Dual-Diagnosis Treatment Program
Many recovery centers say they offer dual-diagnosis services, but too often these otherwise fine facilities really just treat chemical dependency, seeing mental health issues as collateral. One client shared: “I was going to meetings and I got a sponsor. I told him that I’d been diagnosed as bipolar and he was like, ‘Really. I don’t believe in that. There’s only one disease and it’s called Alcoholism.’ Looking back, I’m not mad at him. He’s still my sponsor and I still go to meetings, but I need extra help.” Morningside specializes in offering this extra help. We know the label -- co-occurring disorder, concurrent disorder, co-morbid disorder, dually diagnosed – is not as important as the research that demonstrates that more than half of all individuals who enter addiction treatment have at least one mental disorder in conjunction with their addiction. For clients suffering from a mood, thought or anxiety disorder in conjunction with an alcohol or drug problem, we embrace a total recovery model. We treat substance abuse and mental health issues on an equal basis. We don’t view mental health issues as merely a symptom of drug and alcohol dependency, or vice versa. We treat people, as they are, with any and all unique issues.
Morningside Recovery has a customizable Co-Occurring Disorders program that results in an individualized, personal approach to the treatment of clients with a dual diagnosis. Clients who arrive without a diagnosis receive comprehensive psychological and psychiatric assessments that include an in-depth health review and personal history taking. Clients with an existing diagnosis still receive assessment, and the results of all testing guide our interdisciplinary staff of psychiatrists, psychologists, therapists and chemical dependency counselors in the creation of an individualized plan of treatment. For both new and existing diagnoses, these assessments help determine which of our modalities will work best for the client in our phases of recovery.
Our modalities are individual treatment plans customized for a client’s specific requirements based on the type of substance abuse and regardless of the severity of the co-occurring disorder. For example, a client suffering from a mental illness such as bipolar disorder or major depressive disorder will receive care for both his mood disorder and addiction. In some treatment centers, only one of the two problems is identified and treated. With Morningside’s evidence-based, combined approach, both issues are addressed simultaneously.
This practice avoids a common problem: Clients frequently admit to addiction issues in order to avoid mental health issues, and after putting together 30, 60 or 90 days they drop out of treatment without ever getting the help they need. Likewise a client may reject his diagnosis of borderline personality disorder or depression because it is more ego acceptable to be a labeled an alcoholic. The importance of treating both issues at once is also obvious when considering that psychosis or depression interferes with the client’s ability to fully participate in their own recovery. Thus, in Morningside’s dual-diagnosis system of care each Phase includes elements that address each illness, and deal with the shifts in symptom severity that arise during recovery.
At Morningside, clients receive regular and ongoing intensive psychotherapy to develop skills they can use to manage symptoms associated with their dual disorder. All therapy and curriculum is research-based. One modality Morningside therapists use is Cognitive Behavior Therapy (CBT), which research has demonstrated is effective at treating a variety of co-occurring disorders. In particular, clients with a mental illness find that CBT provides the skills to get the relief they were perhaps seeking through drugs or alcohol. These skills help them meet the world in realistic terms, instead of seeking the temporary relief of substance abuse. CBT is flexible and specific, which is necessary for the many possible combinations of co-occurring disorders.
Clients learn how to handle real-life situations by taking charge of their disease and recognizing symptoms. CBT is also compatible with any necessary medications, so that while learning skills for non-pharmacological symptom management clients can also receive a progressive medication approach. For example, drugs don’t cure schizophrenia, but an imbalance of brain chemicals can benefit from medication. With this in mind, the clinical team assesses the comprehensive profile of each client. Considerations include a client’s age, gender, body chemistry, diet, and addiction history. The clinical team formulates a therapeutic treatment plan that takes into account the effect of medication.
Phase I for dual-diagnosis clients is designed to incorporate healthy activities into each day. Clients can participate in a sunrise meditation overlooking the beach, attend a 12-Step meeting, hit the gym, or just relax at the beach. Every week, the staff leads groups on a variety of experiential activities, such as hiking, bowling, rock-wall climbing. These activities are more than mere diversions. The activities serve experiential therapeutic ends as well. Of course, it’s not all work, with clients cutting loose with whale watching or trips to Magic Mountain. Clients also receive instruction and support on nutrition, in recognition that eating well is an essential part of mental health. Clients learn to shop for fresh foods and how to plan meals to include the right amount of protein, carbohydrates, fiber, vitamins and minerals. Learning shopping and food preparation skills is an important step towards sober independence for many clients.
The family is a big part of the dual-diagnosis treatment offered at Morningside, with client and familial input becoming an integral part of the planning process. During the Morningside Family Program the client and their loved ones have the opportunity to participate in family education as well as individualized family therapy with the client’s primary therapist and Morningside’s Family Relationship Specialists. Family involvement helps define, process and repair much of the dysfunction that occurs within families as a result of untreated mental illness and addiction. This also helps the family anticipate the new life skills their loved one will bring home as a productive member of their community.
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