Meta-analysis of Interventions With Co-occurring Disorders of Severe Mental Illness and Substance Abuse: Implications for Social Work Practice

Abstract

Objective: A quantitative analysis of 15 empirical studies is conducted to determine effective interventions with the dually diagnosed. Method: Client and practitioner characteristics, types of interventions, and treatment effectiveness are examined through meta-analytic techniques. Results: (a) Age of client was positively correlated with effect size, (b) there were no statistically significant correlations between practitioner training or practitioner-to-client ratio and effect size, (c) intensive case management was associated with the greatest effect size, and (d) a small positive effect size was found for standard aftercare with outpatient psychoeducational treatment groups. Conclusions: Social work practice implications, based on the results of the quantitative analysis and trends identified in the studies, are that there is a unique role for practitioners in advocating for linkage of resources, additional supports for clients, and the dismantling of barriers that impede resource access.

Effects of Integrated Trauma Treatment on Outcomes in a Racially/Ethnically Diverse Sample of Women in Urban Community-based Substance Abuse Treatment

“…These findings suggest the long-term positive effect of the integrated services on both mental health and PTSD symptoms. These results are consistent with previous studies [44][45][46][47][48][49] that have documented the importance of addressing trauma and substance abuse in an integrated manner to obtain significant positive outcomes among women with cooccurring disorders. The results also reflect strong associations among severity of substance use, mental health problems, and PTSD symptoms.…”

Cognitive-Behavioral Treatment With Adult Alcohol and Illicit Drug Users: A Meta-Analysis of Randomized Controlled Trials

“…Dumaine (2003) also found a positive association between female participants and effect size in a meta-analysis of treatment with individuals with co-occurring substance and other mental health disorders. Dumaine's fi ndings were based on bivariate correlations, and this meta-analysis may be more conservative given that additional client and study design variables were accounted for in the analyses.…”

“…Psychosocial addictions treatments, other than CBT, have received relatively more attention from meta-analytic inquiry. A review of this literature yielded four meta-analyses of brief motivational interventions (Burke et al, 2003;Dunn et al, 2001;Harvard et al, 2007;Moyer et al, 2002), three on methods based in contingency management (Griffi th et al, 2000;Lussier et al, 2006;Prendergast et al, 2006), three studies on marital or family-based interventions (Edwards and Steinglass, 1995;Powers et al, 2008;Stanton and Shadish, 1997), and three on self-help approaches (Emrick et al, 1993;Kownacki and Shadish, 1999;Tonigan et al, 1996). Moreover, Butler et al (2006) examined the current state of meta-analytic evaluation across 16 studies of CBT for psychiatric disorders and noted a need for meta-analysis specifi c to substance using populations.…”

Meta-analyses of seven of the National Institute on Drug Abuse's principles of drug addiction treatment

“…This left only 3 independent comparisons, which we considered insufficient for meta-analysis. Other overviews (which used different eligibility criteria than EPT) of studies of co-occurring disorders are a systematic review by Drake, O’Neal, & Wallach (2008) and a meta-analysis by Dumaine (2003).…”

“…Prior to 1999, there were few meta-analyses available to inform the development of the NIDA principles (Brewer et al, 1998; Stanton & Shadish, 1997; Marsch, 1998). Subsequently, a number of meta-analyses have been published, e.g., on relapse prevention (Irvin, Bowers, Dunn, & Wang, 1999), co-occurring disorders (Dumaine, 2003), motivational interviewing (Burke, Arkowitz, & Menchola, 2003), naltrexone maintenance treatment (Johansson, Berglund, & Lindgren, 2006), HIV risk reduction among IDUs (Copenhaver, Lee, Harman, Johnson, & Carey, 2006), voucher-based reinforcement therapy (Lussier, Heil, Mongeon, Badger, & Higgins, 2006), contingency management (Prendergast, Podus, Finney, Greenwell, & Roll, 2006), case management (Vanderplasschen, Wolf, Rapp, & Broekaert, 2007), behavioral couples therapy (Powers, Vedel, & Emmelkamp, 2008), and cognitive-behavioral therapy (Magill & Ray, 2009). …”