ABSTRACT
Traditional helping approaches concentrate on the ‘problem’ and emphasise the need to understand it and to recognise where it comes from in order to begin to do something about it. This assumes that problems and symptoms are at the centre of the person’s life and, thus, are the focus for interventions. When working with people with complex needs — that is, with coexisting mental health and substance misuse problems’ — traditional, orthodox treatment approaches are based around practitioners establishing the chronology of presenting problems, and determining whether they require independent treatment or whether treating one will help alleviate the other. In mental health–substance use problems, practitioners often see the solution as simple: stop the addiction or limit the effects of the mental illness and this will allow the person to change. The individual problems of mental health–substance use act on each other synergistically to create a complicated and sometimes intractable situation.
