Living it or Learning It: Attitudes and Beliefs about Experience and Expertise in Treatment for the Dually Diagnosed

This article examines mental health and substance abuse treatment providers' attitudes and beliefs regarding the relative values of academic knowledge and experiential knowledge. These two forms of “knowing” increasingly come into conflict as providers from the two service systems work together to provide services to individuals with co-occurring disorders. Data to address this issue were obtained from seven focus groups conducted with 48 substance abuse and mental health treatment providers and stakeholders in Los Angeles County. Findings suggest the tenuous role of experience-based knowledge within the emergent framework of dual diagnosis treatment and its emphasis on the professionalization of providers. The article raises concerns as to how differing, and often competing, treatment approaches affect the provision of care for this population and questions how these tensions will be resolved within efforts to increase collaboration between the two systems in providing services to dually diagnosed patients.