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Home > Substance use treatment for persons with co-occurring disorders.

Substance Abuse and Mental Health Services Administration. (2020) Substance use treatment for persons with co-occurring disorders. Rockville, MD: Substance Abuse and Mental Health Services Administration. 346 p. Treatment improvement protocol (TIP) series, no. 42. SAMHSA publication no. PEP20-02-01-004.

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This updated (March 2020) TIP is intended to provide addiction counselors and other providers, supervisors, and administrators with the latest science in the screening, assessment, diagnosis, and management of co-occurring disorders (CODs).

The expansive scope of this TIP covers clinically relevant and program-related concepts, guidelines, and topic areas. The section “Content Overview,” broadly outlines the layout of the publication. The following bullets will orient readers to the location of specific subject matter likely to be of high interest. Note that some of the following content may be mentioned or discussed briefly in other chapters; this listing reflects the primary locations in the TIP.
• Ensuring continuity of care: Chapter 2
• Providing essential program services for people with CODs: Chapter 2
• Determining level of service and how to match treatment: Chapter 3
• Screening and assessing for CODs: Chapter 3 (selected tools are located in Appendix C)
• Addressing suicide risk: Chapter 3 (screening and assessment) and Chapter 4 (prevention and management)
• Using motivational enhancement: Chapter 5
• Using relapse prevention techniques: Chapter 5
• Dealing with common clinical challenges in working with clients who have CODs: Chapter 5
• Understanding culture-specific matters, including how to provide culturally competent services: Chapters 5 and 6
• Modifying treatments for clients with CODs based on treatment setting and model: Chapter 7
• Removing treatment barriers and improving service access for people with CODs: Chapter 7
• Offering integrated care: Chapter 7
• Designing residential and outpatient treatment programs: Chapter 7
• Achieving core provider competencies in working with clients who have CODs: Chapter 8


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