Search results for ‘Subject term:"dual diagnosis"’ Sort:
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Substance use in early intervention services for psychosis
- Authors:
- SUMMERS Alison, GOEL Chinar
- Journal article citation:
- Advances in Dual Diagnosis, 4(3), 2011, pp.115-124.
- Publisher:
- Emerald
This discussion paper outlines the nature of early intervention (EI) services in psychosis, substance use in clients in this setting, and ways of working with EI clients where substance use is an issue. EI services for psychosis aim to provide early detection and treatment of psychosis, particularly through increased emphasis on psychosocial interventions. The authors begin by outlining the nature of EI services and early psychosis and go on to discuss the impact and management of substance use in this setting. Case studies and service examples are included. When substance use problems persist and play an important part in the client’s story it may be particularly important to address these issues, including the demands on staff and the care they offer. The authors emphasise the importance of understanding the individual and the complexity of their relationships with practitioners and services. Many EI services, through better staffing ratios and more emphasis on psychosocial care are able to offer more holistic approaches to the treatment of psychosis than traditional services making them particularly appropriate for clients with persisting problems with substance misuse as well as psychosis.
Drug and alcohol workers' view of positive psychology in the treatment of coexisting problems
- Authors:
- GOMEZ Katalin Ujhelyi, et al
- Journal article citation:
- Advances in Dual Diagnosis, 12(3), 2019, pp.145-160.
- Publisher:
- Emerald
Purpose: Positive psychology (PP) interventions have been suggested to be beneficial in the treatment of dual diagnosis (DD). The purpose of this paper is to investigate the perspective of psychosocial intervention (PSI) workers to explore the potential of a positive strengths-based approach in DD recovery. Design/methodology/approach: A qualitative approach was employed with PSI workers who attended and observed a positive intervention delivered to DD clients. A focus group explored what these practitioners are already doing that resembles PP and their opinion regarding the utility of such interventions in recovery. Findings: Findings revealed that practitioners were already engaging in positive practice, however, randomly and infrequently with limited impact. Although this new approach was found valuable, potential challenges were identified and a possible discrepancy between staff views of clients and clients’ views of themselves in terms of their potential was detected. Research limitations/implications: The study involved a small and homogeneous sample. Further research is necessary to investigate staff views and ways of integrating PP with traditional treatment. Practical implications: Rather than merely attending to the psychological problems and dealing with symptoms, it is also necessary to directly target well-being to enable people to flourish with consideration of their readiness to change. Originality/value: Addressing a gap in the literature, the present study explored positive themes in current practice and forms part of the evaluation of a newly developed strengths-based approach for individuals with coexisting problems. (Edited publisher abstract)
“Acute concerns”: is the mental health workforce equipped and supported to meet complex needs?
- Authors:
- HUGHES Elizabeth, BROWN Yvette, TUMMEY Robert
- Journal article citation:
- Advances in Dual Diagnosis, 5(1), 2012, pp.15-22.
- Publisher:
- Emerald
There is a perceived need for the improvement of acute psychiatric care in England care; concerns have highlighted the lack of a therapeutic approach. This electronic survey was designed to identify the types of training that acute mental health workers were able to access, in relation to workforce development and substance misuse issues. All clinicians working in acute mental health services across a region in England were contacted by email. A total of 89 clinicians responded and the results for 77 were analysed (some failed to give consent). Most acute care staff had only accessed mandatory training such as risk assessment; few had been trained in the use of psychosocial approaches. Overall drug and alcohol specific activities were performed only 'sometimes'. Limitations are noted in relation to sample selection meaning the results may not be generalisable. In addition, the survey did not specifically set out to examine substance misuse issues. The authors suggest that in the face of service users’ increasingly complex needs, creative and cost effective ways of facilitating access to training and support must be found to ensure that staff have the competencies to identify and manage substance users effectively in acute mental health settings. The findings highlight the deficit in access to psychosocial interventions training for acute care staff.
Psychosocial intervention research on co-occurring disorders
- Author:
- DRAKE Robert E.
- Journal article citation:
- Journal of Dual Diagnosis, 3(2), 2007, pp.85-93.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This update on the literature of psychosocial interventions for co-occurring disorders shows significant progress since the late 1980s when there were very few relevant intervention studies. By 2006 more than 40 controlled trials of psychosocial interventions had been reported, and there has been a rapid increase in the number of pharmacological trials. A brief summary is presented of evidence on integrated mental health/addiction treatment approaches, and specific psychosocial interventions. The evidence base is currently limited by a lack of methodological standardisation and rigour, and lack of replication. Future research and practice needs, some of which are already being addressed, include the development of methodological standards; longitudinal studies; effectiveness studies of interventions for different stages of recovery, subgroups and treatment settings; the development of practice guidelines; and the development of electronic decision support systems. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Evidence-based time-limited treatment of co-occurring substance-use disorders and civilian-related posttraumatic stress disorder
- Authors:
- BACK Sudie E., et al
- Journal article citation:
- Brief Treatment and Crisis Intervention, 6(4), November 2006, pp.283-294.
- Publisher:
- Oxford University Press
Substance use disorders (SUDs) and posttraumatic stress disorder (PTSD) frequently co-occur, and this comorbidity results in a more severe clinical presentation and treatment outcome. Consensus is lacking regarding best practices; however, a number of integrated psychosocial treatments (e.g., Seeking Safety, Substance-Dependence PTSD Therapy, Concurrent Treatment of PTSD and Cocaine Dependence) have shown empirically supported promise in reducing symptoms of both disorders. Very little research has been conducted to date on pharmacological treatments for this dual diagnosis or on assessments. This article reviews the developing literature in this area and discusses future directions for research.
Barriers for homeless with dual diagnosis: lessons learned from intensive mobile psychosocial assertive community treatment program
- Authors:
- ZOLNIKOV Tara Rava, et al
- Journal article citation:
- Advances in Dual Diagnosis, 14(4), 2021, pp.169-182.
- Publisher:
- Emerald
Purpose: Dual diagnosis is a term that describes the co-occurrence of mental health disorders or illness and substance use or abuse disorders. Because this co-occurrence results in multiple diseases, layers of treatment are often needed to successfully create positive change in the individual. The purpose of this study is to explore factors of treatment that could facilitate improvements in functionality and quality of life for those with a dual diagnosis. Design/methodology/approach: A secondary data analysis, using both quantitative and qualitative data, was completed. Secondary analysis is an empirical exercise that applies the same basic research principles as studies using primary data and has steps to be followed, including the evaluative and procedural steps commonly associated with secondary data analysis. Documentation data from the intensive mobile psychosocial assertive community treatment program was gathered for this analysis; this program was used because of the intensive and community-based services provided to patients with a dual diagnosis. Findings: The major findings from this secondary analysis suggested that significant barriers included “denial” (e.g. evasion, suspension or avoidance of internal awareness) of diagnoses, complicated treatment and other barriers related to housing. Ultimately, these findings provided greater insight into potential effective treatment interventions for people living with a dual diagnosis. Originality/value: This study adds to the growing body of literature showing that patient-centred care allows for more effective treatment and ultimately, improved health outcomes. (Edited publisher abstract)
Clinical outcomes from a 10-week follow-up psychoeducational program for dual diagnosis
- Authors:
- CHILTON J., CRONE D., TYSON P. J.
- Journal article citation:
- Journal of Dual Diagnosis, 14(2), 2018, pp.102-110.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Background: Dual diagnosis covers a broad spectrum of mental health and substance misuse conditions occurring concurrently (NICE, 2016 NICE. (2016). Coexisting severe mental illness and substance misuse: Community health and social care services. London, England: National Institute for Health and Clinical Excellence). Its manifestation is complex and, as such, the disorder is recognised as influencing adherence to prescribed medication and service engagement and has a worse prognosis than substance use and mental health conditions occurring independently. Aims: To determine the effectiveness of psychoeducational group therapy in a sample of dual diagnosis patients. Methods: Patients who met the Diagnostic and Statistical Manual of Mental Disorders-IV Axis 1 criteria for serious mental illness and current substance misuse were approached to take part in a psychoeducational program. Those who consented were assessed at baseline and end point using measures of psychiatric syptomatology, psychological well-being, and substance use patterns with the following scales: the Brief Psychiatric Rating Scale, the Hospital Anxiety and Depression Scale, the Maudsley Addiction Profile, and the Warwick-Edinburgh Mental Wellbeing Scale. Results: Fifty-one patients completed the program, while 29 dropped out after initial assessment. Between baseline and follow-up, there was a decline in the number of participants using alcohol, cannabis, cocaine, amphetamine, illicit benzodiazepines and methadone. However, the number of participants using heroin remained constant. The mean amount of substances used was not reduced over the study period except in the case of alcohol. Overall improvements in syptomatology and psychological well-being were observed. Discussion: Mental health services should focus on integrated approaches via multimodal treatment interventions that encapsulate harm reduction and educational initiatives. Despite the modest sample, the findings have emphasised the importance of a broad range of treatment approaches delivered within a unitary delivery system. (Edited publisher abstract)
Outcomes of a drug and alcohol relapse prevention programme in a population of mentally disordered offenders
- Authors:
- RITCHIE Gordon, et al
- Journal article citation:
- British Journal of Forensic Practice, 13(1), February 2011, pp.32-43.
- Publisher:
- Emerald
Substance abuse in individuals who have a serious mental disorder such as psychosis may increase their risk of committing crime, particularly violent crime. It is therefore important that dual-diagnosis patients in forensic services should receive adequate intervention and treatment to minimise future substance use and potential for criminal behaviour. This article explores retrospectively the effectiveness of one such intervention, the Relapse Prevention Programme (Saying No; Coping and Social Skills Programme) which is based on cognitive behavioural principles. This programme was developed in the Scottish High Secure Forensic Hospital in response to their high intake of patients with a history of alcohol and drug abuse. The evaluation of the programme comprised a pre- and post- intervention design using 4 measures: the Drug Taking Confidence Questionnaire (DTCQ), the Multidimensional Locus of Control Questionnaire, the Stages of Change Questionnaire and the Rosenberg Self-Esteem Scale. The participants were 83 men who undertook the programme between May 2003 and June 2009. The results indicate that there was significant change in the DTCQ post-treatment while no other measures yielded a statistically significant result. Possible reasons, implication for practice and limitations of the current study are discussed.
Treatment of dual diagnosis in mentally disordered offenders: application of evidence from the mainstream
- Authors:
- WELDON Sarah, RITCHIE Gordon
- Journal article citation:
- Advances in Dual Diagnosis, 3(2), May 2010, pp.18-23.
- Publisher:
- Emerald
Noting that empirical evidence suggests that a complex relationship exists between substance misuse, mental illness and violence in forensic populations, this paper provides a summary of issues concerning treatment of dual diagnosis and how this may be related to mentally disordered offenders, mainly focusing on treatment and psychosocial outcomes of patients with severe and persistent mental illnesses, including schizophrenia and psychotic illness, and comorbid substance use issues. It covers treatment of substance use among people with severe mental illness, the transtheoretical model of change, psychosocial interventions, and efficacy of psychosocial treatments in forensic populations. The authors conclude that the most effective intervention currently consists of an integrated, long-term treatment approach adopting motivational interviewing principles combined with CBT, with social and coping skills training.
A literature review of family interventions for dual diagnosis: implications for forensic mental health services
- Authors:
- RICHARDS Margaret, DOYLE Mike, COOK Peter
- Journal article citation:
- British Journal of Forensic Practice, 11(4), November 2009, pp.39-49.
- Publisher:
- Emerald
Dual diagnosis strategies are developing in medium secure services in response to both government policies and clinical need. Noting that working with families has been identified as important in helping prevent relapse of mental illness, and that in addition there is a need for an organised, consistent and robust approach to family work to meet the specific needs of people with psychosis and an additional substance misuse problem who are managed by forensic mental health services, this paper aims to review the literature on family interventions in dual diagnosis and its applicability to forensic mental health inpatient services. Relevant literature was identified using searches of online databases, the Cochrane library, government and related voluntary body websites, and internal publications from medium secure units. The findings indicated the potential for positive outcomes for families following family interventions in dual diagnosis, which may be beneficial in a forensic setting in lowering risk.