1. The document provides instructions for students to respond to three classmates' discussion posts about integrated treatment for individuals with co-occurring mental health and substance use disorders. 2. Students are asked to respond separately to each classmate, citing sources to support any claims. They are also provided with a list of required sources to use for their responses. 3. The responses should further the discussion by asking questions, sharing insights, offering opinions, validating ideas with experience, or expanding on the original posts.

1. Week 8 Discussion Response to Classmates
Please no plagiarism and make sure you are able to access all resource on your own before
you bid. Main references come from Van Wormer, K., & Davis, D. R. (2018) and/or American
Psychiatric Association. (2013). You need to have scholarly support for any claim of fact or
recommendation regarding treatment. I have also attached my discussion rubric so you can
see how to make full points. Please respond to all 3 of my classmates separately with
separate references for each response. You need to have scholarly support for any claim of
fact or recommendation like peer-reviewed, professional scholarly journals. If you draw
from the internet, I encourage you to use websites from the major mental health
professional associations (American Counseling Association, American Psychological
Association, etc.) or federal agencies (Substance Abuse and Mental Health Services
Administration (SAMSHA), National Institute of Mental Health (NIMH), National Institutes
of Health (NIH), etc.). I need this completed by 04/19/19 at 7pm.Expectation:Responses to
peers. Note that this is measured by both the quantity and quality of your posts. Does your
post contribute to continuing the discussion? Are your ideas supported with citations from
the learning resources and other scholarly sources? Note that citations are expected for
both your main post and your response posts. Note also, that, although it is often helpful
and important to provide one or two sentence responses thanking somebody or supporting
them or commiserating with them, those types of responses do not always further the
discussion as much as they check in with the author. Such responses are appropriate and
encouraged; however, they should be considered supplemental to more substantive
responses, not sufficient by themselves.Read a your colleagues’ postings. Respond to your
colleagues’ postings.Respond in one or more of the following ways:· Ask a probing
question.· Share an insight gained from having read your colleague’s posting.· Offer and
support an opinion.· Validate an idea with your own experience.· Make a suggestion.·
Expand on your colleague’s posting.1. Classmate (N. Pra)Strengths One major strength
with an integrated treatment approach is that a client may receive services at one location.
Typically it is much more difficult to treat a client who struggles with a co-occurring
disorder, whether that is because they do not attend treatment regularly, relapse, or
another perceived obstacle. Having a treatment facility that tackles all areas does make it
significantly easier for a client to maintain their mental health and sobriety. A second
strength is that this approach is not only holistic in nature, but it strengthens the continuity
of care between the treatment team and client. Being all-encompassing, a client can work
with their therapist in individual counseling, attend a recovery group with another, and/or

2. see a psychiatrist for their medications (Van Wormer & Davis, 2018).Weaknesses One
weakness of the integrated treatment approach (and counseling those with dual-diagnoses),
is that many have a high probability of being homeless, and unemployed. Without a steady
flow of finances, and reliable transportation, showing up to scheduled appointment times
can become nearly impossible. Case-management services could be used to link the client
up with local and federal resources, but sometimes these will fall short, especially if the
client suffers from a severe mental illness, such as schizophrenia (Moore, Young, Barrett, &
Ochshorn, 2009). A second weakness is how difficult it is to utilize an integrated approach
with untrained staff. Many therapists and psychiatrists are untrained with co-occurring
disorders, and provide inadequate treatment. It can be very costly, and time-consuming to
train, and get every staff member on board, and many organizations simply do not have
these finances or resources (Van Wormer & Davis, 2018).Conceptualize My client’s name
is Pete, a thirty year old, white male. He has been struggling with depression since he was
fourteen, and after his parent’s divorce at sixteen, he began abusing prescription pills. By
the time he was twenty, he had graduated to heroin, and cocaine. At twenty-three he
overdosed on a speedball, and after recovering at the hospital, he entered a rehabilitation
clinic. Over the next five years, Pete has been in and out of the rehab. He has relapsed four
times, but continues to seek a clean life. He has not used in the last eight months, and as his
year mark creeps up, he feels that he will fail again. Lately his depression has worsened, and
he has gotten into the habit of self-harming (burning or pinching himself) when he becomes
triggered. In this case, Pete has been struggling with his mental illness and substance
abuse for a long time. Using techniques to curb his severe depression, and self-harm like
Cognitive-Behavioral Therapy (CBT) will do wonders on his self-esteem, and identity.
Tackling his substance abuse with weekly group meetings, and other positive, and
supportive outlets will help him keep on the track to sobriety. Having trained staff, like a
psychiatrist, or nurse practitioner can also help Pete, but this avenue will have to be
monitored closely, if not avoided due to his past (McKee, Harris, & Cormier,
2013).ReferencesMcKee, S., Harris, G., & Cormier, C. (2013). Implementing Residential
Integrated Treatment for Co-occurring Disorders. Journal of Dual Diagnosis, 9(3), 249–259.
https://doi-org.ezp.waldenulibrary.org/10.1080/15504263.2013.807073 Moore, K., Young,
M. S., Barrett, B., & Ochshorn, E. (2009). A 12-Month Follow-Up Evaluation of Integrated
Treatment for Homeless Individuals With Co-Occurring Disorders. Journal of Social Service
Research, 35(4), 322–335. https://doi-
org.ezp.waldenulibrary.org/10.1080/01488370903110829 Van Wormer, K., & Davis, D. R.
(2018). Addiction treatment: A strengths perspective (4th ed.). Boston, MA: Cengage.2.
Classmate (C. Ree)Main Discussion PostCo-occurring disorders are the presence of both a
mental health and concurrent substance use illness. Examples of co-occurring disorders
include a person who is both an alcoholic and dealing with depression, or an individual who
is addicted to illicit drugs and also struggles with post-traumatic stress disorder. The
handling of mental illness and substance use is known as integrated treatment. Integrated
treatment provides simultaneous treatment for the mental illness and the substance use
disorder (Van Wormer & Davis, 2018). Van Wormer and Davis continue to discuss the
strengths and weaknesses of integrated treatment. Stating that integrated treatments

3. include more stable remission rates (10-20%), better housing, decreased shame, and
learning and insight. Whereas the weaknesses include small studies, heterogeneous
samples, short follow up periods and unclear description of treatment
components. Successful implementation requires vigorous on-site leadership, managing of
staff turnover, and technical, financial, and political support from the greater administrative
environment (Torrey, Tepper, & Greenwold, 2011). Hypothetical Client ExampleDerek, an
African American male, aged 40 deal with mental illness (depression) and a substance
(alcohol). Derek is married and works at the local Piggly Wiggly as the Assistant Manager.
His wife reports that he spends more time at the bar after work then he does at home. Derek
also has two sons age 12 and 15. He sons say that their dad has missed several of their
games or when he comes he is drunk and embarrassing. Derek has received several DUI’s
and has missed some of his appointments with his mental health counselor. Derek declares
that his drinking is under control and that he drinks to ease his sad moods. An integrative
treatment approach would work for Derek since he displays signs of a mental illness
coupled with a substance use issue. The evidence for mental health and addiction service
integration is strong (Woods & Drake, 2011) so getting Derek into such a program will help
him tremendously. It would be important to get him services that will allow him to focus on
his behavior, his substance use, and to help him connect with community resources. In
process this would include a multidisciplinary team engaging him in the community using
outreach, support, motivational interviewing, and other techniques. Bond, Drake, Mueser,
and Latimer (2001) discuss a holistic approach known as Assertive Community Treatment
(ACT) that is geared towards providing services like helping with medications and finances
or any need the client may present. This treatment seems to fulfill the needs that Derek
need to help him with his depressive symptoms and alcohol use.ReferencesBond, G. R.,
Drake, R. E., Mueser, K. T., & Latimer, E. (2001). Assertive community treatment for people
with severe mental illness. Disease management and health outcomes, 9(3), 141-
159.Torrey, W. C., Tepper, M., & Greenwold, J. (2011). Implementing integrated services for
adults with co-occurring substance use disorders and psychiatric illnesses: A research
review. Journal of Dual Diagnosis, 7(3), 150–161.Retrieved from the Walden Library
databases.Van Wormer, K., & Davis, D. R. (2018). Addiction treatment: A strengths
perspective (4th ed.). Boston, MA: Cengage.Woods, M. R., & Drake, R. E. (2011). Treatment of
a young man with psychosis and polysubstance abuse. Journal of Dual Diagnosis, 7(3), 175–
185.Retrieved from the Walden Library databases.3. Classmate (L. Sim)It is important to
understand the presentation of an individual with co-occurring addiction and mental health
issues. Different concerns will arise, requiring specific treatment. Van Wormer and Davis
(2018) shared that treatment of individuals with coexisting disorders needs a supportive,
long-term commitment and a combination of substance abuse and mental health treatment
approaches. There must be an understanding of how to treat all aspects of an individual.
Utilizing an integrated approach will be beneficial, even with presented
weaknesses.Strengths and WeaknessesThere are both strengths and weaknesses with an
integrated treatment approach. Utilizing an integrated approach suggests treatment of an
individual entirely. It allows for the individual to be looked at as an individual, as different
treatment needs are addressed. Further, Van Wormer and Davis (2018) shared that

4. simultaneous treatment is provided for mental health and substance abuse, also meaning an
individual only must travel to one location. This may be a huge benefit for someone,
certainly if they are struggling with their mental health and addiction. Another strength of
this approach is how it looks at individuals through a strengths-based perspective (Van
Wormer & Davis, 2018). Treating individuals with a strength perspective will provide
support and encourage personal motivation to be successful in treatment. Services
should include specifically trained employees, including 24-hour availability (Van Wormer
& Davis, 2018), which is a weakness of integrated treatment. The specialist needed may not
be available, requiring other staff members. There is a potential need for many staff
members to be employed. Additionally, Torrey, Tepper, and, Greenwold (2011) stated that
integrated treatment is long term and the process can be long to successful treatment. This
extensive time frame for treatment can present as a weakness, where individuals may
struggle to remain engaged and committed.ClientJack is a 35-year-old man, who is
presenting with symptoms suggesting a mental health disorder and substance abuse
disorder. He reports hearing voices, the inability to speak clearly and in an organized
manner, and behaviors which have caused him to be unable to maintain a job. Jack is
diagnosed with schizophrenia. In addition to this diagnosis, Jack has been utilizing drugs.
Van Wormer and Davis (2018) shared that 50% of those diagnosed with schizophrenia have
comorbid substance abuse. Jack presents with significant symptoms related to his mental
health diagnosis. Due to his presentation, working with Jack from the quadrant model, he
fits into category II (Van Wormer & Davis, 2018) as his schizophrenia is more
severe. Assessment and treatment need to be appropriate for Jack. Lubman, King, and
Castle (2010) shared that there needs to be comprehensive assessment with access to a
large range of interventions. Assessment can assist with understanding the severity of the
disorders Jack presents with. This can allow clinicians to understand where Jack is and help
him receive treatment in the best environment. As stated, he fits in category II, where he
would receive treatment in a mental health system. Lubman et al. (2018) shared that
psychopharmacological intervention is appropriate for treating schizophrenic symptoms
with comorbid substance use. This is important for Jack, as medication can work to limit his
experienced schizophrenic symptoms. Further, psychosocial interventions are appropriate,
which is a must in conjunction with medication (Lubman et al., 2018). It is important to note
the need for different interventions and the concept of the impact on both disorders.
Lubman et al. (2018) shared that one intervention alone was not successfully, but including
cognitive behavioral therapy (CBT), motivational interviewing (MI), and family work prove
to be successful. Again, this speaks to the need for an integral approach. Utilizing CBT and
MI with Jack can assist him with understanding presenting symptoms, potential warning
signs for psychosis and relapse, and help him to understand how his disorders impact his
life. His understanding of the negative impact can support his want to change, impacting his
dedication and commitment.Conclusion Individuals presenting with co-occurring
disorders need to receive integral treatment, as they need to be addressed in their entirety.
Understanding the needs of individuals with co-occurring disorders is important. Integral
treatment approaches encourage the best treatment, as both disorders and their specific
impacts are addressed.ReferencesLubman, D. I., King, J. A., & Castle, D. J. (2010). Treating

5. comorbid substance use disorders in schizophrenia. International Review of Psychiatry,
22(2), 191. Retrieved from https://search-ebscohost-
com.ezp.waldenulibrary.org/login.aspx?direct=true&db=edb&AN=50872258&site=eds-
live&scope=siteTorrey, W. C., Tepper, M., & Greenwold, J. (2011). Implementing integrated
services for adults with co-occurring substance use disorders and psychiatric illnesses: A
research review. Journal of Dual Diagnosis, 7(3), 150–161.Van Wormer, K., & Davis, D. R.
(2018). Addiction treatment: A strengths perspective (4th ed.). Boston, MA: Cengage.Bottom
of FormRequired Resources Van Wormer, K., & Davis, D. R. (2018). Addiction treatment:
A strengths perspective (4th ed.). Boston, MA: Cengage. Chapter 4, “Substance Misuse
with a Co-occurring Mental Disorder or Disability” (pp. 151-190) Drapalski, A.,
Bennett, M., & Bellack, A. (2011). Gender differences in substance abuse, consequences,
motivation to change, and treatment seeking in people with serious mental illness.
Substance Use & Misuse, 46(6), 808–818. Retrieved from the Walden Library databases.
Kennedy, K., & Gregoire, T. K. (2009). Theories of motivation in addiction treatment:
Testing the relationship of the transtheoretical model of change and self-determination
theory. Journal of Social Work Practice in the Addictions, 9(2), 163–183. Retrieved from
the Walden Library databases. Kerfoot, K., Petrakis, I. L., & Rosenheck, R. A. (2011).
Dual diagnosis in an aging population: Prevalence of psychiatric disorders, comorbid
substance abuse, and mental health service utilization in the Department of
Veterans Affairs. Journal of Dual Diagnosis, 7(1/2), 4–13. Retrieved from the Walden
Library databases. Lachman, A. (2012). Dual diagnosis in adolescence—An escalating
risk. Journal of Child & Adolescent Mental Health, 24(1), pv–vii. Retrieved from the
Walden Library databases. Torrey, W. C., Tepper, M., & Greenwold, J. (2011).
Implementing integrated services for adults with co-occurring substance use disorders
and psychiatric illnesses: A research review. Journal of Dual Diagnosis, 7(3), 150–161.
Retrieved from the Walden Library databases. Woods, M. R., & Drake, R. E. (2011).
Treatment of a young man with psychosis and polysubstance abuse. Journal of Dual
Diagnosis, 7(3), 175–185. Retrieved from the Walden Library databases.