Dual Diagnosis Capability in Mental Health and Addiction Treatment Services: An Assessment of Programs Across Multiple State Systems

McGovern, Mark P.; Lambert-Harris, Chantal; Gotham, Heather J.; Claus, Ronald E.; Xie, Haiyi

doi:10.1007/s10488-012-0449-1

Cited by 98 publications

(64 citation statements)

References 28 publications

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“…As one of the few programs in the United States that focuses on the provision of integrated treatment for co-occurring disorders, the clinic provided an uncommon empirical opportunity to learn about the subjective experience of career development in the context of appropriate rehabilitative supports (McGovern, Lambert-Harris, Gotham, Claus, & Xie, 2014). Services included education, case/care management, medication management, assistance with daily living tasks, assistance with housing, money management, cognitive behavioral therapy, substance use counseling, family psychoeducation, and a variety of related evidence-based interventions and other specialized counseling (Woods & Drake, 2011).…”

Section: Methodsmentioning

confidence: 99%

A Qualitative Study of Career Exploration Among Young Adult Men With Psychosis and Co-occurring Substance Use Disorder

Luciano

Carpenter‐Song

2014

Journal of Dual Diagnosis

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Objective This article explores the meaning and importance of career exploration and career development in the context of integrated treatment for young adults with early psychosis and substance use disorders (i.e., co-occurring disorders). Methods Twelve young adult men (aged 18 to 35 years) with co-occurring disorders recruited from an integrated treatment center completed a series of three semi-structured in-depth qualitative interviews. Data were transcribed verbatim and analyzed using thematic analysis. Purposive sampling ensured participants represented a range of substance abuse treatment stages. Results Participants had a mean age of 26 (SD = 3) and identified as White. Two-thirds of participants (n = 8, 67%) were diagnosed with schizophrenia-spectrum disorders, three (25%) with bipolar disorder, and one (8%) with major depression; four (33%) also had a co-occurring anxiety disorder. The most common substance use disorders involved cannabis (n = 8, 67%), cocaine (n = 5, 42%), and alcohol (n = 5, 42%). These young adult men with co-occurring disorders described past jobs that did not align with future goals as frustrating and disempowering, rather than confidence building. Most young adult participants began actively developing their careers in treatment through future-oriented work or school placements. They pursued ambitious career goals despite sporadic employment and education histories. Treatment engagement and satisfaction appeared to be linked with career advancement prospects. Conclusions Integrating career planning into psychosocial treatment is a critical task for providers who serve young adults with co-occurring disorders. Whether integrating career planning within early intervention treatment planning will improve clinical, functional, or economic outcomes is a promising area of inquiry for rehabilitation researchers and clinicians.

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Section: Methodsmentioning

confidence: 99%

A Qualitative Study of Career Exploration Among Young Adult Men With Psychosis and Co-occurring Substance Use Disorder

Luciano

Carpenter‐Song

2014

Journal of Dual Diagnosis

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“…Participants were recruited from a health center offering integrated treatment for co-occurring mental health and substance use disorder, which is rare in the United States (McGovern, Lambert-Harris, Gotham, Claus, & Xie, 2014). …”

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confidence: 99%

Long-Term Sobriety Strategies for Men With Co-occurring Disorders

Luciano¹,

Bryan²,

Carpenter‐Song³

et al. 2014

Journal of Dual Diagnosis

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Objective Roughly half of people with severe mental disorders also experience a co-occurring substance use disorder, and recovery from both is a critical objective for health care services. While understanding of abstinence initiation has grown, the strategies people with co-occurring disorders use to maintain sobriety are largely unknown. This article reports strategies for relapse prevention as described by men with co-occurring disorders who achieved one or more years of sobriety. Methods We analyzed semi-structured interviews conducted with a sample of 12 men with co-occurring psychosis and substance use disorder who achieved and maintained sobriety for at least one year, supplemented with demographic and diagnostic clinical record data. These men were participating in residential or outpatient treatment at a private, non-profit integrated treatment clinic. Results The 12 men were primarily Caucasian (91.7%) and unmarried (100%), and their ages ranged from 23 to 42 years. The two most common psychiatric disorders were schizoaffective disorder (n = 4, 33.3%) and bipolar disorder (n = 4, 33.3%), while the two most commonly misused substances were alcohol and cannabis. Qualitative analyses showed that participants maintained sobriety for at least one year by building a supportive community, engaging in productive activities, and carefully monitoring their own attitudes towards substances, mental health, and responsibility. Alcoholics Anonymous might act as a catalyst for building skills. Conclusions People with co-occurring disorders who achieve sobriety use a variety of self-management strategies to prevent relapse—seeking support, activities, and a healthy mindset. The findings suggest a relapse prevention model that focuses on social networks, role functioning, and self-monitoring, and conceptualizes self-care as critical to extending periods of wellness.

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“…Estimates of the degree to which SUD facilities co-locate and integrate treatment for CODs range widely based on the methodology and data source utilized (Bond and McGovern, 2013; Ducharme et al, 2006, 2007; Gil-Rivas and Grella, 2005; Gotham et al, 2010; Guerrero et al, 2014; Knudsen et al, 2004; Lambert-Harris et al, 2013; McGovern et al, 2006, 2007, 2014; Timko et al, 2005). Data collected from program providers typically utilize a single item to assess the capability to treat CODs.…”

Section: Introductionmentioning

confidence: 99%

“…The DDCAT ratings correspond with ASAM (2001) criteria. In one study, only 18% of a sample of US-based SUD treatment providers were dual diagnosis capable using the DDCAT (McGovern et al, 2014). The comprehensive DDCAT data collection requires using external raters, which can be resource-intensive and cost-prohibitive, therefore limiting the sample sizes of studies (McGovern et al, 2014; Sacks et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

“…In one study, only 18% of a sample of US-based SUD treatment providers were dual diagnosis capable using the DDCAT (McGovern et al, 2014). The comprehensive DDCAT data collection requires using external raters, which can be resource-intensive and cost-prohibitive, therefore limiting the sample sizes of studies (McGovern et al, 2014; Sacks et al, 2013). Despite its increased uptake across the US (e.g., Sacks et al, 2013) and internationally, DDCAT data are not available for facilities nationwide.…”

Section: Introductionmentioning

confidence: 99%

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Classifying substance use disorder treatment facilities with co-located mental health services: A latent class analysis approach

Mauro

Furr‐Holden

Strain³

et al. 2016

Drug and Alcohol Dependence

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Background The Affordable Care Act calls for increased integration and coordination of behavioral health services, as people with co-occurring disorders (CODs), meeting criteria for both substance use and psychiatric disorders, are overrepresented in treatment samples. Nationwide estimates of mental health (MH) service co-location in substance use disorder (SUD) treatment facilities are needed. We empirically derived a multiple-indicator categorization of services for CODs in SUD treatment facilities. Methods We used latent class analysis to categorize 14,037 SUD treatment facilities in the United States and territories included in the 2012 National Survey of Substance Abuse Treatment Services. Latent class indicators included MH screening and diagnosis, MH support services, psychiatric medications, groups for CODs, and psychosocial approaches. Multinomial logistic regression compared facility-identified primary focus (i.e., SUD, MH, mix of SUD-MH, and general/other) and other facility characteristics across classes. Results A four-class solution was chosen with the following classes: Comprehensive MH/COD Services (25%), MH without COD Services (25%), MH Screening Services (21%), and Limited MH Services (29%). The former two classes with co-located MH services were less likely to report a SUD-primary focus than the latter classes reporting only MH screening or Limited MH Services. Only the Comprehensive MH/COD Services class also had a high probability of providing special groups for CODs. Conclusions Approximately half of SUD treatment facilities were in classes with co-located mental health services, but only a quarter provided comprehensive COD services. Future studies should assess differences in patient experiences and treatment outcomes across facilities with and without COD services.

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Dual Diagnosis Capability in Mental Health and Addiction Treatment Services: An Assessment of Programs Across Multiple State Systems

Cited by 98 publications

References 28 publications

A Qualitative Study of Career Exploration Among Young Adult Men With Psychosis and Co-occurring Substance Use Disorder

A Qualitative Study of Career Exploration Among Young Adult Men With Psychosis and Co-occurring Substance Use Disorder

Long-Term Sobriety Strategies for Men With Co-occurring Disorders

Classifying substance use disorder treatment facilities with co-located mental health services: A latent class analysis approach

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