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Dan Pickett
President, Hudson Equity
TRI’s solution will define the behavioral health industry’s best practice for assessment and treatment for the foreseeable future.  The benefits to patients, providers and payers are unmatched.
Anthony V. Rubonis, Ph.D.
President, Metric Moon Research
TRI has developed sophisticated and comprehensive assessment/treatment planning instruments, which provide an uncompromising balance of psychometric quality and clinical utility. These instruments are derived from sound theoretical principles. TRI's commitment to scientific excellence in behavioral health is laudable.
September 2004
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A couple of decades ago, the terms "dual diagnosis," and "co-occurring disorders" emerged, recognizing the significant percentage of individuals who struggle with both substance abuse and mental illness.

Fragmentation of the existing public-sector treatment delivery system and inadequacies in treatment approaches became apparent and were identified as limiting the success of rehabilitation efforts.

In reaction, efforts were made to reduce fragmentation of treatment delivery systems and improve treatment approaches (i.e., increase dissemination of information about advances in treatment, efforts to improve communication/coordination between substance abuse and mental health providers, and the promotion of "parallel treatment").

More recent literature encourages progressing beyond parallel treatment to the development of integrated treatment models and comprehensive treatment by one provider.

Numerous treatment models emerged integrating aspects of existing substance abuse and mental health treatment (Carey 1996; Mercer et al. 1998; Minkoff 1996; Ziedonis & Trudeau 1997). Unfortunately, these integrative approaches have not been widely adopted.

Several factors impede the adoption of integrated treatment (e.g., differences in clinical training among providers, restrictions from licensing and governing bodies, billing practices and payment sources, limited transfer of information between research and treatment providers, etc.).

A salient factor limiting treatment integration is associated with how the dual diagnosis population is viewed. Typically, dual diagnosed individuals are seen as predominantly having a combination of mental health and substance abuse problems that need to be addressed. Clinical experience and research show this view to be narrow. The problems this population experiences are far more complex and extend into a greater variety of life areas.

Clinician training biases the clinician to focus on either mental health or substance abuse treatment. This unilateral training focus, not only impedes integration of substance abuse and mental health approaches, but also is inconsistent with the development of a broader, more holistic model.

This comprehensive, holistic model should outline the different life dimensions constituting an individual's functioning, and the interconnectedness among such dimensions. This model should organize current treatment approaches and facilitate the development of future treatment interventions. Integration of this model into one's practice should be supported by assessment/treatment planning instruments consistent to the model. The MTM achieves the above objectives.

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