TRADITIONAL THERAPEUTICAL APPROACHES:TYPOLOGY AND ANALYSIS
Sequential intervention
DEFINITION: The patient is treated independently and sequentially for each of his pathologies, by independent treatment teams.
CONSEQUENCES:
-The peculiarity of the dual picture as a pathological entity in itself is not recognised, therefore
- The other pathological axis’ impact is not considered in the picture and thus it will consistently interfere, lengthening the treatment and undermining its efficiency.
-It is not technically feasible to achieve the stability when acting on only one of the axes.
Parallel intervention
DESCRIPTION: The patient is treated simultaneously for both pathological axes but by independent technical teams which depend on different treatment centres.
CONSEQUENCES:
- The teams are not coordinated.
- This will lead to overlapping, duplication or interference of interventions.
- The patient receives a treatment focused on a specific problem in each centre, but there is no global approach, and therefore,
- It is impossible to control the other axis’ impact.
Comprehensive Intervention in Non Specific Centres
DESCRIPTION: The patient receives a comprehensive and integrated treatment for both pathologies of the clinical picture by the same Treatment Team.
A non specific centre adapts to the dual Diagnosis treatment via the creation of new treatment programs.
The staff has experience and/or training in one of the axes.
CONSEQUENCES:
- It ensures the idea of a dual picture as a pathological entity in itself needing an appropriate approach.
- A Multidisciplinary technical team is created in order to respond to the patient’s needs.
- The professionals are not specialist on Dual Diagnosis, as they are not experts on one of the axis or in their interaction.
- Complementary actions (not just therapeutic) will be developed with groups that suffer from other pathologies, and the dual patient will notice the inadequacy to his characteristics (i.e.: Work Integration Services)
- It will involve a lower assistance cost than the creation of specific centres.
Comprehensive Intervention in a Specific Centre
DESCRIPTION: The patient receives a comprehensive and integrated treatment for both pathologies of the clinical picture by the same Treatment Team.
The centre is specific and has treatment programs designed for the particularities of the dual patient.
The staff is selected according to their knowledge of dual diagnosis.
CONSEQUENCES:
- The patient receives specialized treatment on a technical level which includes his total dual picture.
- A Multidisciplinary Technical Team is created in order to respond to the patient’s needs.
- If there are no other specific support or follow up resources, the patient will feel more strongly the discrepancy when discharged from the centre.
- Treatment alternatives adapted to each moment of the process will be created.
- It will imply a financial investment at an assistance level.
- It will translate in a pressure release for non specific centres.
- The situation nowadays
- Approach and treatment difficulties
- Traditional therapeutical approaches
- Integrated treatment