Integrated treatment of dual disorders in The Netherlands: a qualitative study of client experiences

Abstract

Purpose Many clients who suffer from severe mental health problems also struggle with alcohol and drug use. And although there seems to be a consensus in most European countries that integrated treatment models (especially the integrated treatment of dual disorder clients model) are best fitted to help these clients, none of these have strong evidence, mostly owing to methodological limitations in the studies. This study aims to contribute to the knowledge of why integrated treatment is helpful by conducting in-depth interviews with dual disorder clients who are currently receiving integrated treatment. Design/methodology/approach This study is a qualitative thematic analysis using a timeline tool to elicit participants’ responses. In the interviews, dual diagnosis clients with severe problems reflected on their situation at admission, the care they received in integrated treatment and their opinions on positive and negative elements. The interviews were coded and analysed with MAXQDA. Findings In the analyses of the interviews, this study found three clusters of elements that clients indicated were the most helpful during their treatment and recovery process: trusting and meaningful relationship with the team, components of integrated treatment and organisation of care. Originality/value The findings emphasized the importance of working relationship in the treatment of complex and long-term problems. This has implications for the evaluation of these integrated treatment models which so far mainly focuses on specific interventions.

Participatory practice guideline development at the intersections of domestic and family violence, mental distress and/or parental substance use

“…The emergence of the dual diagnosis field has led to new service delivery models and practices that have increased our understanding of the interconnections between substance use and MH and have resulted in many innovative practices (Rettie et al, 2021;Wamel et al, 2021). Yet, DFV has been largely constructed as "co-existing" rather than as a central issue of concern and often part of the tactics of coercive control.…”