The dual diagnosis staff screens applicants for admission on an elective basis, with primary focus on acceptance of chemically dependent individuals with motivation, who have the desire for sobriety and need for psychiatric treatment. Admission is denied to those not highly committed to the process of recovery. A comprehensive history and physical examination are done on the day of admission.6 Appropriate laboratory studies are done. Feedback about the patient from family, a previous physician, or through other means greatly improves the evaluation. In this population, establishing a productive therapeutic alliance is critical to gaining trust and keeps the patient in the program.
Psychiatric management follows a thorough evaluation of all signs, symptoms, and history.
Psychotherapy, individual counseling, and group therapy are provided, as are educational and recreational activities. With its strong peer group involvement, AA is a potent factor in confronting denial. Each individual receives support in this manner. They are instructed to choose as sponsors recovering individuals who have maintained steady recovery for at least 1 year. Double Trouble is a new type of 12-step program8 for persons with both a psychiatric disorder and an addiction.