Dual diagnosis refers to co-existing problems of substance abuse and mental illness. According to Rebecca Woolis, author of "When Someone You Love Has a Mental Illness," for most clients with severe psychiatric disabilities, any use of street drugs, alcohol, or prescription medication other than as prescribed constitutes abuse. The group process is one type of treatment for this population.
Potential Members
According to the National Alliance on Mental Illness, or NAMI, of those diagnosed with severe mental disorders, approximately half also have a substance abuse problem. Symptoms, such as depression, psychosis, mania and anxiety, may increase with active chemical dependency or withdrawal.
Features
In dual diagnosis group treatment, members of the group share similar experiences. Clients relate and bond to each other through common histories, concerns and goals. In this setting, both hope and relapse are reminders of the need for recovery. The work done in groups can provide both subjective and objective education.
Types
An intervention is a one-time group process brought about by family and friends to get the person with dual diagnosis to accept help. It can be powerful to have those who care strongly expressing concern, aided by a trained facilitator. Intervention can work for those with stable psychiatric disorders dealing with relapse in addictions. Group intervention would not be appropriate for those with psychosis or paranoid delusions.
Twelve-step based dual diagnosis self-help groups focus on abstinence from substance abuse while affirming the need to take psychiatric medications. This contrasts with other meetings where dual diagnosis clients may look for excuses to stop taking necessary drugs.
Inpatient or outpatient groups with mental health facilitators can help staff assess which clients are in trouble and need extra help. Group members may come to depend on one another to process stressors in their lives that might otherwise lead to unhealthy coping mechanisms.
There are also a growing number of self-help groups organized and run by clients and former patients. These may meet weekly or monthly to provide comfort and connections not found anywhere else.
Benefits
People who have a co-occurring disorders are often able to learn and accept things from peers that health professionals and families have not been able to convey, according to NAMI. Group members learn how to make friends, get along with family, deal with symptoms, and accept limitations. Groups strengthen positive, consistent relationships.
Considerations
Harm reduction is an approach providers may use for clients who deny they need help, reports Woolis. Rather than trying to convince the person to admit addictions, harm reduction seeks to assist the client in living as well as possible while minimizing dangers. Abstinence is not considered a short-term goal. Attendance at a dual diagnosis group within a mental health setting fosters connections and builds trust so that progress, however slow, can be made.
References
- "When Someone You Love Has a Mental Illness;" Rebeca Woolis, MFT; 2003
- NAMI: Dual diagnosis and integrated treatment
- SAMHSA: Co-occuring disorders
