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Intensive Outpatient Programs

Co-occurring Disorders Dual-diagnosis Treatment

Co-occurring Disorders Treatment (Dual-Diagnosis) with eating disorder treatment at Rebecca's House, we utilize a strong clinical model, which is an essential feature of successful care for most individuals suffering eating disorders defined in the DSM-IV-TR, such as anorexia nervosa, bulimia nervosa, or an eating disorder not otherwise specified (EDNOS).  Why is building upon a strong clinical foundation so important?  The statistics may surprise you:

—In a major Swiss study, researchers discovered that nearly 84% of women (or about 5 out of 6) with an eating disorder had one or more additional psychiatric disorder.

—Of these women, more than a quarter of them had at least one suicide attempt (SA) in the past and also more than a quarter of these eating disordered individuals were currently having suicidal ideation (SI). 

—Indicating additional risk, there is the NEDA statistic that of all other mental illnesses, it is an eating disorder, anorexia nervosa, that carries the highest premature mortality rate among females.  Despite such risk, only 6% of individuals with bulimia and 33% of individuals with anorexia seek treatment for their mental health needs. 

—Further, a recent SAMHSA study indicates that among individuals with at least one serious mental disorder and a substance use disorder, almost half of them receive additcion treatment, eating disorder treatment, or mental health treatment of some kind.  However, only 11.8% (about 1 in 9) of them receive treatment for both their mental illness as well as their substance use disorder. 

What can we extrapolate from the data, and what does it really mean to us?  It means that most people with multiple disorders need help desperately but very few receive the kind of treatment they need. 

What is key in our clinical paradigm for eating disorder treatment is our integrated approach to treating not just the eating disorder but simultaneously treating any additional mental health and substance used disorders that may be—and in fact, usually are—co-occurring disorders.  

What defines having a “co-occurring disorder”?  When you have at least one substance use disorder in addition to at least one mental illness, then you have a co-occurring disorder (COD).  This used to be called having a “dual diagnosis” or “dual disorders,” but these were misnomers because often, it's not just “dual” but actually “multiple” disorders you may be experiencing. 

Mental illness and chemical dependency or abuse usually occur simultaneously, so we address them simultaneously.  Many people come to us having addressed their chemical dependency problem first at another treatment program and now want to address their eating disorder.  That's a beneficial scenario because in that case, we continue to help you maintain your successful recovery from alcohol and drugs while also beginning your successful recovery from compulsively disordered eating. 

There are nearly countless examples of co-occurring disorders:  For instance, you might have bulimia nervosa, major depressive disorder, and alcohol dependence all occurring simultaneously.  You might have anorexia nervosa, polysubstance abuse, generalized anxiety disorder, and borderline personality disorder co-occurring.  You might have a binge eating disorder not otherwise specified, marijuana abuse, and post-traumatic stress disorder (PTSD).  The co-morbidity among many these disorders is quite high, so we see them co-occur quite frequently. 

Because there's such a need and because integrated care is consonant with our treatment philosophy, we maintain a clinical focus and emphasis on treating co-occurring disorders.  If you're suffering co-occurring disorders, we hope you come to understand that you're not alone.  Millions of Americans (over 5,000,000) are currently suffering co-occurring disorders.  Tragically few of them have sought treatment for both their mental illness and their substance use problems, but you can.     

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