COUN 5223

COUN 5223 Week 9 Assessment 1 Consultation, Supervision, and Advocacy Plan Student Name Capella University COUN 5223 Professor Name Submission Date Attention Deficient and Hyperactive Disorder co-occurring with Substance Use Disorder Substance use disorder (SUD) significantly complicates the delivery of behavioral health services to people who have ADHD. Services must be designed to meet the behavioral health needs of people who have ADHD and SUD. People experiencing this dual diagnosis are known to have challenges such as relapse, poor performance, and emotional dysregulation. It is known that about 25-30% of adults who are in treatment for substance use disorders have ADHD (Barbuti et al., 2023). This article reviews the historical development of clinical mental health counseling for people with a dual diagnosis of ADHD and SUD. Additionally, it reviews the role of a community-based service in the comprehensive care system and describes models and methods for the provision of on-site and outreach consultation, supervision, and advocacy services. Serving Individuals with ADHD co-occurring with SUD Particularly challenging are individuals with Attention Deficit Hyperactivity Disorder (ADHD) alongside a developing Substance Use Disorder (SUD). These individuals belong to the developing group referred to as adolescents, between the ages of 12 and 18 years, when the individual starts developing their sense of identity, but is also most vulnerable to engaging in risky behaviors. The ADHD symptoms of inattention, impulsivity, and dysregulation can predispose individuals to experiment with substances during adolescence. Young et al. (2023) indicate that ADHD and SUD co-occurrence is evident and can be directly linked to environmental influences. Integrated counseling approaches, which combine ADHD symptoms and substance use behaviors, are necessary to address this group of adolescents. Counselors would employ structured and systematic interventions that include behavioral and relapse prevention therapies and pharmacological interventions to enable adolescents to gain self-regulation and control, reduce their substance use, and achieve sustained recovery. Historically, mental health systems separated the treatment of adolescents with co-morbid ADHD and SUD. Relapse rates were high as treatment sought to remediate substance misuse with no consideration for ADHD. Modern ADHD treatment practices recognize the importance of integrated and coordinated care in addressing the combination of ADHD and substance misuse behaviors (Srichawla et al, 2022). One of the most widely researched counseling practices for this population has been cognitive behavioral therapy (CBT). CBT helps improve their impulse control and coping skills and adjust their dysfunctional thinking. Additionally, Haugan (2022) expressed the importance of careful consideration in the regulation of stimulant medications and the inclusion of sustained-release or non-stimulant options, as this can mitigate some of the risks of developing SUD in the presence of ADHD. These innovations to address behavioral substance misuse and ADHD significantly transformed the clinical mental health care practices for adolescents, emphasizing the need for integrated and evidence-based treatment. Counseling Services across the Continuum of Care Ambrosia Behavioral Health is a behavioral health treatment center located in South Florida that offers a diverse range of services to customers experiencing issues with both behavioral health and substance use. Some of the organization’s programs include outpatient and inpatient therapy, intensive outpatient therapy, partial hospitalization therapy, and a range of traditional and integrative holistic therapies such as medicinal therapy, mindfulness therapy, and wellness therapy (Dfasam, 2026). Thus, Ambrosia Behavioral Health is positioned throughout the behavioral health continuum of care, with an emphasis on the range of residential, partial hospitalization, and intensive outpatient services. These programs are designed to offer supportive therapeutic structure to individuals who are in need of more than conventional outpatient services, yet do not require the acute level of therapeutic intervention that is offered in a hospital setting. To provide comprehensive services, the agency partners with health and community service providers across the full range of mental health continuum services. Individuals with severe psychiatric symptoms who also have physical health complications or who are in crisis are referred to an inpatient psychiatric hospital to provide daily medical supervision and care. Individuals on an inpatient unit who show symptoms of improvement are transitioned to an intensive outpatient program. This outpatient program allows individuals to attend therapeutic group sessions during the weekday while leaving the program to attend to their obligations. Therapeutic groups are held on a daily basis and allow the individual to be present during work, school, or home obligations for the duration of the program. Services that promote recovery after one is discharged from an intensive therapeutic program and provide counseling that addresses the prevention of relapse, recovery support services, and community mental health services are geared toward the promotion of sustained recovery and the prevention of relapse. These services are especially important to persons with ADHD and those individuals who have challenges with substance use disorders. Consultation Plan This consultation plan will utilize Caplan’s Mental Health Consultation Theory with a specific focus on the Program-Centred Administrative Consultation Model and associated strategies. The strategies mentioned will include needs assessment as well as interdisciplinary case consultation meetings, staff training on both CBT and Motivational Interviewing (MI), and the use of proprietary ADHD and substance use screening assessment tools. (Isaacs & Duncan, 2025). The aim of the consultation is to enhance the provision of integrated services for adolescents presenting with co-occurring ADHD and SUD. In agreement with Caplan’s consultation model, the first step of the consultation process is the assessment of the needs and requests of the agency. This is in order to better understand the prevailing treatment approaches, the systems of referral, and the staff and team capabilities with respect to understanding and treating ADHD and substance use disorders (Dfasam, 2026). This entails the analysis of the agency’s treatment policies, case/clinical documentation, and the interviews of the agency’s staff and administrators. The goal is to identify the gaps in the agency’s coordinated/integrated care. The next step involves the initiation of specialized training and consulting for the clinical personnel. Training will cover the use of evidence-based treatment such as Cognitive Behavioral Therapy and Motivational Interviewing. These therapies are mostly used for treating clients with co-occurring mental and behavioral