Now is the Time to Address Co-Occurring Disorders

As Houston’s leading nonprofit provider of prevention, education, and outpatient treatment services for addiction and co-occurring mental health disorders, The Council on Recovery has helped thousands of people enter recovery and families heal. As a leader though, it is our obligation to do more than serve. We need to look to the future, embrace behavioral health innovations that are grounded in evidence, and inspire others in times of uncertainty.

Over the past year, The Council has led just such a charge, through the formation of The Center for Co-Occurring Disorders. The Center is a groundbreaking initiative designed to address co-occurring mental health disorders concurrently. When we launched The Center, we knew there was an urgent need for these services; we also knew that if we wanted this effort to succeed – and to last – we had much more to learn.

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Our history in the behavioral health field told us that our efforts had to be disruptive. There have been far too many efforts to treat co-occurring disorders that have fallen short because those involved held on to the status quo; others could not conceive of how to reconfigure the existing frameworks; still others sought a one-size-fits-all solution; and others focused solely on direct services without modifying the systems in which they operate.

We knew The Center had to be different.

Our first year was a time to envision, generate ideas, and challenge existing systems. Through this process, we recognized that the approach to treating co-occurring mental health disorders needs to be multi-dimensional and uniquely catered to the individual patient. Here’s what we accomplished in the first year of this initiative:

  • We assessed the readiness of The Council’s own treatment programs to address co-occurring disorders in our clients.
  • We formed an advisory board comprised of leaders from the health, psychiatry, addiction and IDD (intellectual and developmental disability) fields.
  • We launched a 6-part workshop series that trained medical professionals in Houston to understand and address co-occurring mental health disorders, free of charge.

And these are just the first steps. Moving forward we intend to incubate, test and adapt the best models of assessment, treatment and payment. We will continue to educate the medical community on various aspects of co-occurring disorders, including their connection to trauma and suicide. We will continue to empower and equip healthcare providers with the skills and tools necessary to effectively and compassionately help those in need.

The Impact of Addiction on The Family System

This blog post is contributed by Ashley Taylor, MSW, LMSW, of Heights Family Counseling and Rachel Evans, LMSW, of the Center for Recovering Families

When someone we love deals with addiction, wishful thinking tends to surround their recovery. We think to ourselves, “If this person just gets better, then everything else will fall into place.” No matter how desirable that outcome, substance use disorder is a systems disease that requires a systems solution. Substance use disorders not only affect the person suffering, but also the people closest to them.

“By the time people get treatment, the family system has often regulated around the addiction to maintain the status quo,” says Rachel Evans, family therapist at the Center for Recovering Families. “The addiction has become the locus of control.”

Everyone who is involved in the system has adapted in ways they might not even recognize in order to maintain a sense of normalcy and peace, while watching someone they love battle a difficult disease. Because of this, many families are exhausted by the time their loved one enters treatment. Regardless of the ways in which the support system has regulated itself around the addiction, the relationship between the person dealing with substance use disorder and their families can be an important one.

impact of addiction on family system

“The collaborative effort of treatment is very beneficial,” says Rachel. When appropriate, having family members present for treatment improves success rates, and treatment benefits both the person struggling with substance use disorder, as well as the family members. When it comes to recovery, it is crucial that everyone is willing to do things differently in order to set family recovery at the core of the system. Through family recovery, everyone is able to gather and understand different strategies for coping with the new way of life for this person, as well as unlearning potentially harmful practices that had been in use prior to the recovery process.

This help can take the form of family treatment, support groups such as Al-Anon and Nar-Anon, and even individual therapy. When an entire system is affected, addressing the entire system is the most effective treatment. This takes the responsibility off one individual and makes the process a collaborative one. In this way, the person going through recovery can feel more supported in their journey, and feel the love and encouragement from those closest to them.

The process of addiction recovery is rarely linear, nor does it only impact the person working to overcome substance use disorder. When addiction is viewed as a systems disease, it can be addressed throughout the whole system. By viewing this process in a more collaborative light, we are able to better support and understand the journey of our loved ones.

If you or a loved one is struggling with substance use disorder, call us today at 713.914.0556, or contact us through our website.

The Council Responds to the State of Emergency on Child and Adolescent Mental Health

The American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry and Children’s Hospital Association declared a state of emergency in child and adolescent mental health, citing the ongoing COVID-19 pandemic and the inequities that result from structural racism. The Council on Recovery remains steadfast in our goal to help any and every child and adolescent affected by substance use and other mental health disorders in the midst of these national crises.

Child and adolescent mental health had worsened in the decade before the pandemic, with suicide becoming the second leading cause of death among this population by 2018. This only intensified with the challenges children and adolescents faced in the last year and a half. Students lost consistent access to friends and adults supports. Many took on new responsibilities, including childcare, housework and part time jobs, putting added pressure on developing minds. Tragically, more than 140,000 children in the U.S. lost a primary or secondary caregiver to COVID-19, with youth of color disproportionately impacted.

child and adolescent mental health

With substance use disorders and overdoses continually skyrocketing across all demographics, we commend and support the proposals included in this state of emergency declaration, including but not limited to:

  • Increase federal funding dedicated to ensuring all families and children can access evidence-based mental health screening, diagnosis, and treatment to appropriately address their mental health needs, with particular emphasis on meeting the needs of under-resourced populations.
  • Improve access to technology to assure continued availability of telehealth to provide mental health care to all populations.
  • Increase implementation and sustainable funding of effective models of school-based mental health care.
  • Fully fund comprehensive, community-based systems of care that connect families in need of behavioral health services and supports for their child with evidence-based interventions in their home, community or school.
  • Promote and pay for trauma-informed care services that support relational health and family resilience.

“One thing we know is that children and adolescents are 100% our future,” says Alejandra Ortiz, LMSW, adolescent therapist at the Center for Recovering Families, “And it is our responsibility that they feel empowered and safe enough, physically and mentally, to take on the curve balls life can throw at them.”

The Council’s Center for Recovering Families offers assessment, counseling, education and support for children and adolescents. This can include parent consultations and coaching as well. To learn more about our Children & Adolescent Services, call 713.914.0556, or contact us through our website today.

The Impact of Family Roles on Addiction

This blog post is contributed by Lori Fiester, LCSW-S, MAC, CIP, CDWF, Clinical Director for The Council on Recovery

Have you ever wondered why some families seem to have roles in their family? I’m not talking about the roles of mom, dad or siblings, but roles people assume throughout their lives. As a therapist and an adult child of an alcoholic, I’ve been aware of my role in the family, both at work and in relationships. I’ve often joked that I didn’t become a social worker because I like people, but because I was born into this role. I am the hero child! And I worked hard to be that way… until it stopped being functional.

family roles

Family roles can happen in a family system where there has been upheaval, but they are usually solidified if that upheaval becomes a chronic occurrence, like in addiction. Basically, the family system strives for equilibrium.  Equilibrium is what holds the family steady. Family members slip into their roles to re-establish equilibrium when faced with anxiety. For instance, when one member is struggling, usually the system helps that one member gets back on their feet, and the system returns to normal.  When addiction occurs, the anxiety becomes chronic, and the roles are then utilized until eventually they become part of our behavior pattern – all in the name of equilibrium. 

Frequently observed family roles:


The addict is the one who is addicted to a substance and is the person the family revolves around to unconsciously provide equilibrium.

The enabler or caregiver is most likely the significant other. That role entails making sure everyone is happy and ensuring the addict suffers no consequences. Enablers often lose themselves in the lives of others.

The hero ensures that the everyone in the family looks good by overachieving, overdoing, and perfection.

The joker keeps the family laughing, which helps distract the members from the pain and suffering.

The lost child’s job is really to stay out of the way and not create any concern for the family or cause further distraction.

The scapegoat is similar to the joker, which is to provide distraction for the family through rebellion and drama.

If you or a loved one is struggling with addiction or a related mental health disorder, The Council can help you and your whole family to break these roles and recover together. For more information, or to get help, call us at 713.914.0556 today or contact us here. Telehealth options are available.

How Can We Fix Texas’ Mental Healthcare Crisis?

This blog post is co-authored by The Council on Recovery’s President & CEO Mel Taylor, MSW, and Executive Vice President Mary Beck, LMSW.

Substance use is a primary driver of readmission to the hospital and/or criminal justice systems.  If we addressed substance use disorders in conjunction with mental health disorders, the number of people in need of care would significantly decrease. Yet time and again, substance use is viewed as a secondary concern and not as a confounding disease affecting the majority of people with a mental health disorder.

As we read Alex Stuckey’s three-part series How Texas Fails the Mentally Ill, we were met with a mix of emotions. On the one hand, it is heartening to see a light being shined on this decades long travesty – a crisis that strips people of their dignity and basic human rights; that tells people they have to wait, homeless on the streets or in jail to get the care they desperately need. On the other hand, it is concerning to see the pronounced blind spot regarding co-occurring mental health and substance use disorders that exists among healthcare providers, behavioral health providers, policy makers, and the community at large.

According to the National Institute on Drug Abuse, multiple national population surveys show that about half of those who experience a mental illness during their lives will also experience a substance use disorder and vice versa. And the coronavirus pandemic is only making matters worse. A recent study conducted by The Recovery Village asked 1,000 American adults about their use of drugs and alcohol in the past month, and 55 percent reported an increase in their alcohol consumption in the past month, with 18 percent reporting a significant increase. When asked what prompted their substance use, respondents cited stress, boredom, and an effort to cope with anxiety or depression.

mental healthcare screening

At The Council on Recovery, we’ve watched this dynamic intensify over the past year, with more clients struggling with relapse, suicidal ideation, and overdose. So what can be done? First, we must acknowledge and embrace the fact that the mental health care system is in disarray, and if co-occurring substance use disorders continue to be discounted and dismissed, it is unlikely that outcomes will improve.

Beyond that, we know that we cannot overcome this crisis if fragmented policies and underfunding continues. Texas needs a comprehensive analysis and long-range plan for the entire system, led by behavioral health experts who equally represent substance use and mental health disorders. The plan must study leading-edge best practices for the treatment of co-occurring disorders. Most importantly, it must identify multiple financing options that incentivize public and private providers – as well as payers – to participate in the plan and to provide best practice care.

Last fall, The Council on Recovery launched The Center for Co-Occurring Disorders as just such an initiative.

This multi-partner Center will explore and document current best practices, conduct evaluation on models of care, and identify and advocate for financing options. Led by The Council, other partners include The Harris Center for Mental Health and IDD, Harris County Psychiatric Center, Baylor College of Medicine and Harris Health, as well as a psychiatrist in private practice and community members with lived experience.

Over the last 75 years, The Council has witnessed the changes in the landscape of behavioral health care unfold in real time, along with the devastating consequences. In the wake of the pandemic, the oncoming tidal wave of mental health and substance use disorders will undoubtedly inflict even more suffering on the individuals trapped within our broken system.

But we can turn the tide.

Initiatives like The Center for Co-Occurring Disorders can help to educate the public, policy makers, and behavioral health professionals about the crisis in our mental healthcare system. Together we can advocate for legislative priorities that support these efforts. Because doing nothing is not an option.

If you or someone you love is struggling with substance use or a co-occurring mental health disorder, contact The Council today. We offer telehealth services to all who need it, regardless of their ability to pay.

The Importance of Treating Substance Use & Mental Health Disorders Together, with Dr. Kimberly Parks

This fall, The Council launched the Center for Co-Occurring Disorders, a groundbreaking initiative designed to address substance use and mental health issues together.

Substance use and mental health disorders often go hand-in-hand, with the National Institute on Drug Abuse estimating that about half of those who experience a substance use disorder will experience a mental illness during their lives and vice versa.

Despite the well-established link between these conditions, many treatment providers cannot or do not address substance use and mental health together, which leads to increased costs, duplication of services, and – most importantly – poorer outcomes overall. The Council launched our Center for Co-Occurring Disorders to respond to this critical challenge.

In this episode of Healing Choices, we will explore the connection between substance use and mental health, as well as the challenges and benefits of treating these conditions together. Plus, we’ll explore this history of substance use and mental health treatment in Houston – and how for 75 years, The Council has played a role in advancing care, research, and training around these life-changing conditions.

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