Comorbidity
a training module
This module examines the basic knowledge required for understanding the co-morbidity of substance use and mental health. It aims to equip people with an understanding of mental health disorders commonly associated with substance misuse, the nature of co-occurrence, commonly co-occurring psychological disorders and what the average comorbidity worker might do with it all.
Mental health problems are common in people with substance use disorders. It follows that people without specialist knowledge are likely to encounter these challenges. The module addresses the needs of staff at different levels of expertise and with different treatment roles.
The module has been designed for use in conjunction with result4addiction. It will take you to the relevant content on the website. You can work through the module topics at your own pace, however, to keep up a momentum we suggest you set a timetable. Each topic has a variety of tasks: watching videos, reading scientific articles, taking in checklists, for example. The four topics are summarised below. Each topic has three tasks to complete. The first task will guide you to the website pages where you can find important background information - explore these pages as much as you like. The second task raises a controversial issue in the form of a debating point - the idea is to stimulate your thinking about good practice.
For the third task, ideally you will have convened, or joined, a Study Group (this could be a peer group, just one colleague, or a trusted supervisor) for your topic discussions. Arrange your meeting times right away and use these as the deadline for completion of each topic. The aim of the Study Group is to sharpen up your thoughts on each topic and reflect on your current practice.
Be sure to add your reflections after each task and save them for your portfolio of professional development. Click where you see the lightbulb icon.
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Topic One - comorbidity, anxiety and depression
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First task: explore the resources for this topic
This topic explores the mechanisms of comorbidity and how services might be organised to deal with the variety of problems related to addiction. The topic goes on to look at some common mental health problems, notably depression and anxiety and how best to deal with these.
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Second task: the debate
This task takes the form of a debate to raise a controversial subject about which you are expected to form an opinion. The motion is: 'lifestyle change is the only intervention needed for the treatment of anxiety and depression'.
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Third task: your study group discussion
In discussion with your study group, however you have construed it, clarify your thoughts about these common mental health problems and how you might change your practice. Think about using rating scales to help determine when it is appropriate to refer to specialist comorbidity services.
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Topic Two - substance induced mental illness
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First task: explore the resources for this topic
This topic is all about the most serious mental illnesses that are associated with substance misuse. It is crucial that addiction services can identify these conditions even if the service is not involved in treating them. You will explore some actions that can be helpful.
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Second task: the debate
The motion for the debate is: 'specialist services are not specialist enough if they fail to give vitamin prophylaxis and treatment'.
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Third task: your study group discussion
In discussion with your study group clarify your thoughts about these serious mental illness problems and how you might change your practice. Think about using rating scales to help determine when it is appropriate to refer to specialist comorbidity services.
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Topic Three - personality disorders
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First task: explore the resources for this topic
Personality disorder is a difficult subject and this topic explores the usefulness of the concept and why personality problems and addiction are often associated. There is a focus on emotionally expressive disorders, which commonly co-occur, and treatment with Dialectical Behaviour Therapy.
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Second task: the debate
For this topic the motion is: 'the stigma attached to personality disorder is inevitable'.
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Third task: your study group discussion
Use your study group discussion to check your knowledge of personality disorders and how you might address them in your practice. Think about using rating scales to help determine when it is appropriate to refer to specialist comorbidity services.
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Topic Four - trauma and substance use
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First task: explore the resources for this topic
It is a common finding that people with addiction problems have at some time in their lives experienced trauma, albeit that the trauma might not have been life-threatening, as defined in PTSD. This topic explores the relationship of trauma with addiction and when an intervention is called for.
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Second task: the debate
The controversial motion for this debate is: 'not everybody who has experienced trauma needs or wishes to have trauma treatment'.
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Third task: your study group discussion
In your study group discuss your knowledge about the role of trauma in perpetuating an addiction and how this might best be addressed. Be sure to take a view on when it is helpful to discuss early life trauma and when it is best left alone.
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Meet your tutors…
Dr Gillian Tober
Consultant Addiction Psychologist and previously Head of Training at Leeds Addiction Unit
Dr Duncan Raistrick
Consultant Addiction Psychiatrist and previously Clinical Director at Leeds Addiction Unit
Your learning outcomes…
You will be able to…
understand the mechanisms of comorbidity and ways to organise services
identify common mental health problems, serious mental illnesses and what action to take
demonstrate knowledge of how you address trauma and PTSD
have an understanding of personality disorders