Co-Occurring Disorders Among Adolescent Treatment Populations

Update from CSAT’s Co-Occurring and Other Functional Disorders Cluster Group

SAMHSA’s Center for Substance Abuse Treatment (CSAT) provides funding for many innovative treatment activities across the United States. One CSAT initiative that is having a significant impact in closing the national treatment gap is the Targeted Capacity Expansion Program (TCE). Within the TCE program, CSAT requires each grantee to collect specific accountability data and to produce research findings concerning the population and treatment strategies for dissemination to the field. One way each grantee participates in this process is by joining a CSAT-sponsored group of grantees (or “cluster”) serving similar populations and addressing similar issues. A cluster provides grantees the opportunity to exchange information, collaborate around common interests, enhance program management, share treatment strategies, collect and analyze data across multiple sites, and facilitates an open exchange between grantees and CSAT.

In 1999, several grantees asked CSAT to consider the development of a cluster to address the growing population of individuals with co-occurring substance-related and mental health disorders. CSAT agreed to sponsor this new cluster and during the past year a group of grantees has been meeting with the goal of improving services for consumers with co-occurring disorders. Almost immediately, this group realized that not only mental illness, but a wide range of other disabilities, complicated recovery from addictions. These include physical disabilities, sensory disabilities, traumatic brain injury, and cognitive disabilities, all creating significant challenges in daily living and recovery. The group therefore adopted an inclusive definition of Co-Occurring and Other Functional Disorders (COFD) as:

“the simultaneous existence of a substance use disorder interacting with one or more independent DSM-IV Axis I or II mental disorders and/or a cognitive/physical/sensory/ and/or developmental disability. The disorder/disability is of a type and severity which exacerbates the substance use disorder or other conditions, and/or complicates treatment of the substance use disorder, and/or interferes with functioning in age-appropriate social roles.”

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