Formerly known as “dual diagnosis”, “co-occurring disorders” (COD) refers to an individual having one or more substance abuse disorders in addition to one or more psychiatric disorders.  In the past, mental health and substance abuse disorders were treated separately.  Evidence has shown that treating just one disorder will not cause the other to automatically improve.

At Turnbridge, mental health and substance abuse disorders are treated simultaneously. This is known as an integrated approach.  One aspect of the integrated approach involves education about the relationship between substance abuse and mental health disorders.  This fosters an understanding of how the two interact; which is an integral component of drug treatment.  If psychiatric disorders are left untreated, substance use is likely to increase.  It is common for people to self-medicate with mood altering substances in an attempt to reduce mental health symptoms.

When substance abuse increases, mental health symptoms can rise and new symptoms may be triggered.  Sometimes psychiatric medication regimens may be altered or stopped abruptly.  When taken with other substances, mental health medications can become less effective and in many instances may be contraindicated.  The use of alcohol or other drugs not only fails to repair the mental health disorder, but prevents the person from developing effective coping strategies.  

One of my clients struggled with social anxiety since childhood. He tried to avoid social interactions because he feared judgment and criticism.  When he began to drink as a teenager, he would become more outgoing and less inhibited. When alcohol created havoc in his personal and professional life, he sought treatment.  He participated in programs that focused on alcoholism, but was unable to maintain his sobriety. At Turnbridge, his underlying problems were identified and his anxiety was addressed.  He developed coping skills to help him through his discomfort in social situations, while remaining sober.  He had the opportunity to practice these new strategies within the community with the support and guidance from both the clinical and residential teams. A once self-conscious young man became more confident and no longer felt the need to self-medicate with alcohol. He continued to successfully maintain his sobriety and lead the life he imagined.

The coordination of services at Turnbridge enables clients to have continuity and structure in their therapy and psychiatric care.  Long term treatment allows us the opportunity to follow these clients for a year as they face new challenges and stressors in their daily lives. 

MARGO FRIEDMAN – LPC, LADC, CCDP-D

Primary Therapist