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Challenges in working with patients with dual diagnosis
- Author:
- PINDERUP Pernille
- Journal article citation:
- Advances in Dual Diagnosis, 11(2), 2018, pp.60-75.
- Publisher:
- Emerald
Purpose: Studies have shown that mental health professionals find working with patients with dual diagnosis challenging, and the purpose of this paper is to examine some of these challenges. Design/methodology/approach: In total, 85 mental health professionals from 8 different mental health centres in Denmark were interviewed. The data analysis was inspired by a grounded theory approach. Findings: Different challenges in the dual diagnosis treatment were identified and they suggested that the focus of treatment was mainly on the mental illness rather than the substance use disorder. The single focus of the treatment made it challenging to treat patients with dual diagnosis sufficiently. While several studies explain the single focus by inadequate competencies among professionals, the present study suggests that the single focus is also explained by the way that the treatment is organised. For instance, standardized treatment packages and insufficient guidelines on substance abuse treatment make it challenging to treat patients with dual diagnosis. Originality/value: This paper suggests that a more flexible, and a longer period of, treatment, together with more sufficient guidelines on dual diagnosis treatment and a more formalized collaboration with the substance abuse treatment centres, will make it a less challenging issue to treat patients with dual diagnosis. (Edited publisher abstract)
What role does employment play in dual recovery? A qualitative meta-synthesis of cross-cutting studies treating substance use treatment, psychiatry and unemployment services
- Authors:
- HANSEN Jeppe Oute, BJERGE Bagga
- Journal article citation:
- Advances in Dual Diagnosis, 10(3), 2017, pp.105-119.
- Publisher:
- Emerald
Purpose: The role of employment in dual recovery from mental illness and substance use is scarcely addressed in previous studies and a deeper understanding of this issue is needed. The purpose of this paper is to cast further light on the conditions that either facilitate or block the road to employment for dually diagnosed people (DDP) and how these conditions could either promote or hinder recovery. Design/methodology/approach: Drawing on the principles laid out by health researchers Sandelowski and Barroso (2007), the study is designed as a qualitative meta-synthesis comprising a systematic literature search, a critical assessment of the identified studies and an integrative synthesis of the articles’ findings. Findings: The synthesis outlines that the findings from the seven identified studies show a recovery process in which unemployed, DDP are becoming employed people – or where there is an attempt to restore their status as working persons – and how this process is driven or hindered by personal, interpersonal and systemic facilitators or barriers. Research limitations/implications: The synthesis adds nuances to the understanding of employment in dual recovery processes and suggests that unconnected means of, and goals for, intervention among these individuals and systems might reduce the chances of DDP obtaining and maintaining a job. Originality/value: The paper calls for more advanced research and policy on the multiple – and often contradictory – aspects of gaining and maintaining employment as part of dually diagnosed persons’ recovery. (Publisher abstract)