Addiction and personality disorders: towards integrated treatment. Implementation in an Axis II treatment team

Abstract

Background: In the Netherlands, mental illness and addiction are treated separately. This has caused problems when treating dual disorders. There is growing consensus in the Netherlands that the integration of mental health care and addiction care may be the best way to treat dual disorder patients. The effectiveness of Integrated Dual Disorder Treatment (IDDT) has been researched for schizophrenia and mood disorders. However, can IDDT be used in the treatment of personality disorders?

Aims: To determine whether the IDDT model can be applied to Axis II patients and to what effect.

Method: A team dealing with AXIS II patients participated in an IDDT pilot implementation project.

Results: An important question at the introduction of IDDT was what would remain of the model when applied to patients with personality disorders? The findings suggest the model has remained intact.

Conclusions: Although working with motivational interviewing and especially stage-wise treatment seem to be of real value; to a greater or lesser degree, all components of the model are currently being used.

Keywords:

• dual disorder
• integrated treatment
• personality disorders
• substance abuse

Notes

1. SAMSHA, IDDT toolkit www.mentalhealth.samsha.gov/cmhs/communitysupport/toolkits/cooccuring/

2. GGZE is the mental health care institution in the Dutch city of Eindhoven and surrounding areas.