What Are Some Good Assessment Tools Used for Dual Diagnosed Clients?

The term dual diagnosis refers to a person who has been given both mental health and substance use diagnoses by a mental health professional. By understanding the interplay between mental health and substance use problems, clinicians are able to provide the type of treatment interventions that the individual needs. Good assessment tools help clinicians to unravel this interplay and find the right course of treatment.

Client History

• Getting a solid history can help give a clear understanding of the context of substance use and the development of mental health problems. A detailed history includes when substance use started, age and history of mental health symptoms, as well as any past treatment for substance or mental health issues. This information helps the clinician discern whether the mental health or substance use problems started first. Some people with mental health problems may turn to substances in a search for relief from these symptoms. This can lead to abuse and addiction to the substance. In contrast, some people who are addicted to substance use may start to have psychiatry problems, such as substance-induced psychosis.

DSM-IV Diagnosis

• The Diagnostic and Statistical Manual of the American (DSM-IV) is a reference book publish by the American Psychiatric Association and is an important tool for diagnosing both mental health and substance use problems. Clinicians can use the DSM-IV in order to match the symptoms that the client has with different diagnostic criteria. In so doing, the clinician can start to differentiate what role substance and mental health plays in the person's life and how these interact.

Observation

• Observation is an important assessment tool. Paying attention to the client's current symptoms and behaviors can give the clinician a lot of information about what might be going on for the client at the moment. For instance, a client who is unable to sit still and has pressured speech may be in a manic mood and may be suffering from bipolar disorder. However, it is also important to consider that a client who has recently used cocaine may also show "manic" symptoms. In order to get a true diagnosis and to see what issues are contributing to these symptoms, it is important for the clinician to observe the client over time. For instance, it is easier to get an accurate mental health diagnosis when a client has been abstinent from drugs or alcohol for a period of time.

Consult

• Most mental health clinicians work as part of a team. Working in conjunction with other professionals can be a helpful tool to assess dual diagnosis. This gives the clinician a second opinion from another professional who can offer a different perspective. Similarly, other professionals may offer a different area of expertise. Most treatment teams include psychiatrists, doctors, psychologists, social workers and nurses. Consulting with these professionals may help the clinician to see different causes for symptoms and contribute to a more accurate assessment.