5 keys to improve counseling for dual-diagnosis patients
An empathic approach can be effective when treating psychiatric patients with substance use disorders
ADJUNCTIVE TREATMENTS
Self-help groups. Ask whether the patient has attended self-help groups for addiction or psychiatric illness. If so, then ask, “What did you think of the meetings? What did you like and dislike?”
Self-help groups such as Alcoholics Anonymous (AA) or the Manic-Depressive and Depressive Association (MDDA) can help enormously in the recovery process. These groups are free, readily available, and can offer patients a support network. Although many dual-diagnosis patients are reluctant to attend self-help groups, they may benefit from the support, role modeling, practical advice, and structure that these meetings offer.
Drug therapy for the dual-diagnosis patient focuses on the psychiatric disorder and is usually combined with psychosocial approaches. There is little evidence that one medication is more effective than others for these patients.
Because medication compliance is key to their effective treatment, be sure to ask patients at each visit, “Have you been taking your medication as prescribed?” Because dual-diagnosis patients have been shown to take more or less medication than prescribed,15 asking how much medication they are taking can be revealing.
Related resources
- American Academy of Addiction Psychiatry www.aaap.org
- National Institute on Drug Abuse www.nida.nih.gov
- National Institute on Alcohol Abuse and Alcoholism www.niaaa.nih.gov
Disclosure
Dr. Manwani receives research support from Abbott Laboratories.
Dr. Weiss is a speaker for Abbott Laboratories and Eli Lilly and Co.
Acknowledgment
Supported by grants K0200326, DA09400, and DA15968 from the National Institute on Drug Abuse and a grant from the Dr. Ralph and Marian C. Falk Medical Research Trust.
