Concluding remarks

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Although much of this review of treatments leaves many questions to be answered, there are some guiding principles that tend to be repeated throughout. It is clear that much more research is needed before definitive practices that will improve outcomes for both mental health and AOD use disorders can be prescribed. Despite this, it can be generally concluded that treatments that work for a single disorder will lead to some improvements in clients with co-occurring conditions, if not in both disorders. Although integrated treatments appear beneficial for some disorders, further investigation is needed [659, 666–669, 954].

For most co-occurring conditions, both psychotherapy and pharmacotherapy interventions have been found to have some benefit. Both of these require some basic knowledge or qualifications on the part of the AOD worker. In particular, psychosocial interventions tend to be based on motivational and cognitive behavioural approaches and AOD workers will benefit significantly if trained in these intervention styles. It is generally acknowledged that manual-based psychological interventions are easy to administer and are the most effective for CBT-style treatments. It is important to recognise that research demonstrating the potential of other approaches to treating co-occurring conditions, such as mindfulness, contingency management, ECT, and e-health interventions, is growing. For pharmacological interventions, an important role for AOD workers is to inform themselves of the benefits, interactions and possible side effects of the medications prescribed for their clients. Workers can assist their clients with suggestions for medication scheduling as well as providing adherence therapy.

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