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Discussion Topic

Clients who suffer comorbid disorders were thought to require separate treatment (e.g., mental health and addiction therapy). Professionals viewed each as a separate disorder that existed in one individual. Now, professionals believe that the person with the disorders requires integrated treatment whereby both the mental health and addiction disorders are treated by the same professional staff. The current belief is to use an integrated approach. This includes stabilizing the client’s mental health while helping him/her to achieve sobriety. To answer the questions below, use information from your assigned reading, especially from your TIP Guide. Some mental health and addictions are commonly seen together in clients. An example is PTSD and alcoholism and another is Generalized AnxietyDisorder and severe, Cannabis Use disorder. Choose one of these pairs (or another if you like) and explain why the disorders are often comorbid. Which treatment models are to treat those disorders? Explain one of the models that are used to help diagnose comorbid conditions. Which strategies for working with clients diagnosed with co-occurring disorders do you think would be effective with the pair of disorders that you chose above?


Carol post

  Post-Traumatic Stress Disorder (PTSD) and Alcohol Use Disorder (AUD) are highly comorbid in humans (Gilpin & Weiner, 2017, p. 15).  It is common for people to “drink their problems away” or use alcohol as a way to forget.  According to Gilpin and Weiner (2017), people with PTSD exhibit structural  and functional changes in the amygdala, as do people diagnosed with AUD (p. 23).  Alcohol-dependent people have lower amygdala volumes, which are predictive of alcohol cravings (Gilpin & Weiner, 2017).  With PTSD exhibiting similar changes to the amygdala, it can be assumed this is why comorbidity is so high within this population. The disease concept model uses a 12-step program, such as Alcoholics Anonymous, along with therapy.  It is important for counselors using this model to be familiar with the step systems so that the counselor can choose a group together and take small steps to “self-reinforce” the client (Durand & Barlow, 2012, p. 202).  There are alternative models that argue AA programs are one-size fits all for a multidimensional problem.  Most of these lean more towards individual therapies designed specifically and intentionally for the client and their particular problems. I actually think that the Disease Concept Model is ideal for someone suffering from PTSD and AUD.  Not only will they receive the one-on-one therapy necessary to walk them through re-integration to society and getting AA to work for them, they will get the group environment with AA where they can find a sponsor and find other people to make them feel validated and accepted.  Finding a specific group that may work more often with PTSD clients would give the client a place to feel less alone in their suffering. 



This unit’s reading I find to be very interesting, especially the comorbid information. It is reasonable to think that if a person primarily struggles from substance use, then that person is more than likely to develop anxiety or depression, or some other type of mental disorder, and vice versa. “Typically, symptoms like aggression and depression that stem from substance use disorders decrease once the person stops using the addicting substance; if this does not happen, it is likely that the psychiatric problem was first” (Capuzzi, 2016). I like the example the book uses when Capuzzi (2016) speaks of a gang member continuing to be involved in criminal activity to obtain the drugs needed to support their habit. This example was an easy insight on how the circle starts. Either the individual began participating in criminal activity which, ultimately, lead to drug use. Or this individual has committed to criminal activity to support their addiction to a substance. To prevent an individual of this nature from relapsing, a professional can help the individual find other issues situated around gang membership. These patterns become compulsive which can interfere with treatment and lead to relapse. 

Capuzzi (2016) discussed the different views a counselor may have on addiction and whether their perception is it is a disease, or if an alternative model is more acceptable. However, both models are beneficial when helping a client overcome a substance dependence. For a client with multiple, severe problems, the disease model concept would be more effective. The client would need to maintain abstinence from all substances at that point, and seek 12-step programs. Addressing the primary issue, and finding their underlying cause for a disorder, or comorbid disorders, would most sufficiently help the client overcome their addiction. 



Capuzzi, D., & Stauffer, M. D. (2016). Foundations of addictions counseling. Boston: Pearson.

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