Is It Mental Health or Addiction?
Is it Mental Health or Addiction?
Generally speaking, individuals who abuse drugs or alcohol will present with psychiatric symptoms also. These may include: sadness, irritability, mood swings, sudden or rapid shifts in personality, pressured speech, poor judgement, poor impulse control, difficulty reasoning, and sometimes difficulty with reality testing including hallucinations and delusions. Due to changes in personality functioning it is not uncommon to hear the term “borderline” used.
When investigating options for addiction treatment it is important to know what their licensed to treat. Some facilities are only licensed to treat Mental Health disorders while others are licensed to treat only addiction. There are also others that are licensed to treat both mental health and addiction also known as co-occurring disorders or dual-diagnosis. A treatment center can identify themselves as being “dual-diagnosis” by virtue of having a psychiatrist on-staff. It does not mean that they are the best option for particular needs.
Determining which came first (the addiction or mental health) disorder is very important in order to guide treatment. Not necessarily challenge whether a problem exists. If you are reading this article chances are a problem exists. Some mental health disorders require a higher level of care (i.e., acute inpatient) treatment in a locked facility that has 24-hour nursing staff, psychiatric technicians, social workers, psychiatrists and essentially what is called a “multi-disciplinary treatment team”. Addiction treatment centers also have “multi-disciplinary teams” but most are “free-standing” meaning they are not part of a hospital or medical facility. They may be licensed to offer detoxification services..Yet, not equipped to handle more serious cases of psychiatric illness. It is important to know what is giving the afflicted person the most trouble (addiction or mental health) concerns because a person with psychotic symptoms or hallucinations will have a very difficult time integrating with an addiction population that they are unable to connect with. For treatment to be effective there needs to be an establishment of trust, empathy, compassion, interpersonal connectedness, inter-dependence, and these are relational qualities that the afflicted individual needs to either possess already or be capable of developing as treatment progresses. When inquiring about a specific facility ask specifically whether they have a psychiatrist on staff. Is the psychiatrist certified by the American Society of Addiction Medicine? Is the psychiatrist Board Certified in General Psychiatry or simply Board Eligible? Some facilities because they deal with a forensic population meaning individuals with psychiatric conditions that are involved in the legal system. Sometimes they may need addiction services while undergoing assessment to determine whether their crime was committed as a result of substance use, abuse, or addiction. Then based upon the assessment it is determined whether the individual is competent to stand trial. The doctor will determine whether there are other factors that should be taken into consideration when sentencing an individual. This is a very specialized area.
Many addiction treatment programs offer “tracks” that are specific to certain issues that co-occur with the addiction such as: trauma, eating disorders, personality disorders to name a few. These tracks usually involve specialty groups aimed at controlling emotional intensity, regulating mood, mindfulness, stress reduction, harm reduction (not totally eliminating the behavior; but reducing its impact). When inquiring about these programs ask about the credentials of the therapists working with this patient population. Professionally and ethically a treatment program and/or “counselor, therapist, behavioral health tech” should not be offering clinical advice, guidance, direction, analysis, interpretation of issues that fall outside the realm of their own professional training. Because someone has training in a certain area, does not mean they are “competent” to treat a particular issue. Inquire whether the person treating you has access to “clinical supervision”. This will help you understand how strong of a clinical team there is at the facility. Professionals who practice in an ethical and professional manner are good at knowing their limits. They seek the input of their colleagues. Programs with specialty tracks usually have a primary therapist working in conjunction with a specialty therapist who has special expertise in other models of therapy commonly referred to as: Dialectic Behavioral Therapy, Somatic Experiencing, EMDR (Refer to Francine Shapiro) on Google to get specific information on EMDR. When working with an EMDR therapist inquire about where they received their training. You may want to know what level practitioner they are? Those who offer these services frequently belong to professional
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