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Program combines treatment for mental health, substance use disorders

Apr. 29, 2021, 9:25 AM

Members of the co-occurring disorders intensive outpatient program include, from left, Susan Crawford, RN-BC, Amy Hulings, LCSW, Jessica Lavender, LPC-MHSP, and Maria Dixon, LMSW.
Members of the co-occurring disorders intensive outpatient program include, from left, Susan Crawford, RN-BC, Amy Hulings, LCSW, Jessica Lavender, LPC-MHSP, and Maria Dixon, LMSW. (photo by Erin O. Smith)

by Emily Stembridge

For people with co-occurring mental health disorders and substance use disorders, finding integrated care that treats both conditions can be a difficult task. Vanderbilt Behavioral Health is seeking to simplify care for these patients through the co-occurring disorders intensive outpatient program (IOP).

“There are lots of programs for behavioral health treatment, and lots of programs for substance use treatment, but they tend to be mutually exclusive,” said Jessica Lavender, LPC-MHSP, director of IOP services for Vanderbilt Psychiatric Hospital. “Co-occurring disorders are extremely common, and we have a need for treating both simultaneously.”

When patients require more than once-a-month appointments with their psychiatrist, but do not need the intensity of a full-time hospital stay, they are considered a good fit for the IOP. Here, they visit four days a week, attending group therapy sessions for a total of three hours a day.

The sessions are all supervised by a board-certified addiction psychiatrist, who is available to ensure IOP is the right program of care, to ensure diagnoses remain accurate, and to address any medication concerns.

The majority of patients in the IOP are existing Vanderbilt patients, and many are referred by physicians at the Vanderbilt Transplant Center, since substance use can worsen patient outcomes before and after a transplant procedure. Patients with a history of substance use problems are required to complete treatment at the IOP before undergoing their transplant.

“The program helped me deal with the problems I was struggling with and gave me the focus to achieve my short- and long-term goals,” said a patient from the IOP who wished to remain anonymous. “My life has changed dramatically since I completed IOP and received my liver transplant. I have a new outlook on life and am grateful for everyone in the program for helping me get through the difficult time in my life.”

Strong connections between the co-occurring disorders IOP and other programs within Vanderbilt Integrated Services for Treatment of Addiction (VISTA) make coordinated care easy for both patients and providers. Since a large majority of the IOP patients are already established in the Vanderbilt network, they feel more comfortable reaching out to the IOP for their services.

“This brings a great deal of continuity of care for the patient and their recovery journey,” said Mariah Smith, MD, assistant professor of Psychiatry and Behavioral Sciences.

“We can connect with their primary care physicians in the outpatient setting, follow them along through the addiction consult service while inpatient, and refer them to our addiction clinics once they have graduated IOP. This brings an invaluable level of wraparound care to our patients that is unique to Vanderbilt,” Smith continued.

“Seeing our patients successfully engage with treatment and get the help they need is one of the most rewarding things to be a part of,” said Amy Hulings, LCSW. “I will always feel honored to be part of their journey and witness them change their lives.”

Since the program began in January 2020, almost 100 patients have been treated by the co-occurring disorders IOP.

“Recovery isn’t always a straight line,” Lavender said. “Offering multiple levels of care ensures we can meet our patients wherever they are on their journey.”

To learn more about the co-occurring disorders IOP program go to

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