Guiding Principles of Treatment


The Substances Abuse and Mental Health Services Administration's (SAMHSA's) Co-occurring Center for Excellence (COCE) publication provides 12 over-arching principles for working with persons with co-occurring disorders (CODs) to help guide, but not define, systemic and clinical responses. Full text is available here. 

  1. Systems planning must address the need to serve people with CODs.
  2. Integrated system of mental health and addiction services emphasizes continuity and quality.
  3. The integrated system of care must be accessible from multiple points of entry (no wrong door) and be perceived as caring and accepting by the consumer.
  4. System of care for CODs should not be limited to a single "correct" model or approach.
  5. Partnership between science and service supports evidence- and consensus-based practices.
  6. Behavioral health systems must collaborate with professionals in primary care, human services, housing, criminal justice, education and related fields in order to meet the complex needs of persons with CODs.
  7. Practitioners must expect CODs when evaluating and treating any person.
  8. Within the treatment context, both CODs are considered primary.
  9. Empathy, respect and belief in the individual's capacity for recovery are fundamental provider attitudes.
  10. Treatment should accommodate the specific needs, personal goals, and cultural perspectives of unique individuals in different stages of change and treatment.
  11. The special needs of children and adolescents must be explicitly recognized and addressed.
  12. The contributions of the community to the course of recovery and the contribution of consumers with CODs to the community must be explicitly recognized.

Center for Substance Abuse Treatment. Overarching Principles to Address the Needs of Persons With Co-occurring Disorders. COCE Overview Paper3. DHHS Publication No. (SMA) 06-4165 Rockville, MD: Substance Abuse and Mental Health Services Administration, 2006.