Screening and Treating Mental Disorders in Addiction Treatment Settings: A Stepped Care Model

Abstract

The comorbidity of mental and addiction disorders is increasingly apparent. Such comorbidity increases overall client morbidity substantially, and reduces the success rate in treating either type of disorder. In addiction treatment settings, the challenge is twofold: first, to develop a method for detecting mental disorders that is valid and practical, and second, to identify treatment approaches that are appropriate to that setting.

Brief web-based intervention for college students with comorbid risky alcohol use and depressed mood: Does it work and for whom?

“…It has been suggested that a stepped care approach could be appropriately utilized with dually diagnosed individuals (Parikh, 2008). Brief alcohol-based feedback interventions have shown efficacy across a variety of drinkers ranging from light, non-problem drinkers to heavy problematic drinkers (for reviews see Larimer and Cronce, 2007; 2011; Murphy et al, 2012).…”

Improving Access to Psychosocial Treatments—Integrating Patient, Provider, and Systems Approaches

“…5 Stepped care already has wide acceptance across medicine, and frequently has been suggested in psychiatric contexts, including substance abuse, mood disorders, and anxiety. 6,7 Our (see Parikh et al 8 ) own experience with recommendations for stepped care for bipolar disorder has led to research studies to compare different treatment methods with widely different costs and intensities, resulting in evidence that brief group psychoeducational interventions may be clinically equal, easier to use to treat larger numbers of clients, and far less expensive than the traditional 20-session dose of individual CBT. 8 Scaling psychosocial interventions broadly across disorders and society requires widening the focus of interventions and delineating the appropriate provider and venue for such treatments.…”