Returning to the ASWB exam content outline, let's look at co-occurring disorders and conditions. Lets get some facts down and then look at how the topic may appear on the social work licensing exam.

Co-Occurring Disorders

First, a definition: Co-occurring disorders, also known as dual diagnosis or comorbidity, refer to the presence of two or more disorders or conditions in an individual at the same time. The term is most commonly used when referring to the coexistence of mental health conditions, such as depression, anxiety, bipolar disorder, or schizophrenia, alongside substance use disorders involving alcohol, drugs, or other substances. However, co-occurring disorders can extend beyond mental health and substance use, encompassing combinations of physical health conditions, developmental disorders, and various other medical or psychological issues.

Having co-occurring disorders can complicate diagnosis and treatment, as the interaction between the different conditions can influence the course and severity of each disorder. Integrated and comprehensive treatment approaches that address both the mental health and substance use aspects of an individual's condition are often considered the most effective way to manage co-occurring disorders. These approaches may involve a combination of psychotherapy, medication, support groups, and lifestyle interventions tailored to the specific needs of the individual.

Co-Occurring Disorders Treatment

Mental health and substance use disorders are interconnected--addressing both aspects simultaneously is crucial for long-term success. Key components and strategies commonly used in the treatment of co-occurring disorders include many components used for all clients. Among them:

  • Integrated Assessment:

    • A thorough assessment is conducted to evaluate the nature and severity of both the mental health and substance use disorders. This includes considering factors such as medical history, family history, social environment, and the impact of the disorders on daily functioning.
  • Dual Diagnosis Treatment Programs:

    • Specialized treatment programs that focus on co-occurring disorders provide integrated care. These programs are designed to address the complexity of treating both mental health and substance use issues simultaneously.
  • Substance Abuse Treatment

    • Substance use treatment may include detoxification, counseling, and behavioral therapies. Motivational interviewing and contingency management are techniques commonly employed to address substance use.
  • Medication Management
    • Psychiatric medications may be prescribed to manage symptoms of mental health disorders. Medications such as mood stabilizers, antidepressants, or antipsychotics may be part of the treatment plan.
  • Psychotherapy:

    • Various forms of psychotherapy, including individual, group, and family therapy, are integral to co-occurring disorders treatment. Cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), and motivational enhancement therapy are often used.
  • Support Groups:

    • Participation in support groups, such as 12-step programs like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA), can provide a sense of community and ongoing support in maintaining recovery.
  • Skill Building and Education

    • Individuals are taught coping skills, stress management techniques, and relapse prevention strategies. Education about the interaction between mental health and substance use is also crucial.
  • Case Management

    • Coordinated and comprehensive case management helps individuals access various services, such as housing, employment support, and community resources, to promote overall well-being.
  • Continuity of Care

    • Long-term follow-up and ongoing support are essential to maintain recovery. Continuity of care involves monitoring progress, adjusting treatment plans as needed, and addressing any emerging challenges.
  • Family Involvement

    • Engaging family members in the treatment process can enhance support systems and contribute to a more stable recovery environment.
  • Crisis Intervention

    • Plans for crisis intervention are established to address emergencies or situations that may jeopardize an individual's safety.

On the Exam

ASWB exam questions on this topic may look something like this:

  • A client is diagnosed with both generalized anxiety disorder (GAD) and opioid use disorder. What should be the social worker's FIRST consideration when developing a treatment plan?
  • A social worker is treating a client with co-occurring bipolar disorder and stimulant use disorder. The client expresses a desire to stop taking prescribed medications for bipolar disorder. What is the social worker's BEST course of action?
  • A social worker is working with a family where a parent has co-occurring depression and substance use disorder. What should be the social worker's focus when considering family interventions?

This material will show up on the exam, in social work practice, or, most likely, both. Get practice on questions like these--with answers, rationales, and suggested links for further study--on Social Work Test Prep's full-length practice tests.

Take Me There.

January 3, 2024
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