Empowering people with concurrent disorder in a clinical context: a structural perspective.

Concurrent Disorder (CD) is a nascent area of study relative to mental health and addiction. Conceptions of effective treatment and desirable outcomes in the field remain contested. In my examination of CD literature, most researchers concluded the preferable outcomes of treatment to be a reduction or cessation of mental health symptoms and abstinence from substance use. The preferences of people with CD were largely absent in the literature review I conducted. The dissonance between CD literature and my structural social work values prompted me to adopt an empowerment lens for my practicum. Empowerment is defined in this report from a structural perspective. Structurally informed empowerment acknowledges that systematic discrimination is a factor precluding people with CD from living as they desire. In a clinical setting, the reduction of adverse effects from CD and oppression are the most prevalent forms of empowerment. Empowerment in a clinical context is aided by utilizing the recovery movement in determining what people define as a meaningful life recovery from CD is possible with the continued presence of mental health symptoms and substance use. Shared decision making (SDM), harm reduction, personal medicine, and treatment modalities are possible empowering clinical methods to enact a person's vision of recovery. Common needs for the increased well-being of people with CD were ascertained through dialogue and observation at the practicum site. Resources to contribute to fulfilling many of the needs were available in Prince George, British Columbia, yet knowledge of their existence is often esoteric. Social workers in the clinical context are able to address many of the needs in micro and mezzo capacities. --Leaf i.