ACS Meets the Challenge: Treating Co-Occurring Disorders

Adolescent Counseling Services (ACS) has long served the mental health needs of teens and their families on the Peninsula.  In 1991, ACS launched the Adolescent Substance Abuse Treatment (ASAT) Program to treat teens with substance abuse and dependency issues.  In the past two years, the program has matured, encompassing multi-modal approaches to treatment for youth who are struggling with issues beyond substance abuse.  “Lately in assessments, we are seeing kids with mental health issues who start using drugs or alcohol at a very early age – 12 or 13,” said Connie Mayer, LMFT, Director of Outpatient Counseling Services.  “With these clients we have to examine which came first: the substance abuse, or the mental health issue that they are trying to manage with using substances?”

What Mayer describes is called a co-occurring disorder, which refers to an individual who has substance use and a mental health disorder at the same time.  These common mental health issues (called Axis I Disorders in the health field) include depression, anxiety disorders, bipolar disorders, and conduct disorders, to name a few.   Currently a majority of ASAT clients have co-occurring disorders.  “When individuals are suffering from any type of mental health disorder, they can begin to self-medicate with drugs or alcohols.  Until treatment begins, the teen and family may have been unaware of the connection between the mental health issues and the substance abuse and that is when the healing can begin,” said Mayer.  With these clients, at first using a substance helped with symptom relief.  What was once an answer to their stressors becomes a bigger problem as their substance use becomes increasingly prevalent.

ASAT therapists use the “Stages of Change” model to assess where ASAT clients are in their recovery.  According to the Substance Abuse and Mental Health Services Administration (SAMHSA), “Stages of Change” are the cognitive and behavioral steps an individual takes to make a change in their life.  The “Stages of Change” are: Pre-Contemplation > Contemplation > Determination (Preparation) > Action > Maintenance.

Treating clients with co-occurring disorders presents new intricacies for ASAT Program staff to ensure clients are receiving the best possible care and treatment plans.  ASAT therapists must work in close coordination with the medical community to appropriately treat these clients.  Many clients with an Axis I diagnosis require medication to manage their disorder.  Specialized training on how to work with co-occurring disorders is provided to ASAT interns so that clients receive the most current and appropriate treatment in the field of substance abuse and addiction.   The ASAT Program is tailored to meet the needs of each teen by providing smaller group sessions, medical referrals if needed, separate individual and family counselors, and other personalized approaches.

Mayer is proud of the work being done in the ASAT Program.  “A solid assessment process, family involvement, group interactions for teens, Motivational Enhancement Therapy, Cognitive Behavioral Therapy, Connectivity to the 12-Step World…we do it all,” said Mayer.  With very few outpatient substance abuse programs specifically for teens in the area, the ASAT Program has seen an increase in referrals from local and private schools, psychiatrists, therapists, and probation departments.  “Providing top-notch care for these teens is our number one priority,” she said.   “Accommodating shifts in what is needed, like working with co-occurring disorders, enables us to provide the best care possible and prepare these future therapists for the changing landscape of the field.”

If you are interested in more information about ACS and the ASAT Program, visit our website ( or contact Connie Mayer, LMFT, Director of Outpatient Counseling Services at or 650-424-0852 ext 104.


  1. Studys Show Substance Abuse Use Higher in Teens with Mental Health Issues | Teen Talk - February 14, 2013

    […] substances?” She talks more about this  in Teen Talk’s January 24, 2013 blog piece “ACS Meets the Challenge: Treating Co-Occuring Disorders” and how ACS’ Adolescent Substance Abuse Treatment Program has adjusted their treatment […]

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