updated on regular basis, in order to best serve their client population.