TRAINING OF RESIDENTS AND MEDICAL-STUDENTS IN THE DIAGNOSIS AND TREATMENT OF DUAL DIAGNOSIS PATIENTS

Treatment of dual diagnosis patients requires simultaneous treatment o f the addictive and the mental disorders. Available data suggest that this does not happen often. In a survey of several psychiatric service s, the unit chiefs reported that dual diagnoses were underreported, no plans were present for combined treatment, families were infrequently involved, and few referrals were made for combined treatment. There i s a need for competent, experienced clinician teachers who have had po sitive experience with the treatment of dual disorders. The training o f addiction and mental health professionals must include cooperation, understanding, and respect for each other. Cross-training is needed in chemotherapy, psychotherapy, abstinence from alcohol and other addict ive drugs, 12-Step programs, spiritual issues, and milieu therapy. Neg ative attitudes and ignorance must be overcome for this training to ta ke place. Faculty Fellow training programs have provided a beginning i n this direction, but have so far involved few professional schools. S ome examples of training with regard to referrals, prescribing, and ps ychotherapy are given. The importance of supervised clinical experienc e in treating dual diagnosis patients is emphasized. The provision of this experience provides a challenge to specialists in addiction medic ine and addiction psychiatry.