Screening and assessment of co-occurring disorders: Towards a phenomenological approach

This paper seeks to challenge traditional approaches to the screening and assessment of concurrent disorders by inviting alternative perspectives of the concept of psychiatric disorder and psychoactive substances. Several approaches are briefly outlined that provide non-medical, front-line treatment staff an opportunity to benefit from the clinical wisdom found within the DSM even when diagnostic information may not be available. The first model refers to symptoms that currently comprise a DSM disorder and transforms each of them from dichotomous, categorical variable to a dimensional, polytomous one. The second model 'deconstructs' the concept of psychoactive substance by focusing on a functional analysis. Finally, the third model re-frames the psychiatric disorder multidimensionally across specific symptoms (i.e. each DSM disorder can be examined at several levels of analysis). The three approaches can be considered both dimensional insofar as they stress the continuum of response on any psychiatric symptom as well as phenomenological insofar as they stress the client's subjective experience of their symptoms and the functional impact of psychoactive substances. © 2007 Springer Science+Business Media, LLC.