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Annu Rev Psychol. 2009;60:197-227. doi: 10.1146/annurev.psych.60.110707.163456.

A tale of two systems: co-occurring mental health and substance abuse disorders treatment for adolescents.

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Addictive Behaviors Research Center, University of Washington, Seattle, Washington 98195, USA.


Co-occurring disorders present serious challenges to traditional mental health and substance abuse treatment systems. Among adolescents in need of behavioral health services, co-occurring disorders are highly prevalent and difficult to treat. Without effective intervention, youth with co-occurring disorders are at increased risk of serious medical and legal problems, incarceration, suicide, school difficulties and dropout, unemployment, and poor interpersonal relationships. In general, current service systems are inadequately prepared to meet this need due to a variety of clinical, administrative, financial, and policy barriers. This article presents an overview of co-occurring disorders among adolescents, highlights general considerations for co-occurring disorders treatment, reviews selected treatment models and outcomes, and discusses recommendations and best practice strategies.

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