Dual Diagnosis

When a person is said to be dually diagnosed, it means that he or she has serious psychiatric problems and also struggles with alcohol or drug abuse/addiction. Other descriptive labels include MICA (Mentally Ill, Chemically Addicted) and MISA (Mentally Ill Substance Abuser).

Regardless of terminology, this problem is not uncommon – it affects about 10 million Americans. At any given time, over half of Project Transition’s members are considered to be dually diagnosed. The person might have been drinking or taking drugs prior to coming to PT. It’s also possible that these behaviors occurred months or years before, yet still represent a zone of vulnerability related to psychiatric difficulties.

The diagnostic, treatment, rehabilitation, and relationship needs of a person who is dually diagnosed are wrought with some unique challenges: hazardous self-medication urges, substance-induced psychiatric ‘crashes’, health risks, the effects of addictive behavior on relationships, and others. These complexities – as well as each person’s assets and strengths – call for a balanced, clinically informed approach that is focused, occurs over time, and features supportive relationships.

Substance abuse treatment and relapse prevention activities are an integral part of Project Transition. Our Certified Addiction Counselors (CAC’s) are experienced specialists in the dual diagnosis field. They work with each PT member for whom drugs and/or alcohol are an active or potential trouble spot. Weekly recovery groups utilize cognitive-behavioral, psychoeducational, and dialectical techniques that support abstinence and recovery. Individual sessions also occur. A number of our members also actively participate in ongoing AA, NA, and Double Trouble support groups.

Self-management: A Cornerstone of Project Transition

For some members of PT, acute episodes of emotional distress are characterized by relapse. While it’s natural to hope that it will not happen again, experience has shown us that a self-management approach helps the person develop confidence and self-direction, even in highly stressful situations. It also tends to reduce the frequency and severity of relapse.

The path toward self-management relies upon self-acceptance, which includes a practical understanding of ones’ vulnerabilities, as well as his or her coping strengths. This sets the stage for the learning and practice of skills, sustained relationships, and a sense of belonging. These elements are reinforced throughout Project Transition, where belief in self-management is “in the air”. It may be discussed in the flow of daily problem-solving, addressed in therapy, and talked about in community meetings. Self-management is a core theme in our relapse prevention training, which is taught in workshops and therapy. It’s also discussed a lot among staff, PT members, and family members.

Mastery in self-management includes:

  • Understanding the nature, symptoms, and pattern of one’s psychiatric disability
  • Identifying the stages and signs of relapse
  • Developing helpful, accessible supports such as peers and staff, friends, family members, mental health services, and preferred medications
  • Practicing ways to forecast, modify, and manage stressors and tension
  • Applying pro-active, adaptive coping responses to stress and emergent symptoms
  • Learning from relapses that do occur by identifying what new coping strategies and supports are needed, then practicing them.

To get a feel for what a typical week at Project Transition is like, visit our Program page.