What Defines Effective Care Planning for a Patient with Dual Diagnosis - Essay Example

College: Effective Care Planning for a Patient with Dual Diagnosis Introduction A person with dual diagnosis is one who has both drug/substance problem and mental/psychiatric disorder; these two problems are often known to occur together. Drastically, drug and alcohol abuse is known to occur with mental problems such as; depression like bipolar depression, personality disorders and anxiety disorders like obsessive compulsive disorder; actually, these disorders start first and people fall into drugs like alcohol, under the idea that these drugs will facilitate them getting better (David, 2005, 102). Abuse of these drugs for a long time can lead to emotional problems or even more mental disorders like Sebastian started with just hearing voices and now it has developed to the feeling of as if people are after him; moreover, it is required that in a case of dual diagnosis both problems be treated together where the first step or the foundation for the treatment is stopping the drugs. Unfortunately, dual diagnosis is more common than most people imagine; research shows that forty five percent of all drug and alcohol abusers have at least one mental problem and of all the people that have mental disorder twenty nine percent are either drug or alcohol abusers (Mark & Tom, 1999, 1098). Apart from cases where people are diagnosed with mental problems first then they start abusing alcohol and drug abuse for relief; there are cases where people start off with drugs when young, which continues into adulthood and this makes a major contribution to emotional difficulties or mental disorders i.e. Sebastian who started of alcohol when he was young which went on to develop a mental problem where he was hearing voices in his head. Assessment Dual Diagnosis recovery has come out as the most thriving treatment aspects of psychiatric and drug abuse treatment where they are treated as part as a continuum instead of treating them one by one or separately by different clinicians (Joanne, 2013, 1). Specialists of drug abuse addiction treatment are now being given training and testimonials in the treatment of mental/psychiatric disorders; additionally, dedicated rehab facilities offer recovery services for individuals with Dual Diagnosis e.g. Sebastian being treated by a single doctor who specializes in both drug abuse and psychiatric disorders. However, the challenging part of it is finding the precise rehabilitation program especially if the person has a combination of drug addiction and depression or anxiety disorders. In the past Dual Diagnosis has been defined along drug abuse and mental disorders alone; shockingly, today there are other addictions that have been added into the classification i.e. sex addiction, gambling addiction or another behavioural addiction like Sebastian listening to music as he smokes cannabis. Significantly, for a person with dual diagnosis to undergo the proper treatment and increasing the chances of a full recovery; they should be concerned with a few things; psychotherapeutic medication, supportive approach to therapy by a highly trained treatment team or specialist and inclusive treatment strategy where family, relatives and other household members are involved in therapy. In Sebastian’s case, the treatment will commence with two brief screen tests; one that deals with issues of alcohol and cannabis abuse, and the other test will for the mental disorder, which will assist in identifying the need for co-occurring mental disorder services (David, 2013, 14). Even though the screening does not diagnose the co-occurring disorder, it is effectual in identifying the need for an assessment to look at the dealings between his psychiatric disorders symptoms i.e. voices in his head and alcohol and cannabis abuse, and the effect they have on his health. Some of the tools to be used in the screening process will include the AUDIT and CAGE, which should provide a surprisingly significant amount of information that will be very useful in Sebastian’s treatment; answers to the questions asked will help evaluate Sebastian’s condition i.e. some of these questions will include; how often does he abuse the cannabis and alcohol, has he ever felt that he should reduce the drinking or has he ever felt sad or remorseful after drinking etc. After the screening is done, the next step is basic assessment where key information about Sebastian will be gathered; the counsellor will engage in a process that will facilitate their understanding about Sebastian i.e. his strengths, disabilities, areas mostly affected by the problem and if he is ready to change (DDO, 2013, 1); this process involves physical assessment, risk assessment and examining the mental state; it includes tests and, written and oral exercises. Sebastian physical evaluation will involve testing of the assessment of ailments that are directly involved with the abuse i.e. hypertension, schizophrenia and others caused by alcohol include; cardiovascular and liver disease. The information acquired in this stage includes; Sebastian’s family background where factors such as history of domestic violence, trauma history, financial and marital status and other personal factors like how he started abusing the drugs at the age of ten or how he is willing to change but doesn’t know what to do is put into consideration. Moreover, the time of duration that Sebastian has used alcohol and cannabis, the main thing that influence him to start abusing (mother- alcohol), whether there is a family history about substance abuse or he was influenced by his peers, and finally information about his mental disorder problems where he is used to hearing voices and is worried that people are out there to get him. This entails whether there is any history of family mental health issues, patient’s history of psychiatric disorders like cases where Sebastian was hospitalized, diagnosis or any other cases of treatment (Crome, 2009, 3). The assessment will also include Sebastian’s potential to harm himself or even others like his mother; this will be examined by checking if there are any past records of Sebastian trying to commit suicide i.e.in our situation Sebastian has a past history of suicidal thoughts, however at the moment he denies ideation. With this in mind, the specialist will get an idea of how to determine whether Sebastian is really suicidal or homicidal or not as he claims and from this, they will form a basis of the treatment concerned with this situation. A comprehensive assessment and collection of this information will serve as the foundation of Sebastian’s treatment since there is no single action or intervention program for people with dual diagnosis hence the treatment is based on every patient’s needs after the assessment results being considered i.e. the specialist in this scenario might encourage Sebastian to start playing the guitar again and avoid missing lectures for starters (Chloe, 2010, 1). After this, what is left is the recovery, which is the most complex step since it depends on how the two problems are approached. Recovery Recovery from dual diagnosis takes time, courage and dedication from both the patients and the specialists; sometimes it takes months and others years, which depends on the readiness to change of Sebastian to change and these three factors (CMH, 2013, 4). Significantly, these problems should be treated simultaneously and from the same treatment provider or team; this is very significant especially in cases of relapse where it is easy to encourage Sebastian to proceed with the treatment. The treatment can be administered using groups or as an individual and sometimes both and for effective recovery Sebastian must; learn how to manage his stress, know what triggers him and how he will be able to overcome this, get therapy and stay in a support group, follow doctor’s orders and also watch on their health by getting enough sleep, exercise regularly and practice relaxation techniques (CWRU, 2011, 1). Conclusively, Sebastian’s treatment starts with detoxification first, therapy second, then joining support groups and throughout medication is in required i.e. he should be motivated by his counsellor and family members giving him hope all the time. References Joanne. S. 2013.Substance Abuse and Mental Health: Help Guide Organization. Web [Accessed 27th August 2013] David, S. 2013. Integrated Dual Disorders Treatment;A New Wave in Recovery: Social Work Today. Vol.8 (6), p.14, Web [Accessed 27th August 2013] Mark, H., Tom, D.1999. Hallucinations and Delusions 2: A Dual Diagnosis Case Study. Web < http://www.internurse.com/cgi-bin/go.pl/library/article.cgi?uid=6516;article=BJN_8_16_1095_1102;format=pdf > [Accessed 27th August 2013] David, M. 2005. Co- existence of Drug, Alcohol and Mental Health Problems: Dual Diagnosis Internurse. Web < http://www.internurse.com/cgi-bin/go.pl/library/abstract.html?uid=17439 > [Accessed 27th August 2013] Chloe, B., 2010. Dual Diagnosis: Home Nurse Care Providers. Web < http://www.patient.co.uk/doctor/dual-diagnosis > [Accessed 27th August 2013] Dual Diagnosis Organization (DDO)., 2013. Dual Diagnosis Treatment: Integrated Treatment for Substance Abuse and Mental Illness. Web [Accessed 27th August 2013] Crome, I., 2009. Substance Misuse and Dealing with Mental Health Issues; The Relationship between Dual Diagnosis: Social Care Institute for Excellence. Web < http://www.scie.org.uk/publications/briefings/files/briefing30.pdf > [Accessed 27th August 2013] Centre for Mental Health (CMH)., 2013. Dual Diagnosis: A Challenge for the Reformed NHS for Public Health England. Web < http://www.drugscope.org.uk/Resources/Drugscope/Documents/PDF/Policy/DSDualDiagnosisDiscussionPaper.pdf > [Accessed 27th August 2013] Case Western Reserve University (CWRU)., 2011. Integrated Dual Disorder Treatment: Centre for Evidence Based Practices. Web [Accessed 27th August 2013] Lady Bird., 2011. Co-occurring Substance Misuse and Psychosis: Dual Diagnosis. < http://www.communitycare.co.uk/carespace/blogs/ladybird/archive/2011/02/21/co-ocuring-substance-misuse-and-psychosis-dual-diagnosis.aspx> [Accessed 27th August 2013] Read More