Dual Diagnosis

Dual diagnosis is a term that has historically been used to describe individuals who have a psychiatric disorder, and who also abuse drugs or alcohol. Dual diagnosis today can be used to describe a wide variety of co-occurring disorders.

Patients with one disorder often have other disorders that require medical and psychiatric care. Common examples of a dual diagnosis for patients who have an eating disorder include:

• Post-traumatic stress disorder or depression
• Obsessive-compulsive disorder
• Self-harming behavior, such as cutting or burning
• Drug or alcohol addiction

It takes an integrated model of care to treat a person with a dual diagnosis successfully. Unless co-occurring disorders are treated simultaneously, one disorder may worsen as the other improves.

Signs Of A Dual Diagnosis

A dual diagnosis is an expectation, not an exception for Walden patients. A dual diagnosis is so common, at Walden Behavioral Care we assume that every patient has a dual diagnosis until a thorough assessment shows otherwise.

Treating Patients With Dual Diagnosis

When patients are admitted, the treatment team meets to develop and implement a multidisciplinary treatment plan that is frequently reviewed and revised according to the patient's response to treatment.

It is important that all medical and psychiatric issues be identified and treated concurrently. When patient care focuses on just one disorder and fails to deal with issues that led to the disorder, the patient may develop another disorder as a substitute.

A Dual Diagnosis Model

A "four quadrant" model is used to categorize patients with a dual diagnosis. The model categorizes patients, based on the severity of each disorder in their dual diagnosis. The following model is for patients with a dual diagnosis of a psychiatric disorder (PD) and an eating disorder (ED), but it can also apply to patients with any other dual diagnosis.

When a patient has a dual diagnosis, neither disorder should be given priority over the other disorder.

Case management and clinical care for patients with dual diagnosis must be properly balanced with empathic detachment, opportunities for empowerment and choice, contracting and contingent learning. The model says that the identified care that is common for each disorder must be balanced with contingent learning, which is based on trying additional treatment based on past experience, patient history and other factors.

There is no one correct approach to treating individuals with a dual diagnosis. Again, different people have different needs. Each patient's dual diagnosis should be considered individually, and a treatment plan should be developed and implemented by a team of professionals, based on best practice requirements - but with enough flexibility to adjust to the patient. Whatever the patient responds best to is the best plan for treating the patient with a dual diagnosis.

Treatment for patients with a dual diagnosis is still evolving, but Walden Behavioral Care is already experiencing success with the approach outlined here.

Helping Someone With Dual Diagnosis

If you suspect you or someone you know has dual diagnosis, do something about it. Seek professional counseling immediately.

For help, contact Walden Behavioral Care at 781-647-6700 or Info@waldenbehavioralcare.com.