Search results for ‘Subject term:"dual diagnosis"’ Sort:
Results 1 - 2 of 2
Treatment development for psychosis and co-occurring substance misuse: a descriptive review
- Authors:
- BARROWCLOUGH Christine, et al
- Journal article citation:
- Journal of Mental Health, 15(6), December 2006, pp.619-632.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
It is common for people with psychosis to have co-occurring drug or alcohol problems. This combination of problems is associated with poor outcomes for clients and presents many challenges for services. This review aims to discuss contextual issues underlying treatment difficulties, to briefly review the treatment literature to date and to describe a randomized controlled treatment trial (RCT) currently being conducted in the UK. Consensus agreement emphasizes the need for integrated treatment strategies that match the client's current level of motivation. There have been encouraging results from recent studies evaluating motivational strategies, either alone or in combination with CBT. Whilst for many clients with established illness and substance using histories, brief therapy does not seem to be adequate, longer term interventions show promise. A current RCT evaluating motivational interviewing with CBT is described. The evidence base for treatment recommendations is still quite small. The MIDAS trial will hopefully make a significant contribution to the literature on treatment options for this high risk group.
Integrated motivational interviewing and cognitive behavioural therapy for people with psychosis and comorbid substance misuse: randomised controlled trial
- Authors:
- BARROWCLOUGH Christine, et al
- Journal article citation:
- British Medical Journal, 4.12.10, 2010, p.1204.
- Publisher:
- British Medical Association
This study aimed to evaluate the effectiveness of integrated motivational interviewing and cognitive behavioural therapy in addition to standard care for patients with psychosis and a comorbid substance use problem. 327 participants were randomly allocated to either the intervention or treatment as usual. Phase one of the intervention, motivation building, concerns engaging the patient, then exploring and resolving ambivalence for change in substance use. Phase two, action, supports and facilitates change using cognitive behavioural approaches. At 24 months, 326 (99.7%) were assessed on the primary outcome and 246 (75.2%) on the main secondary outcomes. The results found that integrated motivational interviewing and cognitive behavioural therapy for people with psychosis and substance misuse did not improve outcome in terms of hospitalisation, symptom outcomes, or functioning. However, it did reduce the amount of substance used for at least one year after completion of therapy.