Search results for ‘Subject term:"dual diagnosis"’ Sort:
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Help is at home
- Author:
- THOMPSON Audrey
- Journal article citation:
- Community Care, 18.3.99, 1999, p.27.
- Publisher:
- Reed Business Information
Looks at the award-winning Alcohol Recovery Project, which helps people who have a serious drink problem by supporting them in their homes.
The individualized addictions consultation team residential program: a creative solution for integrating care for veterans with substance use disorders too complex for other residential treatment programs
- Authors:
- KEATING Sarah, et al
- Journal article citation:
- Journal of Dual Diagnosis, 17(2), 2021, pp.172-179.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Objectives: The Veterans Affairs (VA) healthcare system is one of the main providers of substance use treatment within the United States, and many veterans with a substance use disorder (SUD) present with co-occurring diagnoses or other concerns. Though there has been increasing recognition of the need for integration of treatments for SUD and comorbid mental illness, there have been limited studies of such programs, particularly within the VA healthcare system. To address that gap in the literature, this paper examines treatment outcomes in an integrated model of dual diagnosis residential treatment for veterans: the Individualized Addictions Consultation Team (I-ACT) program. Methods: The current paper draws from clinical outcome evaluation data within a residential treatment program at a large Midwestern VA Medical Center (VAMC). The I-ACT program provides residential substance abuse treatment to individuals with a primary SUD and other factors that interfere with the successful completion of a traditional residential rehabilitation program. Between 2017 and 2018, 130 individuals (97.7% men, average age = 60.62 years) entered the I-ACT program. As part of standard measurement-based care, veterans were administered the Brief Addiction Monitor and the Patient Health Questionnaire–9 at admission and discharge. Results: Most individuals (74.6%) who entered I-ACT completed the residential program (average length of stay 34.2 days). Scores on both measures significantly decreased from intake to discharge (p < .001), with the change in depression scores indicating clinically significant improvement. Those with an additional mental health diagnosis achieved similar decreases in substance use symptoms and had lower depression scores at discharge than those with a SUD alone. Conclusions: Our results indicate that even for veterans who may not benefit from traditional SUD treatment programs, a more integrated and personalized residential program can be effective. (Edited publisher abstract)
The recovery paradigm in trauma work: approaches to healing psychiatric disability and substance abuse in women's lives
- Authors:
- BUSSEY Marian, WISE Judith Bula
- Journal article citation:
- Journal of Social Work in Disability and Rehabilitation, 7(3-4), 2008, pp.355-379.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Focusing on women with psychiatric disabilities and substance issues, particularly those who have histories of abuse, violence and trauma, this article addresses the importance of integrative treatment as a prerequisite for psychiatric rehabilitation and recovery. The authors discuss psychiatric rehabilitation, trauma, treatment philosophy, consumer empowerment and the concept of an integrated model of recovery. They describe three integrated trauma and alcohol and other drug models created primarily for women, and discuss their content, the challenges of system change and the results of the integrated model.
From "double trouble" to "dual recovery": integrating models of recovery in addiction and mental health
- Authors:
- DAVIDSON Larry, et al
- Journal article citation:
- Journal of Dual Diagnosis, 4(3), 2008, pp.273-290.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
It is increasingly recognised by both the mental health and substance misuse fields that people with mental illnesses and addictions are first and foremost people rather than diagnoses or disorders. As such, they are the experts in what it means to live through and recover from disorders, and their views need to be accessed in order for the person-first approach to become more than rhetoric. This paper reviews two models of recovery, one in mental health and the other in addictions, that were developed in collaboration with advocates and recovering individuals. These are then integrated to produce a strengths-based model of dual recovery. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Predictors of retention in dual-focus self-help groups
- Authors:
- LAUDET Alexandre B., et al
- Journal article citation:
- Community Mental Health Journal, 39(4), August 2003, pp.281-297.
- Publisher:
- Springer
Attendance at 12-step groups has been found useful in maintaining abstinence from substance use; many members disengage early, missing out on potential benefits. New 12-step based groups have emerged to address the recovery needs of the many substance users with psychiatric comorbidity. Little is known about factors associated with retention in 12-step, especially in this population. This study sought to identify predictors of retention over a one-year period among members of a dual-focus 12-Step fellowship (N = 276). Using multivariate analysis, the following baseline characteristics were associated with greater retention one year later: older age, more lifetime arrests, abstinence in the pre-baseline year, more psychiatric symptoms in the pre-baseline year, not taking psychiatric medication, being more troubled by substance abuse than by mental health, and greater level of self-efficacy for recovery; residing in supported housing and being enrolled in outpatient treatment at follow-up were also significantly associated with better retention. Clinical implications to enhance retention in specialized 12-step groups are discussed.
Nidotherapy in the treatment of substance misuse, psychosis and personality disorder: secondary analysis of a controlled trial
- Authors:
- TYRER Peter, et al
- Journal article citation:
- Psychiatrist (The), 35(1), January 2011, pp.9-14.
- Publisher:
- Royal College of Psychiatrists
This paper reports secondary analyses of data from a previously published trial, involving 37 patients from a central London assertive outreach and rehabilitation team’s caseload of patients with dual diagnoses of substance misuse and psychotic disorders. This randomised, controlled study looks at nidotherapy, which “involves the systematic assessment and modification of the environment to help in minimising the impact of any form of mental disorder on the individual or on society”, as an add-on therapy to assertive outreach treatment alone. Clinical, secondary outcomes, such as levels of symptoms, social function and engagement with services, along with primary outcomes such as bed usage were measured at baseline, 6 and 12 months. Economic costs were determined. Findings included similar reductions in symptoms and engagement with patients receiving assertive care with or without the nidotherapy, with “marginal superiority in social function" for those receiving nidotherapy. In addition, there was a 110% reduction to hospital bed usage after 1 year compared with the control group receiving assertive care only. Primarily as a consequence of this reduced psychiatric bed use, mean cost savings for patients receiving nidotherapy were calculated as £14,705 per patient, per year. The authors conclude that nidotherapy shows promise as an intervention for the treatment of psychoses and substance misuse.
Social networks of people with dual diagnosis: the quantity and quality of relationships at different stages of substance use treatment
- Authors:
- MacDONALD Elspeth M., et al
- Journal article citation:
- Community Mental Health Journal, 40(5), October 2004, pp.451-464.
- Publisher:
- Springer
This study compares the social networks, perceived levels of social support, and satisfaction with this support, for people with serious mental illnesses and comorbid problematic use of alcohol and other drugs who are at different stages of substance use recovery. Participants in the late stage of recovery were more likely to perceive greater social support from their non substance-using social contacts than participants in the early stage. This social support was more likely to be from professionals than other non-substance-using contacts in their networks. The support from professionals is discussed in relation to engagement in integrated dual diagnosis interventions.
Mental health policy implementation guide: dual diagnosis good practice guide
- Author:
- GREAT BRITAIN. Department of Health
- Publisher:
- Great Britain. Department of Health
- Publication year:
- 2002
- Pagination:
- 40p.
- Place of publication:
- London
Supporting someone with a mental health illness and substance misuse problems - alcohol and/or drugs - is one of the biggest challenges facing frontline mental health services. The complexity of issues makes diagnosis, care and treatment more difficult, with service users being at higher risk of relapse, readmission to hospital and suicide. One of the main difficulties is that there are a number of agencies involved in a person's care - mental health services and specialist rehabilitation services, organisations in the statutory and voluntary sector. As a result care can be fragmented and people can fall down the cracks. The guidance provides a framework within which staff can strengthen services so that they have the skills and organisation to tackle this demanding area of work. The authors key message is that substance misuse is already part of mainstream mental health services and this is the right place for skills and services to be. Mental health services must also work closely with specialist substance misuse services to ensure that care is well co-ordinated. The authors have also highlighted some existing examples of excellent services working well now. This guidance and the services mentioned, demonstrate the importance of effective leadership at a local level and rigorous training programmes to help staff maintain high standards of service delivery. Cites numerous references.
Integrated substance use rehabilitation in a secure forensic facility
- Authors:
- EAGLE Kerri, MA Trevor, SINCLAIR Barbara
- Journal article citation:
- Journal of Forensic Practice, 21(1), 2019, pp.50-60.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to inform the development of an evidence-based and effective rehabilitation programme to address substance use disorders in a population of patients with severe mental illness and mental disorders detained in a secure forensic psychiatric facility. A clinical review identified a high prevalence of substance use disorders in the patient population at a secure forensic facility in Sydney, Australia with only a limited number of patients being assessed and offered interventions for substance use problems. Design/methodology/approach: A literature review was undertaken specifically looking at articles between 2009 and 2017 that considered models of care or approaches to substance use rehabilitation in patients with co-morbid psychiatric disorders. Articles were considered based on their relevance to the purpose and the environment of a secure forensic facility. Findings: The literature review emphasised the need for a cohesive model of care integrating substance use rehabilitation with mental health care. Comprehensive assessment and individualised approaches that incorporated patient choice and stages of change were considered essential components to any dual diagnosis rehabilitation programme. Practical implications: The literature regarding rehabilitation approaches for those with severe mental illness and co-morbid substance use disorders was reasonably consistent with the models of care used in relation to criminal offenders and mental illness generally. Integrated and individualised rehabilitation approaches for dual diagnosis patients could play a significant role in forensic settings. Originality/value: Limited robust evidence for substance use rehabilitation has been published. The authors consider the existing evidence base and the underlying theory behind substance use rehabilitation to propose a model for rehabilitation in secure forensic settings. This is the first known review of substance use rehabilitation involving mentally ill offenders with dual diagnoses in secure forensic settings. This paper is the original work of the authors.
The relationship between hope, housing type, and housing characteristics among individuals with dual diagnoses
- Author:
- TSAI Jack
- Journal article citation:
- Journal of Dual Diagnosis, 6(2), April 2010, pp.144-151.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Hope is defined as having a sense of agency over one’s desired goals and positive feelings about one’s ability to reach those goals. Previous research has argued that independent housing allows clients’ freedom and autonomy and may experience fewer restrictions promoting higher self-efficacy, and that those in group homes may feel stigmatised and lack privacy. Therefore, it was hypothesised that clients in independent housing would report higher levels of hope than clients in residential programmes. As such, this study examined whether individuals with dual diagnoses in different types of housing experience different levels of hope and whether or not hope is related to certain housing characteristics. Participants included 65 living in residential programmes and 22 in independent apartments. They responded to questionnaires about hope and current housing arrangements. Findings indicated that hope did not vary by housing type or housing characteristics, with clients in group housing having as much hope as clients in apartments. The author concludes that replication and future study is needed to better understand the relationship between housing and hope.