Concurrent Disorders Specialist (Psychology, BA)

Aaron Argenti, Grand River Hospital

By: Megan Gregorchuk, Outreach & Support Peer

Aaron Argenti graduated from Laurier with a BSc Psychology degree in 2010. He had always contemplated teaching or research as a possible career path, even having started his undergraduate degree in chemistry. Along the way, Aaron realized people made a lot more sense to him than thermodynamics. Following graduation, he completed a one-year diploma in Addictions & Community Service Work and later obtained his Canadian Addictions Counsellor Certification from the Canadian Addiction Counsellors Certification Federation (CACCF). Aaron gained frontline addiction experience through his work at Grand River Hospital Withdrawal Management and at Homewood Residential Treatment Program as an Addictions Counsellor. He also worked for Here 24/7, the central access for Mental Health, Addiction and Crisis services in the Waterloo Wellington region. Eventually, he transitioned to working as a Concurrent Disorders Specialist at Grand River Hospital in both the acute inpatient and tertiary inpatient adult mental health units.

A typical day as a Concurrent Disorders Specialist begins with ‘rounds’. This is when all parties involved in the treatment of a patient meet as a team to discuss the patient’s status and treatment plan. This team typically involves the patient’s psychiatrist, nurse, social worker, occupational therapist, recreational therapist, and possibly a psychologist. The majority of Aaron’s day is spent conducting one-on-one patient counselling or group-based interventions involving education on substance use and mental health. Aaron also drafts treatment plans and performs case management tasks, which typically involve meeting with family members and/or liaising with community staff outside the hospital who are also involved in the patient’s life. At day’s end, all the above activities must be recorded.

Post-graduation, Aaron began to develop a strong interest in positions that would offer him the opportunity to work with overlapping addictions and mental health issues. Concurrent disorders refers to those instances where substance abuse and mental health challenges converge simultaneously. The complexity of working in this overlap is one of Aaron’s favourite aspects of his career. He says the nature of this work can make people feel that there’s no hope, but there is. Getting the right support and coming up with the right solutions can significantly affect the patient’s quality of life and Aaron finds it rewarding to witness a patient’s progress.

According to Aaron, open-mindedness, adaptability, and a good degree of personal resiliency are essential skills and attributes to be successful in this role. Being a Concurrent Disorders Specialist involves remaining open-minded in order to work with patients where they’re at, not based on external expectations. Adaptability comes into play, as you often need to challenge societal and patient expectations such as the idea that treatment will “fix” them or “undo” prolonged substance use that has led to a mental health diagnosis. A Concurrent Disorders Specialist has to set aside their own judgments and preconceptions about people and what they should do. Often, it is assumed that the first goal is to get a patient sober, but unfortunately, it is not that clear cut as patients’ lives are often complex and being able to ‘think in shades of grey’ is required to find solutions. You have to be able to work with trial-and-error, and when encountering an error, be able to say, “Okay, well, what can we do next?” Personal resiliency is helpful to be able to push through challenges faced when working with complex patients and adjust expectations when treatment doesn’t go perfectly to plan. Aaron highlights that this is a tough population to work with as they’ve been marginalized, oppressed, and they carry an increased risk of fatality. Resiliency is key as all of these things can take a personal toll.

Aaron points out that he took the least intensive educational training path to secure his current role, which resulted in six to seven years of experience before attaining a specialist position. He believes a Master’s degree could’ve secured such opportunities in much less time. Therefore, one of the best training routes to becoming a Concurrent Disorders Specialist (and the training route most people take), is typically through either a Bachelor’s or Master’s degree in Social Work. The concurrent disorders field is large and encompasses many possible careers, including occupational therapists, registered nurses and registered practical nurses. This work can occur in almost any area, as it is becoming widely understood that treating addiction separately from overlapping mental health isn’t effective. Therefore, the concurrent disorders field extends into hospitals, residential treatment, outpatient programs, policymakers developing capacity in government, and anywhere within the mental health or addiction fields.

For students intrigued by this field, Aaron recommends using LinkedIn to research and target the career area. Students with interests in substance abuse and/or addictions counselling should direct their attention to the Canadian Centre on Substance Use and Addiction and the Canadian Addiction Counsellors Certification Federation websites for more information.

In Aaron’s opinion, the Concurrent Disorders field is rapidly growing in size as substance abuse is increasingly recognized as a mental health condition rather than a choice. This augments treatment options, and thus jobs, as it is realized that getting the patient sober isn’t always the best or most realistic first step. Due to the increasing favourability of treating disorders concurrently, Aaron sees many opportunities for advancement and change within the field. From the front lines, to management, to more specialized environments, to private practice, there is plenty of variety within the field.

Aaron highly recommends volunteering. Getting exposure to this population of people will help you to figure out if it’s the right career for you, while also contributing valuable experience to your resumé that can jumpstart your career right out of school. From someone who took the unregulated healthcare route, Aaron advises that, if you know that becoming a Concurrent Disorders Specialist is of interest, take a regulated educational route (as noted above). He says it will open more doors for you right out of school, rather than having to complete six to seven years of additional experience before qualifying.