The comprehensive analysis delves into mental and behavioral health disorders frequently comorbid with substance abuse and alcohol disorders. It encompasses evaluations, differential diagnoses, and acute, sub-acute, and long-term treatment phases. This content is pertinent for individuals aiming to fulfill addiction certification education prerequisites.

Developed by: Karen Albig Smith, LMFT, LCAS, MAC, CAP, SAP, SAE

Last revision:  2024

Description: What is the most common coexisting condition among those with psychoactive substance use disorders?  How does one distinguish between blackouts and dissociation?  When is it confabulation or memory failure due to intoxication? What are the specifics in evaluating and treating depression or anxiety with substance-involved patients?  Using current literature this program overviews incidence and prevalence information, and contraindications for treatment where psychoactive substance use disorders are co-present with mental and nervous disorders.  Specifically, the study will include the DSM5 criteria for determining diagnosis, various statistics on addictions clients that may present with coexisting disorders, and information concerning the concomitance, co-occurrence, and comorbidity of these disorders in the addictions population.  Later sections discuss mood disorders, anxiety disorders, personality disorders, psychotic disorders and other problems that present among those with addictions and other populations.


  1. Learners will be able to discuss the incidence and prevalence various coexisting conditions as they may present with substance abuse problems.
  2. Learners will be able to describe a methodology for assessment of coexisting conditions.
  3. Learners will be able to utilize guiding principles for systems and providers in providing care for people with co-occurring conditions.
  4. Learners will be able to discuss the treatment similarities and differences across three service systems.
  5. Learners will be able to observe for DSM criteria for each of six disorder groups.
  6. Learners will be able to utilize epidemiological trends to improve differential diagnosis.
  7. Learners will be able to discuss acute, subacute and long-term treatment phases for persons with co-existing illnesses.
  8. Learners will be able to explain the utility of motivational interviewing, and stages of change in working with co-occurring mental illnesses.

Learning Assessment   Learners will be able to:

Define six terms used to describe co-existing conditions
List two criteria used to determine substance-induced disorder.
Discuss the incidence and prevalence of co-occurring illness across six disorder groups.
List the six principles guiding systems of care for people with a co-occurring illness.
List the six principles that guide provider activity for people with co-occurring disorders.
Compare and contrast treatment approaches in mental health, dual disorder and the addiction treatment systems across five domains.
List the DSM5 criteria for six disorder groups. (Mood disorders, anxiety disorders, psychotic disorders; personality disorders, selected other conditions and the psychoactive substance abuse disorders)
Distinguish antecedent and precipitous relationships within and among the six disorder groups.
Identify at least three key elements in the differential diagnosis of persons with co-existing disorders.
Describe specific concerns in the acute and sub-acute treatment phases for patients across the six disorder groups.
List the six stages of change used in motivational interviewing and specific application for a dual disorder.
Describe the five principles of motivational interviewing and correlates to co-existing conditions.

CE Credits: 9

Training Agenda:
Hour One:  Introduction and Definitions Coexisting Disorders.
Hour Two:  Substance Abuse Disorders.
Hour Three: Alcohol Abuse Disorders.
Hour Four:  Mood Disorders.
Hour Five: Anxiety Disorders.
Hour Six: Personality Disorders.
Hour Seven: Psychotic Disorders.
Hour Eight: Other Disorders.
Hour Nine: Posttest.

CE Broker#:  20-11232

Methods: Pre-test, study guide, posttest and evaluation, internet sources via URLs, Q&A by email.

Content Areas: Clinical evaluation and assessment, Understanding addiction, Social and clinical foundations, Co-occurring disorders, Addictions, Dual disorder, Special populations, Behavior disorder

Purpose:    Practitioners completing this course will be better equipped to observe for diagnostic criteria indicating coexisting illness, and better able to work with multi-disciplinary treatment efforts and further, to equip the practitioner to intervene and improve outcomes and client retention.

Target Audience:  Social workers, marriage and family therapists, licensed professional counselors, mental health counselors, nurses, employee assistance professionals, addiction professionals, behavioral health technicians, and other allied professionals who may work with these populations.



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