Post by nataliewhite on Jul 5, 2015 3:37:26 GMT
Dual Diagnosis involves psychiatric comorbidity: where the client has a dependence on one or more illicit drugs/alcohol, alongside a diagnosis of a mental health disorder (Prodromou, Kyritsi, E & Evamorfia, 2014).
During the workshop presented to our graduate group, I was surprised by the statistics presented to us regarding the prevalence of dual diagnosis. In particular, I was taken aback to learn that the highest percentage of alcohol abuse occurs in the elderly- when in my mind 18-25 year olds would have been the most likely to abuse this substance. This information has highlighted to me the importance of assessing every client of every age for drug and alcohol abuse and risk factors associated with this.
I also found it beneficial to have the education staff reiterate the importance of approaching clients in a non-judgemental manner whilst discussing their drug/alcohol addiction. Prejudice against people with a dual diagnosis is one barrier to effective treatment this group of clients (Moore, 2013). In my own practice since the workshop, we have had 2 clients admitted to PIIU who have a Hx of drug use, one of which has a partner who still actively uses. I have found that approaching this topic in a relaxed, non-judgement manner allows these clients to comfortably discuss their substance use with staff. We have spent time discussing triggers for temptation to begin using again, and why they have chosen currently to abstain from use. Moreover, we have spent time discussing why they enjoy using, and what they don't like about using the substance. Being non-judgemental allows us as staff to be available and supportive of their needs as clients with a dual diagnosis.
Another beneficial element of the session run was the stages of change which a client goes through regarding their drug dependence and need for change. They assisted us to understand that the stages are not followed sequentially by every client, and clients can jump back and forth through stages. It is important to consider where your client is in the stages of change model, as this will heavily impact upon the kind of care, risks, and referrals they have.
*Pre-contemplation
*Contemplation
*Preparation
*Action
*Maintenance
*Relapse
*Lapse
Another activity which I found to be of use was sorting the street names of different types of illicit substances. This is something that I have little experience with, and found that this activity allowed me to build upon my understanding of the many different names for drugs. Such understanding is of benefit when communicating with clients and speaking to them in their own 'language'.
Overall, the dual diagnosis session run for our graduate group was highly beneficial in educating us about topics and issues surrounding dual diagnosis. The knowledge gained during this session will be highly beneficial in all areas of mental health, and is applicable to both of my rotations for this year.
References
Moore, J. (2013). Dual diagnosis: training needs and attitudes of nursing staff. Mental Health Practice 16(6), 27-31. Retrieved from web.a.ebscohost.com.ezproxy2.acu.edu.au/ehost/pdfviewer/pdfviewer?sid=88512c8b-0b56-49df-94f9-880c876206d9%40sessionmgr4001&vid=0&hid=4104
Prodromou, M., Kyritsi, E., & Evamorfia, K. (2014). Dual diagnosis affects prognosis in patients with drug dependence in integrative care setting. Health Science Journal 8(2), 216-28. Retrieved from web.a.ebscohost.com.ezproxy2.acu.edu.au/ehost/pdfviewer/pdfviewer?sid=d04b320f-9262-49f0-98f0-f4df81205098%40sessionmgr4001&vid=0&hid=4104