Co-occurrence of these disorders occurs with sufficient frequency in both systems that a continuous and integrated approach to assessment and treatment is required, regardless of the location of initial clinical presentation. For persons with more serious co-occurring disorders, continuity of integrated treatment is significantly associated with better outcome and reduction of more expensive service utilization. Consequently, the service system for persons with co-occurring disorders must develop mechanisms for identifying all such persons with serious symptomatology, and establish a collaborative system of continuous care management for those persons. A goal of the service system is to provide persons with co-occurring disorders early access to continuous integrated treatment relationships which can be maintained over time, through multiple episodes of acute and subacute treatment, and which are independent of any particular setting or locus of care. The co-occurring disorders treatment and recovery process can be divided into similar phases for each disorder.
Models based on readiness for treatment and level of engagement exist.
Engagement and Motivational Enhancement Interventions designed to establish a primary clinical relationship and to facilitate the person s ability and motivation to initiate and maintain participation in a program of stabilizing treatment. Active Treatment to Maintain Stabilization Interventions of any type which are designed to stabilize the symptoms of the disorder, prevent relapse, and help persons to maintain a stable baseline and optimal level of functioning. Rehabilitation and Recovery Interventions designed to help persons to develop new skills, reacquire old skills, and achieve personal growth and serenity, once prolonged stabilization has been consistently established. With all models, the phases of treatment are not necessarily linear or sequential. With various clients, phases of treatment for psychiatric and substance disorder often differ, and persons may move in either direction from one phase of treatment to another.