Integrated Scope of Practice for Singly Trained Clinicians Working with People with Co-Occurring Issues

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  • Convey a welcoming, empathic attitude, supporting a philosophy of dual recovery.
  • Screen for comorbidity, including trauma history.
  • Assess for acute mental health/detoxification risk, and know how to get the person to safety.
  • Obtain assessment of the comorbid condition, either one that has already been done, or, if needed, a new one.
  • Be aware of—and understand—the diagnosis and treatment plan for each problem (at least as well as the person understands them).
  • Support treatment adherence, including medication compliance, 12-step attendance, etc.
  • Identify stage of change for each problem.
  • Provide one-on-one and group interventions for education and motivational enhancement, to help people move through stages of change.
  • Provide specific skills training to reduce substance use and/or manage mental health symptoms or mental illness (e.g., help people to take meds exactly as prescribed).
  • Help the person manage feelings and mental health symptoms without using substances.
  • Help the person advocate with other providers regarding mental health treatment needs.
  • Help the person advocate with other providers regarding substance abuse/ dependence treatment needs.
  • Collaborate with other providers so that the person receives an integrated message.
  • Educate the person about the appropriateness of taking psychiatric meds and participating in mental health treatment while attending 12-step recovery programs and participating in other addiction treatment support systems.
  • Modify (simplify) skills training for any problem to accommodate a person’s cognitive or emotional learning impairment or disability, regardless of cause.
  • Promote dual-recovery meeting attendance, when appropriate for the person and such meetings are available.