East Bay Community Recovery Project

This article gives an overview of the development of mutual-help groups for addictive disorders, mental health disorders, and co-occurring disorders. It highlights the history and current status of each type of group, discusses some alternatives to 12-step programs, and describes current challenges and dilemmas. It reports on the limited research on groups for co-occurring disorders and highlights the research in the other areas. It also reviews some of the interventions designed to facilitate the use of mutual-help groups, including groups for individuals with severe mental illness.

The Methamphetamine Treatment Project (MTP) offers the opportunity to examine co-occurring psychiatric conditions in a sample of 1016 methamphetamine users participating in a multisite outpatient treatment study between 1999-2001. Participants reported high levels of psychiatric symptoms, particularly depression and attempted suicide, but also anxiety and psychotic symptoms. They also reported high levels of problems controlling anger and violent behavior, with a correspondingly high frequency of assault and weapons charges. Findings continue to support the value of integrated treatment for co-occurring conditions, especially the importance of training counseling staff to handle psychotic symptoms when needed.

This article describes an adolescent with a history of severe traumatic experiences and treatment in a residential program for chemically dependent, severely emotionally disturbed youths between the ages of 12 and 18. It begins with a description of the long-term treatment program, the types of clients admitted, and the treatment activities provided. Basic findings from an outcome study conducted within the program made predictions regarding the length of time of residential treatment for drug addicted, severely emotionally disturbed adolescents regardless of trauma history. Pretreatment psychiatric functioning was addressed by utilizing GAF scores from the DSM-III-R for each of the participants in the study. Of 102 participants in the study, 34 were survivors of sexual abuse, physical abuse, or devastating natural disasters. A clinical case of a traumatized adolescent is presented in relation to adolescent identity, the distinction between adolescent and adult treatment, and a variety of treatment strategies that can influence an abused adolescent's long-term recovery from both addiction and trauma, including retention in treatment, the developmental stage of adolescence, identification and diagnosis of trauma during adolescence, building a working alliance, individual psychotherapy, psychopharmacology as an aid to psychotherapy, psychological debriefing, and group psychotherapy.