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A License To Heal Diagnosing a duality In treating drug and alcohol addiction, one of the major challenges for providers is diagnosing and treating (or referring for treatment) clients with co-occurring addiction and mental illness. As clinical director at All Joshua, licensed clinical social worker Pam Smelser brings several decades worth of experience and expertise in treating mental illness. Smelser spent 36 years working for the Maryland Department of Social Services, helping children and families. In that role, she saw ! rst-hand the impact of mental illness and addiction. “At least half – maybe as much as 80 percent – of the child welfare cases that come to the attention of state authorities involve addiction and/or mental health issues. I’ve learned how interconnected those things are. We’re all on a mission to save lives,” says Smelser. Treatment is hard work stage of change they are in and hold people to that. “It is a contractual relationship, no matter how you slice it. And like any kind of helping en deavor, it’s a # uid process of constant assessment and reassessment.” When she met All Joshua founder Mike Robinson in 2015, Smelser was impressed with his approach. “He wants to serve the whole man or the whole woman, not only treating the addiction, but also ! nding what has been going wrong in your life and how can we work with you to help you move through life in a healthier, better direc tion. Mike’s goal is to develop complete case-management services downstream.” “Treatment is a fluid process of constant assessment and reassessment.” - Pam Smelser, All Joshua clinical director 30 “In treating addiction we have to ! nd out what are the issues that led people to that door. And treating addicts is hard work: you have to have the training and experience to understand that people don’t become addicts because they want to be. And they don’t come to recovery easily or stay in recovery easily.” " e basis for the treatment process that follows is an initial, evidence-based assessment of the client’s level of willingness to commit to recovery and what