This case study reflects the experience of a former Destination Hope client. Identifying details have been removed to protect his privacy. His story shows how our dual diagnosis model treats a mental health condition and substance use as one diagnosis, with a single clinical team and one coordinated plan.
The Client’s Presentation
The client was a man in his early 30s who came to Destination Hope for alcohol use disorder, substance use disorder, depression, and a history of suicide attempts. He reported using substances before the age of 10, and he was first diagnosed with depression after entering treatment for the first time. His suicidal thoughts and attempts were tied to the guilt and shame he carried after the death of a close family member.
By the time he reached us, the weight of all of this had reshaped his life. He had taken a leave of absence from work to seek treatment, had run-ins with law enforcement, and had been through treatment twice before. His depression and his substance use were not separate problems. Each one fed the other, and neither had been fully addressed on its own.
The Therapeutic Process
The client entered our partial hospitalization program. He was honest with his therapist from the start, including about a relapse during treatment. His plan was to return home after 45 days to complete his probation, even though his home environment carried real clinical risk: a history of relapse there, a toxic relationship with his spouse, and no sober support to return to.
Therapy focused on how he functioned internally and how those internal states drove behavior that kept costing him. Over time he was able to speak openly about feeling depressed and suicidal, and about being in an abusive relationship. He did the grief work he had avoided for years. In group, using a role-play exercise, he was finally able to say goodbye to his mother, grieve properly, and reach a measure of closure and acceptance. From there he could see the pattern clearly: he had been drinking, using substances, and self-harming to cope with his depression and his grief.
The Outcome
Working with his therapist, case management, and our psychiatrist, the client addressed his depression, his substance use, his legal situation, his employment, and his past suicidal ideation as one connected plan. He came to recognize that he had been using substances to self-medicate. He accepted the psychiatrist’s recommendation to add antidepressant and anti-craving medication to his treatment, and he committed to relocating so he could break the cycle of relapse tied to his old environment. His care drew on Motivational Interviewing, Cognitive Behavioral Therapy, psychoeducation grounded in 12-step recovery, and group work.
He was discharged into local sober living and aftercare with a structured relapse-prevention plan, a sponsor, and a connection to our alumni programming to keep him engaged in recovery.
Why Integrated Dual Diagnosis Care Mattered Here
Depression, unresolved grief, and substance use had been driving one another for most of this client’s life. Treating the drinking without treating the depression and the grief would have left the engine of the addiction running. Our dual diagnosis program treats mental health and substance use together, with one team and one plan, across a continuum that reaches from partial hospitalization through aftercare and alumni support.
If you or someone you love is facing depression, grief, or another mental health condition alongside substance use, Destination Hope can help. Call us at (954) 302-4269 or start the admissions process to talk with our team.
Crisis and Emergency Resources
If you or someone you know is in a substance use or mental health crisis, help is available now. Contact the SAMHSA National Helpline at 1-800-662-HELP (4357) for free, confidential treatment referrals 24/7. Reach the 988 Suicide and Crisis Lifeline by calling or texting 988. The Crisis Text Line is available by texting HOME to 741741. For emergencies, call 911.
