DAILY / MAY 5, 2012, VOL. 2, NO. 18   Send Feedback l View Online
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2012 APA's Annual Meeting Special Edition
Holistic Approach to Youth With Psychosis, Substance Abuse Promotes Recovery

Robert DrakeA holistic approach to the treatment of young people who have experienced a first episode of psychosis and who also have co-occurring alcohol and substance abuse disorders may prevent years of disability. Robert Drake, M.D., Ph.D., the Andrew Thomson Professor of Psychiatry and a director of the Dartmouth Psychiatric Research Center at Dartmouth University, explained the concept to an audience at a symposium sponsored by the U.S. National Institute on Alcohol Abuse and Alcoholism symposium titled “Integrating the Full Spectrum of Alcohol and Other Drug Problems in Psychiatric and Primary Care,” at APA’s 2012 annual meeting on Saturday.

Drake related his experiences participating with
westbridge community services, a family-centered treatment program for co-occurring mental illness and substance abuse disorders with locations in Manchester and Medford, New Hampshire. “The overall approach is optimistic,” he said. “We know that most patients recover from a first episode of psychosis. Our goal is to enhance that expected recovery.”

In addition to incorporating the treatment of comorbid alcohol and substance abuse disorders, the Westbridge model uses peer support, especially from previous patients who still live in the community. Family education and support are also key, as is integrated care for any existing medical disorders. “We see this as a holistic approach,” said Drake, who made the case that early and effective interventions may actually save health care costs associated with long-term disability, high health care utilization, and other community costs in the long run.

Drake described one aspect of the program that goes against conventional wisdom, that of encouraging and assisting patients to make a rapid return to work or school. Many treatment programs assume a break from routine tasks is necessary for recovery after a first psychotic episode, but in the Westbridge program, explained Drake, “We often find that it is the job or the school program that keeps these young patients engaged in their treatment.”



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