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Co-occurring care · one team · one recordDual diagnosis virtual IOP: both conditions, one team
Treating the drinking in one place and the depression in another is how people end up with two plans that contradict each other. Dual diagnosis care means the same clinical team holds both, in the same record, at the same time.
Co-occurring conditions treated together, not in sequence.
Dual diagnosis, also called co-occurring, means a substance use disorder and a mental health condition present at the same time. Shift treats alcohol, opioid, stimulant and polysubstance use disorders alongside depression, anxiety, PTSD, bipolar and other mental health conditions, with one team, one record and one treatment plan.
The clinical work is cognitive behavioural therapy, dialectical behaviour therapy, motivational enhancement and interviewing, and trauma-informed care, delivered as individual and group sessions by California-licensed clinicians. Psychiatry sits on the team, so medication management happens inside the program rather than in a separate referral loop. If you already have a prescriber, we work with them rather than displacing them.
Intake starts with an ASAM-aligned biopsychosocial assessment, which is also where the level of care is set. Not every co-occurring presentation belongs in an outpatient program, and the screen says so when that is the answer.
What integrated care means in practice.
A substance use disorder and a mental health condition at the same time. Co-occurring is the same thing.
Alcohol, opioid, stimulant and polysubstance use disorders.
Depression, anxiety, PTSD, bipolar and other co-occurring conditions.
The same clinical team holds both sides, so the two plans cannot contradict each other.
On the team, for medication management inside the program. We coordinate with an outside prescriber when you have one.
CBT, DBT, motivational enhancement and interviewing, trauma-informed care.
An ASAM-aligned biopsychosocial assessment at intake, which also sets the level of care.
Three to five a day on weekdays, morning, afternoon or evening cohort, all by secure video.
Family programming and a couples track when they are clinically indicated.
42 CFR Part 2 protections apply to the substance use treatment record throughout.
Eating disorders, obsessive compulsive disorder as a primary presentation, and acute psychiatric stabilization. We name who does, rather than taking a case we should not hold.
We read your plan before you commit to anything.
Covered by many PPO plans. We check your benefits first.
Shift bills most major commercial plans on an out-of-network basis, and in-network credentialing is in process. We read your plan, tell you what it pays toward intensive outpatient care, and give you that number in writing before your first appointment.
Medi-Cal. We cannot bill Medi-Cal today, because we hold no county contract yet. If Medi-Cal is your coverage, tell us and we will point you to a county provider who can help now.
More on coverage: what it costs, what out-of-network means, your carrier.
The ones people ask first.
Are both conditions treated at the same time?
Yes. That is what integrated means here: one assessment, one team, one plan, rather than treating the substance use first and the mental health condition afterwards.
Do you prescribe medication?
Psychiatry is on the team and medication management happens inside the program when it is part of the plan. If you already have a prescriber we coordinate with them, with a signed release.
Can I keep my own psychiatrist or therapist?
Yes, and we would rather you did. We coordinate with a release and hand the work back at the step down. See what happens after IOP.
Is a virtual program enough for co-occurring conditions?
For some people at this level of care, and not for others. That is what the clinical screen decides, and it will route you to a higher level of care when that is the right answer. How the decision is made is here.
What if the mental health condition is the bigger problem?
Say that at the screen. The assessment weighs both, and the resulting plan reflects which one is driving the week.
Bring both halves to the screen.
A benefit check and a short clinical screen, and a straight answer about whether this level of care fits what is actually going on.
If you or someone you are with is in immediate danger, call or text 988 (the Suicide and Crisis Lifeline) or call 911. Shift Support Network is an outpatient program and is not an emergency service. Related: What we do · Family program · Do I qualify · Levels of care.