Dual diagnosis treatment for Highland Beach — substance use and mental health, together.

For Highland Beach residents, the twelve-minute drive down A1A to RECO's Delray campus gets you something a Boca behavioral-health office usually cannot deliver — addiction psychiatry, trauma-trained therapists, and PHP/IOP under one roof, with one treatment plan that addresses substance use and co-occurring depression, anxiety, PTSD, or bipolar disorder concurrently. Families in Bel Lido Isle and Toscana get coherent care rather than coordinated referrals.

Highland Beach sits between Delray and Boca Raton along A1A, a narrow oceanfront town where the drive to RECO Intensive’s Delray campus runs about seven miles and twelve minutes. For families in Bel Lido Isle, Toscana, Boca Cove, Ocean Cove, or the Penthouse condominiums, that proximity matters when the clinical question is complicated: a loved one whose drinking or drug use is tangled up with depression, anxiety, PTSD, or bipolar disorder. General behavioral-health practices in Boca can manage one side of that equation at a time. RECO is built to manage both at once. Our dual diagnosis program treats substance use disorder and co-occurring psychiatric conditions concurrently, with the same clinical team, in the same week — not sequentially, not across two referrals that rarely talk to each other.

What follows is a plain description of how integrated treatment works here, the conditions we see most often alongside addiction, and how the program is structured for someone driving down A1A from Highland Beach.

Why integrated treatment outperforms sequential

The research on co-occurring disorders has been consistent for more than two decades: addressing substance use and a psychiatric condition together produces better outcomes than treating one and then the other. SAMHSA’s evidence reviews, the NIDA principles of effective treatment, and a body of randomized trials all point in the same direction. When a client is sent to detox first and told to “come back for the depression later,” the depression usually drives a return to use before the later ever arrives. The reverse fails for the same reason — outpatient antidepressant management cannot keep pace with an active alcohol use disorder.

Sequential treatment also splits responsibility in a way that erodes accountability. The addiction counselor assumes the psychiatrist is handling the trauma. The psychiatrist assumes the counselor is handling the drinking. Neither has the full picture. Integrated care closes that gap by having one team carry both diagnoses through assessment, treatment planning, and discharge. Decisions about a buprenorphine titration get made in the same case conference as the SSRI cross-taper. That coherence is most of what makes the model work.

The conditions most commonly co-occurring with substance use disorder

The conditions we see most often alongside SUD are major depressive disorder, generalized anxiety disorder, post-traumatic stress disorder, bipolar I and II, and adult ADHD. Personality-disorder features — particularly borderline traits — are also common and shape treatment planning. RECO has clinical depth in each of these areas, with structured intake assessments that screen for them rather than waiting for them to surface in week three.

• Depression and anxiety: CBT and DBT skills work delivered in group and individual sessions, with SSRI/SNRI management when indicated.
• PTSD and complex trauma: EMDR and Trauma-Focused CBT delivered by clinicians specifically trained in those modalities (more below).
• Bipolar disorder: Mood stabilizer management coordinated with abstinence-based work, with attention to the substances most likely to trigger episodes.
• ADHD: Careful differential during early sobriety, then evidence-based treatment that accounts for stimulant abuse history when present.

Medication management for any of these conditions is provided in-house, which means a psychiatric assessment within days of admission rather than a four-to-eight-week wait for an outside referral — a wait that, for Highland Beach residents who could otherwise be driving to a Boca psychiatrist’s office, often becomes the breaking point.

Trauma-focused therapy as a core modality

A large share of substance use is downstream of unprocessed trauma — childhood adversity, sexual assault, combat exposure, medical trauma, sudden loss. Treating the use without ever touching the trauma is a strategy that tends to hold for a few months and then collapses. RECO’s clinicians are trained in Trauma-Focused CBT and EMDR, and our group facilitators run trauma-informed groups rather than confrontational ones.

EMDR in particular has strong evidence for PTSD and is delivered by certified clinicians on our team. We are deliberate about timing — clients typically need a stretch of stability and skill-building before reprocessing work begins, and that pacing is part of the treatment plan rather than an afterthought. CBT for insomnia, Motivational Interviewing for ambivalence, and DBT skills for emotion regulation round out the modalities that show up most days of the week.

In-house psychiatry coordinated with therapy

The structural advantage of having psychiatry under the same roof is that medication and therapy decisions happen in conversation, not in silos. Our addiction psychiatrist sees clients within the first week of admission, attends case conferences, and consults directly with the primary therapist when a medication change is being considered. If naltrexone or acamprosate is the right call for alcohol use disorder, it gets started promptly. If buprenorphine is indicated for opioid use disorder, induction happens here. Vivitrol injections are administered on-site for clients who prefer monthly dosing.

For someone driving the twelve minutes south from Highland Beach, this means one address, one chart, one team. No coordinating between a Boca prescriber, a Delray therapist, and a primary care physician who is trying to make sense of both. The partial hospitalization program and intensive outpatient program are both built around this integration, and clients step down through them based on ASAM Criteria dimensions — withdrawal risk, biomedical conditions, emotional/behavioral conditions, readiness, relapse potential, and recovery environment — rather than a fixed timeline.

Local proof points, insurance, and how to start

For Highland Beach families, the practical questions tend to be the same: who do you take, how long is this, and what do we do tomorrow morning. RECO is in-network with most major commercial carriers — including Aetna, Cigna, Blue Cross Blue Shield, and many Florida Blue plans — and our admissions team can verify benefits and explain coverage before you commit to anything. The insurance verification page outlines the process.

Length of stay varies by clinical need. A typical dual diagnosis course runs four to six weeks of PHP, followed by six to eight weeks of IOP, with a step into structured sober living and aftercare for clients who benefit from continued support. For some, residential care is the right starting point — particularly when home environment or acute psychiatric symptoms make outpatient unsafe. For others driving in daily from Bel Lido Isle or Toscana, PHP is exactly the right level.

Common substance-specific concerns — alcohol use disorder and opioid use disorder — are addressed within the dual diagnosis framework rather than separately. To start, call the admissions line; a clinician will return the call the same day and walk through what the first week looks like.

Serving residents of: Bel Lido Isle, Boca Cove, Ocean Cove, Toscana, Penthouse.