Dual diagnosis, co morbidity and co-occurring disorders are terms often used interchangeably to describe mental ill health and substance abuse (drugs and/or alcohol) in various combinations. These disorders may occur at the same time or one may follow the other. Even though the diseases of mental illness and drug abuse are comorbid, causality is not implied and either condition may precede the other (Fortinash and Holoday Worret, 2012).
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The symptoms of one condition may mask or conceal the symptoms of the other, with either condition assuming priority at any given time. Alcohol is the most widely used drug. The National Institute for Clinical Excellence (NICE) estimated in 2011 over 24% of people in England consume alcohol levels that are potentially or actually detrimental to health. The co morbidity of depression and alcohol dependence are two of the most prevalent psychiatric disorders affecting the general population. Evidence suggests that alcohol use disorders are linked to depressive symptoms and that alcohol dependence and depressive disorders co-occur to a larger degree than expected by chance. However, it is not clear whether the depression causes alcohol problems, whether the alcohol consumption or alcohol problems caused depression, or whether both could be attributed to a third cause (Royal College of Psychiatrists, 2015). This assignment will consider the case scenario of Simone part time social worker, aged 43 with depression and alcohol abuse. Simone lives with her three children and the intervention of choice is Cognitive Behavioural Therapy (CBT). This section will define CBT and its uses and adopt the Critical Appraisal Skills Programme (CASP) toolkit (2013) to critically evaluate and discuss two CBT research articles in treating depression and alcohol abuse to evidence why this is an appropriate intervention for Simone. CBT is defined as ‘a talking therapy that can help individuals manage their problems by changing the way they think and behave’ (Frances and Robson, 1997). Commonly used to treat a range of mental health issues including depression, anxiety disorders, phobias, but also deemed valuable in treating alcohol misuse, especially as part of an overall programme of recovery. The goal of cognitive behavioural therapy is to teach the person to become aware of incidences and situations which trigger the need to drink, to learn to avoid putting themselves in these situations and to develop coping strategies to deal with other problems and behaviours which may lead to drinking. Until recently the effectiveness of CBT for comorbid alcohol had not been studied, however, the first of two research articles will now be critically evaluated and discussed below. Developing an Integrated Treatment for Substance Use and Depression Using Cognitive Behavioural Therapy (Osilla et al, 2009) is an American qualitative research article. The research goal was to design and develop a treatment programme for delivery by substance abuse counsellors in outpatient mental health settings.
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