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General

Double Trouble: Mental Illness and Addiction, Part 2

On Wednesday, we featured the first part of our interview with Dr. David Sack, psychiatrist and CEO of Promises Treatment Centers. Today, we continue our conversation about co-occurring mental illness and addiction, also known as dual-diagnosis, with Dr. Sack. RZ: Today, more and more addiction and mental health treatment providers are recognizing that co-occurring disorders are quite common. It used to be that addiction treatment programs didn't always recognize that large percentages of their clients were mentally ill chemical abusers (MICAs), unless their mental illness was very apparent. Now mental health care providers are getting on the bandwagon and beginning to recognize that many of their patients are medicating themselves with everything from wine to prescription pain killers to illicit drugs—leading to potentially serious chemical abuse problems. Do you have any suggestions about how to motivate mental health care patients to be more upfront about substance abuse?


Depression

Double Trouble: Mental Illness and Addiction, Part 1

In the past few years, more and more states as well as the federal government have begun to examine the complex relationship between substance abuse and mental illness. Having been involved in both addiction and mental health treatment for over two decades, I can attest to the fact that though plenty of people struggle with both issues simultaneously, many of them don’t get correctly diagnosed. Frequently, patients are diagnosed with either a mental health problem or an addiction. This means that an important part of their treatment is missing. Dr. David Sack, a psychiatrist who is certified in psychiatry, addiction psychiatry, and addiction medicine and is the CEO of Promises Treatment Centers, a California-based treatment program, has generously agreed to discuss co-occurring mental illness and addiction, also known as dual-diagnosis.


Your Mental Health "To-Do" List

To give our readers a better sense of what an effective mental health treatment plan looks like, I have been recreating a treatment plan here through a series of blog posts. To see other posts in this series, please click here. If your therapist is the GPS, you are the driver. Ultimately, you have control over where you are going emotionally.* Therefore, outlining courses of action that you will take is as vital to your success as are your therapist’s courses of action, which we discussed in our blog post Your Therapist's "To Do" List. The next section of the mental health treatment plan I use is called the Patient’s Objectives—in a nutshell, your own “to do” list. These objectives are the actual courses of action you will take to help you reach your goals. They will usually be a reflection of your therapist’s objectives.


Communication

New Video Series: How to Talk to Your Therapist—or Anyone Else!

What can you do to get the most out of your therapy sessions? What basic communication and relationship skills (see videos, below), can you learn in order to improve all your relationships, not just your relationship with your therapist? One day a few months ago, I was doing a weekly training for therapists and one of them said, "I wish my patients could sit in on this training—it would be really beneficial to them." Bingo! It occurred to me that if I could distill some of the information about communication skills that I impart to therapists and patients—keep the content simple and the explanations brief—it might help patients get more from therapy.


interviews

Part II: Near-Death Experience Changes Therapist's Life and Work

On Friday, we featured the first part of our conversation with psychotherapist and Is God Pink? author Mary Jo Rapini, MeD, LPC, who told us about her near-death experience after suffering a cerebral aneurysm. Today, Mary Jo’s story continues with her return to this world. “Suddenly I was back in this place. My husband Ron was shaking me and crying—he was really the one who suffered during my illness. He told me I might not be able to run or walk and asked me if I understood what this meant. He then told me that he wanted me to be strong. He said, ‘You are so strong, Mary, please don't die.’” “I told him, ‘I'm not going to die, Ron. I just talked to God and he won't take me.’”


Your Therapist's "To Do" List

To give our readers a better sense of what an effective mental health treatment plan looks like, I have been recreating a treatment plan here through a series of blog posts. To see other posts in this series, please click here. The next section of the mental health treatment plan I like to use is number three—the Therapist’s Objectives—in a nutshell, your therapist’s “to do” list. These objectives are the actual courses of action that your therapist will take to help you reach your goals. They may be very specific, and describe the methods and techniques (also known as interventions), that your therapist will be using. Or, they may be more general.


General

Near-death Experience Changes Therapist's Life and Work, Part I

Today we’re taking a break from the discussing the sections contained in the treatment plan to share with you the story of the life-changing events that happened to psychotherapist Mary Jo Rapini, MeD, LPC, author of Is God Pink? Ms. Rapini has been featured on TLC’s new series, Big Medicine. She has also appeared on CNN Prime News, CBS, The Discovery Channel, Montel, Fox National Morning News, and more. She is a contributing expert for Cosmopolitan magazine, Women’s Health, First, New York Daily News, Seventeen, Redbook, and Self. She also writes for the Houston Chronicle and Houston Family Magazine. She is the Intimacy/Sex psychotherapist for the Pelvic restorative center at Methodist Hospital in Houston, Texas, and also has a private practice. Ms. Rapini is the author of Is God Pink?, the story of her near-death experience. She also authored Dying to Heal and is co-author of Start Talking: A Girl’s Guide for You and Your Mom about Health, Sex or Whatever. Keep up with Mary Jo Rapini or learn more about her at maryjorapini.com. She shared her story with us over the phone. Mary Jo Rapini, a sex therapist with a flourishing practice, lived with her husband, a physician, and their children in Houston, Texas. One day, everything changed. Her husband was offered a job in Lubbock, a conservative town in West Texas, smack in the middle of the “Bible Belt”. Here's her story, in her own words:


How to Move Towards Emotional Well-Being: Treatment Goals

To give our readers a better sense of what an effective mental health treatment plan looks like, I have been recreating a treatment plan here through a series of blog posts. To see other posts in this series, please click here. The next section of the mental health treatment plan I use is called the Treatment Goal, or Goals. I’ll introduce this section with an excerpt from Therapy Revolution: Find Help, Get Better, and Move On (Without Wasting Time or Money): Treatment goals are the patient’s clinical (and sometimes life) goals as described in the treatment plan. You and your therapist have to know where you are going in order to get there! Therapy that meanders on without a clearly defined destination (and perhaps a couple of important pit stops on the way) reminds me of a scene in an old movie where the distraught hero jumps into a cab. “Where’re you going, buddy?” asks the cabbie. Our hero says, “Nowhere in particular. Just drive.” That’s a fine idea if you’re a hero in a black-and-white movie trying to forget your broken heart, but a terrible idea if you are in therapy. Your primary destination must be the completion of your treatment goal(s).


What's the Problem?

A reader suggested that it would be helpful to see an actual mental health treatment plan. In order for you to better get a feel for what a treatment plan is, and why every therapy patient should have one, I am going to recreate a treatment plan here over the course of several blog posts. It is important to understand that though there is common ground between treatment plans—especially treatment plans for patients facing similar problems, there is no such thing as a standard treatment plan because each treatment plan must be individualized for each patient. Also, it is useful to note that psychotherapists have many different—and valid—ways of assembling a written treatment plan. My plan is a 10 section plan and is based on a synthesis of existing plans. I use this plan format because it works well for me and for patients, and I train my staff to use this approach as well. It is the plan described in my book, Therapy Revolution. However, as long as treatment plans are written, contain the basic information I will list in these blog posts, and are referred to and updated frequently during the course of treatment, the format used is immaterial.