The term “integrated treatment” refers to a service provider who provides both mental health and substance abuse services at the same time. Trauma can occur after a person experiences an event or series of event that can hurt them emotionally or physically. This takes a toll on a person’s mental, emotional and physical health. There are various types of trauma.
The Most Common Ones Are:
- Rape
- Domestic violence
- Physical assault
- Parental neglect
- Bullying or ongoing harassment
- Emotional or verbal abuse
- Terminal illness
- Accidents
Providing integrated treatment for people who have been victims of mental disorders is crucial to their recovery. They include depression, anxiety disorders, drug abuse and alcoholism, posttraumatic stress disorders (PTSD), borderline personality disorders, eating disorders, self-injury and even suicide. Depression can occur when a person is experiencing feelings of loss, anger, sadness that affects their day to day activities. However, feeling sad or down is a normal part of life. But when it becomes something an individual experiences daily, it is known as depression. When depression is not recognized, it will worsen even after its treatment with integrated treatment is started.
A person becomes addicted when they can not stop taking drugs that harm their bodies or fail to get an integrated treatment that can help. A person can be addicted to drugs, alcohol and other dangerous substances.
An integrated treatment program for addiction, depression and traumatic abuse has a dangerous connection. The connection between these disorders is that trauma can create various long term mental health issues. These issues may lead many individuals to self-medicate, excessive drinking or drug abuse. There is a high probability that addiction results from past traumas, whether the individual is aware of this or not integrated treatment for addiction.
Here Are a Few Connections that Show the Importance of Connecting Trauma and Drug/substance Abuse Treatment:
- Traumatic Induced Addiction Starts at a Young Age: Various studies have shown a connection between trauma and drug/substance abuse in young people. Researchers found that children who experience trauma are five times more likely to consider alcoholism-integrated treatment. Another research showed that young people who have been abused at least three times are more likely to turn to drug/substance abuse than those with no past trauma. This connection is relatively straightforward. Experiencing stress, abuse, shock, or injury at a young age can contribute to mental health problems that need integrated treatment.
- One Key in Making the Connection Between Trauma and Drug/substance Abuse Is Self Medication: Self-medicating either with drugs or alcohol is the first step to drug/substance abuse. While drug/substance abuse is the step before Addiction. Some individuals who have experienced trauma believe that self-medication with drugs or alcohol helps manage traumatic abuse stress. This simply means people turn to these substances to deal with trauma’s mental, emotional and physical impact. The idea is that taking these substances help to numb the pain or feelings.
- The Connection Between Traumatic Abuse and Addiction Goes Both Ways: As stated, earlier traumatic abuse creates an environment where Addiction occurs. It is also vital to know that drug/substance abuse can also lead to secondary trauma. Trauma increases the risk of drug/substance abuse, which increases the risk of concussion-integrated treatment for those who abuse drugs/substances. Alcohol or drug abuse tends to impair a person’s body function and brain. This ensures that individuals who are already addicted to drugs or alcohol find it difficult to deal with traumatic abuse.
- Most People Do Not Realize the Need to Account for Traumatic Abuse and Addiction Treatment: Many individuals suffering from Addiction are unaware of the reason behind their Addiction. Individuals are most likely to continue in the path of Addiction if they did not recognize past traumatic abuse. This creates a cycle of trauma and Addiction until the individual receives trauma integrated addiction treatment.
Trauma Integrated Addiction Treatment
Although research and documentation on integrated approaches are still at their initial stages, it is preferred as a mode of treatment for individuals experiencing these disorders. Integrated treatments are increasingly recognized over the sequential and parallel models. This sequential model of treatment dominated the clinical field for an extended period.
A common misconception is that if trauma is simultaneously treated with addiction, it will complicate and aggravate symptoms of integrated treatment. This particular model came with a lot of problems. For example, a focus on drug/substance abuse without paying attention to the cause of the trauma can lead to a regeneration of the situation in the nearest future. Another issue was that the aggressive approach typically used could escalate posttraumatic stress disorders (PTSD) and anxiety disorders.
Thereby, researchers are continuously attempting to understand how integrated treatment helps individuals achieve their goals. According to a recent study, The Foundations Associates, based in Nashville, Tennessee, is in the process of completing a three-year SAMHSA CSAT funded grant through the Department of Mental Health and Developmental Disabilities. In this project, the goal was to define and evaluate a new integrated treatment continuum’s efficacy and identify the specific techniques specific to this integration since the preliminary results of the integrated treatment look promising.
This article would show the project’s effort and effectiveness. Moreover, it aims to point out parallels in key program elements as they compare to a few principles described by Minkoff1 as a necessity in an integrated model of treatment:
- Co-Occurring Disorder/disease is an Expectation, Not an Exception: The project experienced few difficulties engaging participants throughout its duration. It was hard to reach the population because they were open-minded to community-based and integrated treatment programs. The Consumer base has primarily consisted of high severity substance/SPMI population. Before being admitted to integrated treatment, most participants had various psychiatric and psychological episodes. These participants admitted, regularly failed single system treatment experiences. Integrated treatment that combined aggressive psychopharmacologic treatment, behavioral health counselling and 12-step Dual Recovery Anonymous (DRA) tenets were expected to be successful.
- A Successful Treatment Requires Welcoming, Hopeful and Empathetic Continuous Treatment Relationships. This Helps to Sustain Coordination and Integrated Treatment Throughout Various Treatment Programs In this program, each intervention is emphasized using a staff client relationship and working in a conducive environment as part of integrated treatment. Motivational enhancement concepts are remodeled as the core for philosophy treatment throughout all activities. To provide dual recovery integrated treatment to an individual, the person must be willing to make changes. When a patient relapses, it is seen as a characteristic of the pathology condition. Whenever this occurs, the patients/clients are aggressively directed to resume the treatment. During therapy and support group sessions integrated into treatment, these episodes help consumers identify triggers and signs of decompensation and relapse.
- Case Management and Care-Taking Must be Balanced with Empathetic Detachment and Confrontation Within the Context of the Continuous Integrated Treatment Relationship. Following the Level of Functioning, Disability, and Capacity for An Individual’s Treatment Adherence Early identification showed that giving treatment according to the individual’s pace was efficient. The technique was also adjusted to match withdrawal, changing symptoms and level of cravings. Individual education sessions and group therapy sessions were often integrated treatment. This helped to address the confluence of disorders throughout a person’s stay. Team members engaged in weekly treatment meetings. As a result, interventions were refocused according to the needs and progress of consumers undergoing integrated treatment. Immediate changes in the relationship structure were made. These changes were based upon withdrawal management, improvement in the program and symptoms. There are earned system of privileges after completion of treatment goals. As the caretaker, a consumer’s responsibilities and the case manager shift for integrated treatment, based on their need. All relapses and infractions are addressed accordingly. Motivational techniques are used to summon a client’s insight into these experiences.
- When Substance and Mental Illness Disorder Co-Exist, Both Conditions Should be Considered Primary, and there is a Requirement for Immediate Integrated Dual Treatment The following are viewed as essential co-primary treatment; Aggressive psychopharmacologic monitoring and therapy applied in conjunction with recovery principles such as structured housing, DRA and sober. Program length needs to be extended based on the severity of the integrated treatment population. The size of an individual’s stay is evaluated based on their progress in the program. The measures and stability levels of individuals are considered before they are moved to less restrictive care integrated treatments. Medications are monitored closely even when consumers are transferred to a lower level of care. In the case of decompensation or relapse, interventions are swiftly rallied. In addition to relapse evaluation committees, treatment contracts can be modified. Intensive psychiatric evaluations can be conducted, or combined integrated treatments can be used. Attendant monitoring of the other globe is increased accordingly when decompensation in one sphere occurs. The aim was to recruit staff that are trained in integrated theories. However, bias develops within skills sets naturally throughout licensing bodies and single system curricula integrated treatment. Hence workshops, conferences and staff training are accentuated. Also, staff members rotate weekly presentations on contemporary approaches to integrated care. An integrated treatment program for dual diagnosis patients involves a library serving as a national repository.
- Psychiatric Illnesses and Substance Dependence are Examples of Chronic, Biological, Chronic Mental Health Diseases. A Disease and Recovery Model is Used to Understand them. Parallel Recovery Phases can Characterize These Disorders. These Phases Include Active Treatment, Acute Stabilization, Prolonged Stabilization and More: A hallmark of this principle is psychoeducation. Educating patients about disease models, treatment strategies, management, and self-monitoring and showing the interconnectedness of conditions, leads to a more hopeful outlook for integrated treatment. This element of hope facilitates movement through stages of change in recovery. This psychoeducation can occur through house meetings, residential therapy programs, the NAMI model, Bridges, family education programs and structured group programs. Integrated treatment programs such as these have consumer-led education groups that meet in-house for integrated treatment. All these psychoeducation groups mentioned above help integrate parallels as a central theme in dual recovery, emphasizing the methodologies for maximizing the quality of the victim’s life.
- There is No Absolute Correct Dual Diagnosis Intervention. Interventions Must be Individualized According to Appropriate Practice Guidelines, Following the Subtype of the Particular Dual Disorder, Specific Diagnosis and Phase of Treatment/recovery, and Functional Capability or Disability Levels. Assessing major life domains and service needs integrated treatment requires measuring and assessing various measures. An individual’s readiness for services is evaluated using various objective indicators, and the outcome domains of integrated treatment are assessed using multiple sources of information. The rulings of the American Society of Addiction Medicine Patient Placement Criteria for the Treatment of Substance-Related Disorders (ASAM PPC-IIR) are integrated with the processes that assist in bench-marking the levels of treatment per the patient’s needs. Therefore, 90% of the population treated at Foundation Associates utilizes the excess 70% of healthcare resources. The occurrence of co-occurrences reinforces the client-tailored treatment approach, which offers multiple approaches to integrated treatment. However, while early phases are aimed at stability, medium phases are more about defining personal goals and plans for attaining those goals, and later phases toward reintegration, services are continually adjusted to match the consumer’s ever-changing needs; Since multiple prior treatments are a feature of the composite pathology of treated patients. Episodes and typical history of only short-term sobriety and enforcement of a zero-tolerance model do not affect any meaningful progress. While abstinence is the final goal, harm reduction must be emphasized to measure progress within both staff and patients. A nonpunitive reaction to relapses and lapses is of great importance to real-time commitment and ultimate improvement through a degree of change integrated treatment approach.
- Within a Managed-Care System, Any Individualized Phase-Specific Intervention can be Applied at Any Level of Care. Consequently, a Layered Approach to the Individual’s Care is Needed. In integrated treatment, the integration of service assessment, intervention, and evaluation is crucial to success. While assessment yardsticks will be discussed in detail in a report that came much later, the ASAM-PPC-IIR criteria, in conjunction with a series of regulated and non-standardized actions, are applied to guide the treatment plan. The report is an essential part of those measures. In an integrated treatment program, it cannot be overstated how crucial it is for clients to comprehend their specific faults. Many practical questions require answers to create a fully functional program. At the beginning of the program, there are usually no easily accessible residential models to build. Following years of integrated treatment, several residential programs have proven effective. We hope that this project’s experiences can inform other programs poised to turn principle into practice while leaving room for plans to customize treatment plans to the needs of the patients. Based on the findings of a 3-year longitudinal study, this modified integrated treatment model provides promising results. The Outcome from these efforts will be reported in a subsequent article in this series, reflecting follow-up data on 86% of the study participants. Foundations Associates, located in both Nashville and Memphis, presents a selection of outpatient plans, along with an in-patient treatment schedule possessing a 72 slot capacity that includes crisis resolution, therapeutic circles, partial or complete housing, and solo living arrangements. All programming is explicitly designed to provide integrated treatment for individuals with co-occurring disorders. For bookings and enquiries, you can reach our chief officer of operations Dick Clark, on 615/345-3214.
Types of Integrated Programs
- Cognitive Behavioural Therapy: In an integrated treatment approach, coping strategies reduce arousal among individuals and reduce symptoms. These individuals were maybe experiencing Post-traumatic Stress Disorder or Drug/substance abuse. An 8-12 session integrated Cognitive behavioral therapy program incorporates some techniques. Integrated treatment techniques include breathing retraining, psychoeducation, relapse prevention, cognitive restructuring, and self-monitoring. Individuals relying on individual addiction counselling integrated treatment are less likely to experience posttraumatic stress disorder and drug use comorbidly.
- TARGET (Trauma Affect Regulation): This group intervention for posttraumatic stress disorder and substance/drug abuse. TARGET is manualized. Integrated treatment techniques for substance abuse are also part of this framework. With this framework, the individuals do not experience psychological symptoms of hypervigilance, dissociation, decompensation, compromising sobriety or avoidance. Ten sessions of integrated treatment are sufficient to complete this curriculum. TARGET was found as a superior treatment in maintaining self-efficacy and sobriety.
- Seeking Safety (SS): It addresses posttraumatic stress disorder co-occurring with drug-abuse integrated treatment and reflects present-focused intervention. This intervention integrates behavioural, interpersonal, cognitive, and participants’ psychoeducation about trauma consequences. This helps to develop the link between trauma and substance abuse. It also helps to develop adequate coping skills. From all integrated treatment plans for Posttraumatic Stress Disorder and addictions, Seeking Safety has received the most empirical attention.
- Traumatic Recovery and Empowerment Model (TREM): This method was original created for women who struggle with trauma and substance abuse. It has recently been adapted for men, known as M-TREM. TREM incorporates CBT techniques, practical coping skills and psychoeducation. It is conducted in 24-29 sessions. This program is used in residential and non -residential correctional institutions, community mental health settings and substance abuse programs.
- Addictions and Trauma Recovery Integration (ATRIUM): This is a twelve-week integrated program. It combines the use of relational treatment and cognitive behavioural treatment. The program is based on integrated treatment of interpersonal violence and childhood trauma. ATRIUM provides training in mindfulness and relaxation. It incorporates expressive and psychoeducational techniques. ATRIUM helps individuals to develop skills that can actively stop negative automatic thoughts. A more appropriate self-care integrated treatment is also made possible through this technique.
- Using Prolonged Exercise for the Concurrent Treatment of Post-Traumatic Stress Disorder and Drug/substance Abuse (COPE): This is a relatively new treatment that addresses PTSD and substance abuse co-morbidity disorders. This program provides more favourable results by reducing Post-traumatic stress disorder symptoms than usual treatment.
Using the experts at FRN, you can find out if your actions are caused by any underlying mental health concerns and develop a plan that’s best suited for you. Get in touch with us today by calling 615-490-9376 to find out more about our options on integrated treatment.
Ben Lesser is one of the most sought-after experts in health, fitness and medicine. His articles impress with unique research work as well as field-tested skills. He is a freelance medical writer specializing in creating content to improve public awareness of health topics. We are honored to have Ben writing exclusively for Dualdiagnosis.org.