The Role of a Dual Diagnosis Psychiatrist in Treating Co-occurring Disorders

Discover how a dual diagnosis psychiatrist can help treat co-occurring disorders in this informative article.

What Is Dual Diagnosis?

Dual diagnosis is when an individual has a mental health and substance use disorder simultaneously. Both disorders can complicate treatment, making it more challenging to achieve recovery. Thus, specialized help from professionals, like a dual diagnosis psychiatrist, is needed.

Also referred to as co-occurring disorders, dual diagnosis is a common issue. About 9.2 million adults in the US have co-occurring disorders.¹

Why Is Dual Diagnosis Treatment Important?

Dual diagnosis requires treatment that addresses both substance use and mental health disorders at the same time. When only one condition is treated, the risk of relapse increases. This is because substance use and mental health disorders often go hand in hand.

For example, treating just the substance use disorder leaves the individual still struggling with their mental illness. To alleviate these symptoms, people commonly turn to substances to self-medicate.

As a result, the individual may turn to substance abuse once more. This is how the relapse cycle begins.

Benefits of a Dual Diagnosis Psychiatrist

Receiving treatment from a dual diagnosis psychiatrist can provide several benefits and outcomes, such as:

Improved mental health and substance use outcomes
Reduced symptoms
Improved functioning
Reduced substance use
Improved quality of life

The Role of a Dual Diagnosis Psychiatrist

A dual diagnosis psychiatrist plays a critical role in treatment of co-occurring disorders. Here are some of the ways in which a dual diagnosis psychiatrist can help:

Accurate Diagnosis

A dual diagnosis psychiatrist has specialized training and experience in diagnosing. They have the ability to differentiate between symptoms and provide accurate diagnoses.

An accurate diagnosis is crucial for determining the most effective treatment. Dual diagnosis psychiatrists achieve this by:²

Conducting thorough assessments
Using structured interviews
Following guidelines, i.e., the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)

Medication Management

A psychiatrist can prescribe medications to help manage symptoms of the co-occurring conditions. These medications can help reduce:

Mental health symptoms
Withdrawal symptoms
Cravings

Psychotherapy

A psychiatrist can provide therapy to help individuals address their issues. Therapy can help people:

Develop coping skills
Identify triggers
Learn how to manage cravings

Coordinated Care

A dual diagnosis psychiatrist can coordinate care with other health care providers. This helps ensure that individuals receive care that addresses all aspects of their health.

Relapse Prevention

A dual diagnosis provider can help individuals develop a relapse prevention plan. A relapse prevention plan includes strategies for:

Avoiding triggers
Managing stress
Seeking support when needed

Dual diagnosis psychiatrists are a critical part of a comprehensive treatment team. They bring expertise, support, and guidance to the treatment process, all while helping those struggling to achieve lasting recovery.

What Qualifications to Look for in a Dual Diagnosis Psychiatrist

When considering a dual diagnosis psychiatrist, it’s important to ask questions about their qualifications, experience, and treatment approach. Don’t be afraid to ask for references or schedule an initial consultation to learn more about their practice.

Ultimately, the goal is to find a knowledgeable, experienced, and compassionate psychiatrist who can help you or your loved one achieve lasting recovery and improved quality of life.

Here are some key qualifications to look for:³

Board Certification

The dual diagnosis psychiatrist must be board certified mental health and addiction psychiatry. Board certification indicates that the psychiatrist has passed rigorous exams in these fields.

Experience

Look for a psychiatrist who has experience treating individuals with co-occurring disorders. The psychiatrist should have a good part of their practice dedicated to treating these conditions simultaneously.

Specialties

Every psychiatrist has their specialties. It is best to look for a psychiatrist who specializes in dual diagnosis. Not only that, these professionals also specialize in specific mental health and substance use disorders.

For instance, some may specialize in depression and alcohol use disorder. Others may specialize in bipolar disorder and opioid use disorder. So, try to find a dual diagnosis psychiatrist specializing in your conditions.

Treatment Approach

Look for a psychiatrist who uses treatment approaches that address both mental health and substance use. You also want to find someone whose style matches what you are looking for.

Referrals

Ask for referrals from trusted sources, such as primary care physicians or addiction specialists. These professionals may have experience working with dual diagnosis psychiatrists and can provide valuable insights.

What Types of Assessments Do Psychiatrists Use to Diagnose a Co-Occurring Condition?

Dual diagnosis psychiatrists use many tools to assess and diagnose co-occurring disorders. This is important to get a full, accurate view of the person they are treating. Here are some of the ways they can do this:

Medical History

The psychiatrist will request and review medical history. This may include information about:

Any previous mental health or substance use issues
Family history
Current symptoms
Any physical health concerns

Mental Health Assessment

The dual diagnosis provider will conduct a mental health assessment. This helps check for any underlying mental health disorders. They may use diagnostic tools such as the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to make a diagnosis.

Substance Use Assessment

The psychiatrist will conduct a substance use assessment. This helps determine the severity and frequency of substance use, along with any withdrawal symptoms or cravings. There are several substance use assessments and tools, including:⁴

Screening to Brief Intervention (S2BI)
Brief Screener for Alcohol, Tobacco, and other Drugs (BSTAD)
Opioid Risk Tool – OUD (ORT-OUD) Chart
Tobacco, Alcohol, Prescription medication, and other Substance use (TAPS)
CRAFFT

Co-Occurring Assessment

The psychiatrist will assess how the disorders are connected and how they impact each other.

Lab Tests

The provider may order lab tests to detect substances and any underlying medical conditions. Lab tests can help contribute to a more accurate diagnosis. Examples of lab tests include:

Urine tests
Saliva tests
Blood tests
Hair tests

Psychiatric Evaluation

The psychiatrist may conduct a psychiatric evaluation to assess:

Mental status
Cognitive functioning
Level of distress

Once the assessment process is complete, the dual diagnosis psychiatrist can determine the appropriate treatment plan tailored to the individual’s unique needs. The team will adjust the plan as needed over time, depending on progress or other concerns.

Interventions for Dual Diagnosis

Dual diagnosis psychiatrists use a variety of interventions. This helps to address both aspects of the diagnosis. Common interventions include:

Cognitive Behavioral Therapy (CBT)

CBT is a type of psychotherapy that is based on the idea that our thoughts, feelings, and behaviors can influence one another. It focuses on identifying and changing negative or irrational:⁵

Thoughts
Beliefs
Attitudes

By changing these negative patterns, CBT helps individuals learn new coping strategies. They also develop more positive and adaptive ways of thinking and behaving.

What Can CBT Help With?

CBT is effective in treating a range of mental health conditions, including:

Anxiety disorders
Depression
Post-traumatic stress disorder (PTSD)
Obsessive-compulsive disorder (OCD)
Substance use disorders

Dialectical Behavior Therapy (DBT)

DBT is a type of cognitive behavioral therapy that emphasizes the integration of:

Mindfulness
Emotion regulation
Distress tolerance
Interpersonal effectiveness skills

How Does DBT Work?

DBT focuses on individuals who struggle with intense emotions and difficulty regulating behavior. The approach believes people benefit from learning skills that help them manage emotions. DBT uses a combination of:⁶

Individual and group therapy
Skills training
Coaching

How Can DBT Help?

DBT is effective in treating a variety of mental health conditions, including:

Borderline personality disorder
Substance use disorders
Eating disorders
Depression
Anxiety disorders

Group Therapy and Peer Support

Group therapy provides a supportive space to share experiences and receive peer support. A mental health professional often runs group therapy. These groups allow individuals to connect with each other in a safe environment.

Peer Support Groups Commonly Used to Help Individuals Maintain Sobriety

Peer support groups are also used for accountability and connection. Common peer support groups include:

Alcoholics Anonymous (AA)
Narcotics Anonymous (NA)
SMART Recovery

Motivational Enhancement Therapy (MET)

MET is a short-term therapy that focuses on identifying and exploring an individual’s reasons for change while addressing any ambivalence or resistance. It is based on the idea that individuals are more likely to change their behavior if they feel motivated to do so.

Family Therapy

Family therapy can help address family dynamics that may contribute to substance use and mental health issues.

Psychoeducation

Psychoeducation aims to provide individuals with information and knowledge about their condition, symptoms, and treatment options. The goals of psychoeducation include:

Helping individuals better understand their condition
Increasing their coping skills
Improving their quality of life

Treatment options and interventions focus on the unique needs and challenges of the individual.

How Do Dual Diagnosis Psychiatrists Coordinate With the Treatment Team?

A dual diagnosis psychiatrist works collaboratively with other treatment team members to provide comprehensive care. The treatment team often includes:

Therapists
Case managers
Primary care physicians
Other support staff

Some ways a psychiatrist works with members of the treatment team include:

Referrals and Coordinated Care

Dual diagnosis psychiatrists can refer individuals to other health care providers, offering more services and support. They can then work with the other providers to ensure that all aspects of their health are being addressed.

They may refer individuals to the following providers:

Addiction specialists
Therapists
Primary care physicians

Treatment Planning

Dual diagnosis psychiatrists can collaborate with other members of the treatment team. This helps to develop individualized treatment plans. These treatment plans address both the mental health and substance use aspects of dual diagnosis.

Family Involvement

Psychiatrists can work with family members and caregivers. This ensures that they are involved in the treatment process and can support their loved ones.

Interdisciplinary Meetings

Psychiatrists participate in interdisciplinary meetings with other members of the treatment team. This is to discuss patient progress, treatment plans, and any concerns or issues that arise.

Collaboration between health care providers is essential for providing effective treatment. A dual diagnosis psychiatrist plays an important role in this process. They bring their expertise and knowledge to the team. This ensures that individuals receive the best care possible.

Medication Management of Dual Diagnosis

Psychiatrists approach medications for individuals with co-occurring disorders with caution. They take into consideration potential risks and benefits.

Common ways a dual diagnosis psychiatrist may approach medication management include the following:

Tailoring the medication to the individual’s unique needs and circumstances. This includes considering the individual’s mental health and substance use history and the type of co-occurring conditions.
Assessing the individual’s substance use patterns. This helps to determine any potential interactions or risks with medications.
Tracking the individual’s response to medications, including any potential side effects or adverse reactions.
Considering the risk of addiction associated with certain medications while taking precautions to prevent misuse or abuse.
Considering the risk of overdose associated with certain medications, particularly ones that are sedating or have a high potential for abuse.

Relevant Considerations With Medication Management

Determining what medication is effective for each person can be difficult. There are many potential considerations or precautions to be aware of. These include:

Risk of Interactions: Medications used to treat mental health or substance use disorders can interact with each other, as well as with other medications. This can lead to possible serious side effects or reduced effectiveness of the medications.
Risk of relapse: Some medications can increase the risk of relapse or worsen substance use disorders.
Risk of Overdose: Some medications can increase the risk of overdose, particularly when combined with other substances.
Risk of Withdrawal: Medications used to treat co-occurring disorders can cause withdrawal symptoms, especially if discontinued too fast.

Goal of Medication Management

The goal is to find a medication plan that effectively manages symptoms while minimizing potential risks and adverse effects. Individuals will work with a dual diagnosis psychiatrist to determine if medication is right for them.

Find a Dual Diagnosis Psychiatrist With Boardwalk Recovery Center

If you or someone you know is struggling with co-occurring disorders, it’s important to seek help from a qualified dual diagnosis psychiatrist. Boardwalk Recovery Center is dedicated to helping individuals find the care they need to achieve lasting recovery.

Our team can help connect you with an experienced dual diagnosis psychiatrist to help you through your recovery journey.

Dual Diagnosis Treatment at Boardwalk Recovery Center

The Boardwalk Recovery Center Dual Diagnosis San Diego treatment team specializes in helping people struggling with alcohol and substance use disorders. Our compassionate and skilled clinicians have vast experience identifying and treating various disorders and concerns, such as:

Anxiety
Depression
PTSD
OCD
Bipolar disorder
Alcohol use disorder
Opioid use disorder
Cocaine use disorder
Marijuana use disorder

We believe in a holistic treatment approach focusing on case management, individual therapy, and group therapy sessions. Our goal is to help you or your loved one not just recover but thrive.

Contact Us Today

We understand that the journey to recovery can be challenging, but we are here to support you every step of the way. Our team’s expertise and commitment to compassionate care make recovery possible.