Co-occurring Disorders Worksheets PDF

Common co-occurring disorders

Co-occurring disorders, where mental health challenges develop and intertwine with substance use issues, present a complex landscape in healthcare. Here are examples of common mental health disorders and substance use problems.

• Depression and alcohol use disorder
• Anxiety disorders and substance abuse
• Bipolar disorder and cocaine addiction
• PTSD and opioid use disorder
• Schizophrenia and cannabis use disorder
• ADHD and nicotine dependence
• Eating disorders and stimulant abuse
• Borderline personality disorder and alcoholism

Symptoms of co-occurring disorders

There are a variety of symptoms that can be related to addiction and mental health issues. This is simply the nature of co-occurring disorders. Here are some symptoms that may be suggestive that an individual has an addiction or more than one mental health disorder from Causes & Effects of Co-Occurring Disorders (2024):

Behavioral indicators

• Coping with anger or sadness by using alcohol or drugs
• Noticeable shifts in personality
• Isolation from family or friends
• Abandoning previously valued activities
• Unpredictable behavior
• Episodes of heightened energy
• Associating with drug-using individuals
• Displaying aggressive behaviors

Physical manifestations

• Insomnia or hypersomnia
• Malnutrition
• Substantial weight loss or gain
• Excessive fatigue
• Poor hygiene

Cognitive indicators

• Paranoia
• Panic
• Confusion episodes
• Disorientation
• Lack of focus
• Blackouts/loss of consciousness

Psychosocial indicators

• Unwarranted anger or aggression
• Dramatic mood swings
• Intense agitation and impatience
• Hostility toward others
• Prolonged periods of profound sadness
• Sense of invincibility or omnipotence
• Episodes of emotional detachment
• Self-hatred
• Suicidal ideation

How to use the co-occurring disorders worksheet?

Using this worksheet within therapy sessions has never been easier. We've created a step-by-step instruction set that is easy to follow.

Step 1: Obtain the worksheet

You can do this by navigating the Carepatron templates page. You can save and download the document to your device for electronic use. Or, if you're happier using a physical copy, you can go ahead and download and print from your device.

Step 2: Talk with your client

As with other mental health treatment worksheets, reviewing this worksheet with your client is a good idea. This worksheet is designed for you to set it as either a homework task or a task during the session. Either way, individuals will need guidance before or during working through this worksheet - so now is an excellent time to offer that support.

Step 3: Review the completed worksheet

You and your client can work through the completed worksheet together during your next therapy session. This feedback can support understanding the difference in the treatment goals and how it would be best to work through the specific difficulties they are facing.

Step 4: Create a treatment plan

Using the information provided by the client, you (with your client and family's input) can work to create a treatment plan that is going to be beneficial. Ask questions about what might work and who else can be supportive. This is also a good time to answer any questions, feelings, or concerns the client may have.

Step 5: Store the worksheet

After completion, storing this worksheet within your client's file is a good idea. This allows you to review information they have provided at a later date. You'll be glad you can easily store information like this worksheet securely within the Carepatron system.

Treating co-occurring disorders

When it comes to the psychological treatment of co-occurring disorders, an integrated treatment approach has been consistently found to be superior. Rather than having a separate treatment for both mental health disorders, an integrated approach allows both disorders to be treated at the same time (National Institute on Drug Abuse, 2020).

An integrated approach to treatment typically involves using Cognitive Behavioral Therapy (CBT) strategies to boost interpersonal skills and develop coping skills. As well as using approaches that identify and name triggers to support motivation and functional recovery (National Institute on Drug Abuse, 2020).

According to the National Institute on Drug Abuse (2020), individuals who are suffering from comorbid mental health issues often exhibit lower treatment adherence as well as elevated rates of treatment dropout. The good news is that there has been ongoing research into established treatment modes for comorbidity. This will allow individuals and mental health professionals to decide on treatment options that will be most beneficial for the patient.

During treatment for co-occurring disorders, sharing the treatment plan is an essential component of recovery. Often involving collaboration between clinical providers and organizations, individuals are supported by both sides of the treatment plan. National Institute on Drug Abuse (2020) suggests that communication is a vital resource for recovery for both the patient and the mental health professional during treatment.

There are a range of behavioral therapies that the National Institute on Drug Abuse (2020) suggests can be helpful for patients struggling with co-occurring disorders. These are:

• Dialectical Behavior Therapy (DBT)
• Assertive Community Treatment (ACT)
• Therapeutic Communities (TCs)
• Contingency Management (CM)
• Motivational Incentives (MI)
• Exposure Therapy
• Integrated Group Therapy (IGT)
• Seeking Safety (SS)

References

Causes & Effects of Co-Occurring Disorders. (2024). Life Center of Galax. https://www.galaxrecovery.com/dual-diagnosis/signs-symptoms-effects/

National Institute on Drug Abuse. (2020, April). What are the treatments for comorbid substance use disorder and mental health conditions? National Institute on Drug Abuse.

What Are Co-occurring Disorders? (2024). Caron Treatment Centers. https://www.caron.org/addiction-101/co-occuring-disorders/what-are-co-occurring-disorders