An Integrated Treatment: Treatment for Dual Diagnosis And Childhood Abuse Trauma

1 INTRODUCTION The conceptual understanding and application of the dual diagnosis model of substance abuse treatment has evolved since its' inception in the New York State mental health system during the early 1980's (Sciacca, 1996), and its' subsequent expansion throughout the substance abuse treatment field through the present. The same need to provide a more comprehensive and complete treatment model which prompted the initial development of the dual diagnosis treatment model is still a motivating factor in refining known practices, as well as searching out and defining the unknown factors to be addressed to ensure that dual diagnosis clients receive the optimal treatment necessary for successful recovery from a life of substance abuse and addiction. In order to reach this ideal of optimal level of treatment other factors beyond mental illness and addiction must be investigated within the dual diagnosis model of treatment. The factors that will be addressed in this research will be the compounding effect of childhood abuse and the long term of effects childhood trauma on dual diagnosis clients in regards to addictive behaviors and substance abuse treatment and recovery success. The term dual diagnosis is used to describe the co-morbidity of substance abuse issues and the presence of Axis I, and Axis II psychiatric disorders. Axis I disorders are classified as clinical disorders, whereas Axis II disorders are classified as personality disorders and/or mental retardation. The clinical disorders include 2 Disorders, and other conditions that may be a focus of clinical attention. Personality Disorders are defined as " prominent maladaptive personality features and defense mechanisms " , (Diagnostic and Statistical Manual of Mental Disorders, Fourth Ed., Text Revision, APA 2000). Statistics have shown that up to 50% of those with mental illness have some form of substance abuse problem, and that up to 37% of alcoholics and 53% of drug addicts are actively suffering from a mental illness, 18 and older, (1 in 4 adults) have some form of diagnosable mental disorder within a given year, and the statistics further indicate that those with a chronic, serious mental illness is about 6%, (1 in 17) of the United States population. Additionally studies on the subject of childhood abuse have indicated that up to 25% of American women, and up to 16% of American men have experienced some form of sexual abuse as children, (Finkelhor, 1994). The numbers of those in the population with mental illness, the …