Disorders: A Guide for Service Providers
recently published Treatment Improvement Protocol 42
(TIP 42), Substance Abuse Treatment for Persons With
Co-Occurring Disorders, to help addiction counselors
and other practitioners treat clients with co-occurring
substance abuse and mental disorders.
Often, clients are treated for only one or the other
problem in either a substance abuse or mental disorder
treatment setting, whereas the use of an integrated approach
enhances treatment outcomes. To this end, TIP 42 describes
a variety of practical, evidence- and consensus-based
approaches that can be used in either setting.
TIP 42 cites data from research over the last decade
showing that co-occurring disorders are common, create
multiple problems, and have a profound impact on treatment
processes and outcomes.
Created by a panel of experts and reviewed by the field,
TIP 42 is designed primarily for service providers who
treat clients on a regular basis, but also is useful
for administrators, primary care providers, criminal
justice staff, and other health care and social service
personnel who encounter people with co-occurring disorders.
The TIP contains nine chapters and 14 appendices and
includes case studies as examples for counselors.
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Early chapters cover the treatment of co-occurring disorders
as an evolving field, the important developments leading
to the creation of TIP 42, the publication’s scope
and intended audience, and the criteria used to select
the strategies, techniques, and models that are described
in subsequent sections.
Definitions and terms defines,
describes, and reviews terms and classification systems
for co-occurring disorders as they relate to substance
abuse, mental disorders, clients, treatment, programs,
and treatment systems.
Workforce development addresses
critical issues in workforce development, including
values, competencies, education, and training.
Assessment includes a review of
key principles, highlights of the selected instruments,
and a description of the 12 steps in an “ideal”
assessment process. TIP 42 encourages counselors
to collect patient information on a continuous basis
and to revise assessments often as the patient moves
Treatment approaches provides counselors
with principles, strategies, and models for treating
clients with co-occurring disorders wherever they
come for treatment—including facilities for
treatment of substance abuse or mental health, or
Traditional settings and models
describes practices that have proven effective for
treatment of persons with co-occurring disorders
in residential and outpatient settings. Several distinctive
models are highlighted.
Special settings and specific populations
explores the particular needs of people with co-occurring
disorders within three key “special”
populations: homeless persons, criminal justice populations,
and women. Recommendations cover the means and methods
of providing treatment to clients with co-occurring
disorders in acute care and other medical settings,
and the ways such programs can be sustained. Emerging
“dual recovery mutual self-help” programs
are also described.
Mental disorders contains key information
about substance abuse and particular mental disorders,
highlighting advice to help counselors work effectively
with clients who have co-occurring disorders.
To obtain TIP 42, Substance Abuse Treatment for
Persons With Co-Occurring Disorders, contact SAMHSA’s
National Clearinghouse for Alcohol and Drug Information
(NCADI) at P.O. Box 2345, Rockville, MD 20847-2345. Telephone:
1 (800) 729-6686 (English and Spanish) or 1 (800) 487-4889
(TDD). Ask for NCADI No. BKD515.
For more information, visit SAMHSA’s Co-Occurring
Center for Excellence at www.coce.samhsa.gov.
To Find TIPs Online
For information and online links to other Treatment
Improvement Protocol (TIP) publications, visit
You can review the entire TIP series by topic or
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