Outpatient treatment of adults with coexisting substance use and mental disorders

Hanson, Meredith; Kramer, Thomas H.; Gross, William F.

doi:10.1016/0740-5472(90)90006-c

Cited by 24 publications

(8 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There are several programs of comprehensive care for dual disorder outpatients with differences in content and intensity of interventions, 177 in areas of admission, 178 in mixed contexts, 153 and inday hospital. 179 …”

Section: Treatment Modelsmentioning

confidence: 97%

Protocols of Dual Diagnosis Intervention in Schizophrenia

Roncero

Barral

Grau-López

et al. 2011

Addictive Disorders &Amp; Their Treatment

View full text Add to dashboard Cite

show abstract

Section: Treatment Modelsmentioning

confidence: 97%

Protocols of Dual Diagnosis Intervention in Schizophrenia

Roncero

Barral

Grau-López

et al. 2011

Addictive Disorders &Amp; Their Treatment

View full text Add to dashboard Cite

show abstract

“…Many studies have shown the negative effect of psychiatric comorbidity on substance abuse treatment outcomes (e.g., Carroll et al 1993;Kranzler, Del Boca, and Rounsaville 1996;McLellan et al 1983;Rounsaville et al 1986;Rounsaville et al 1982;Project MATCH Research Group 1997;Weisner, Matzger, and Kaskutas 2003), and attenuated treatment engagement and early dropout have been identified as key factors in contributing to these negative outcomes (e.g., Booth, Cook, and Blow 1992;Carroll et al 1993;Hanson, Kramer, and Gross 1990). It is reasonable to assume that a very complex interaction of client and program environment characteristics underlies poorer program engagement and retention.…”

Section: The Prevalence Of Co-occurring Disorders and Their Interactimentioning

confidence: 99%

“…This negative life course includes, for example, a higher probability of victimization (Gearon and Bellack 1999; Mueser et al 1998), homelessness (Drake, Osher, andWallach 1991), and incarceration (Drake and Brunette 1998); seeking help from substance abuse and/or mental health treatment services (Kessler et al 1996;Regier et al 1993); and relapse and readmission (Moos, Mertens, and Brennan 1994). Indeed, co-occurring mental disorders are recognized as a particularly prominent characteristic of those who present for publicly (Chan, Dennis, and Funk in press;Diamond et al 2006;Hien et al 1997;Regier et al 1990;Ross, Glaser, and Germanson 1988;Tims et al 2002).Many studies have shown the negative effect of psychiatric comorbidity on substance abuse treatment outcomes (e.g., Carroll et al 1993;Kranzler, Del Boca, and Rounsaville 1996;McLellan et al 1983;Rounsaville et al 1986;Rounsaville et al 1982;Project MATCH Research Group 1997;Weisner, Matzger, and Kaskutas 2003), and attenuated treatment engagement and early dropout have been identified as key factors in contributing to these negative outcomes (e.g., Booth, Cook, and Blow 1992;Carroll et al 1993;Hanson, Kramer, and Gross 1990). It is reasonable to assume that a very complex interaction of client and program environment characteristics underlies poorer program engagement and retention.…”

mentioning

confidence: 99%

The Interaction of Co-Occurring Mental Disorders and Recovery Management Checkups on Substance Abuse Treatment Participation and Recovery

et al. 2008

View full text Add to dashboard Cite

This article examines the effectiveness of quarterly Recovery Management Checkups (RMCs) for people with substance disorders by level of co-occurring mental disorders (34% none, 27% internalizing disorders, and 39% internalizing and externalizing) across two randomized experiments with 92% to 97% follow-up. The 865 participants are 82% African American, 53% female, and age 37 on average. RMC involves identification of those in need of treatment, motivational interviews, and treatment linkage assistance. It is effective in linking participants in need to treatment, with equal or better outcomes among those with more mental disorders. The data support the utility of monitoring and re-intervention for clients with co-occurring disorders.Keywords co-occurring disorders; recovery management; substance abuse treatment outcome Given that substance use disorders are often chronic conditions that may last decades, it is hardly surprising that it takes an average of three to four admissions to treatment for 9 years to reach a sustained recovery Dennis et al. 2005;Grella and Joshi 1999;Hser et al. 1997;Hser et al. 1998). In recognition of these findings and other Reprints: http://www.sagepub.com/journalsReprints.nav Please address correspondence to Brian R. Rush, Center for Addiction and Mental Health, Room T304, 33 Russell St., Toronto, Ontario, M5S 2S1 Canada; phone: (416) 535-8501 (ext. 6625); brian_rush@camh.net. Questions about the Recovery Management Checkup intervention can be addressed to Christy K. Scott, Chestnut Health Systems, 221 W. Walton, Chicago, IL 60610; phone: (312) 664-4321; fax: (312) 664-4324; cscott@chestnut.org. Questions about the broader early re-intervention studies can be addressed to Michael L. Dennis, Chestnut Health Systems, 720 West Chestnut, Bloomington, IL 61701; mdennis@chestnut.org. Matzger, and Kaskutas 2003). This public health approach to longitudinal monitoring and early re-intervention (ERI) provides the foundation for Recovery Management Checkups (RMCs; Scott and Dennis 2003), an evidence-based approach for managing substance users through multiple episodes of treatment. The RMC intervention targets individuals who have previously participated in treatment and are now living in the community using substances. The intervention (described in more detail later) aims to provide immediate linkage back to substance abuse treatment on the basis of need, thus expediting the recovery process. Key components include, for example, assessing eligibility for the intervention and need for treatment, transferring participants in need of treatment from the interviewer to a linkage manager for a brief intervention, linking participants to the intake assessment, and ultimately linking participants to treatment. The intervention does not target or address concurrent disorders specifically. In two closely related experiments (Dennis, Scott, and Funk 2003; Scott and Dennis under review), participants randomly assigned to RMC or a control group were just as likely to be in need of treat...

show abstract

“…For example, recent research has documented the frequent co-occurrence of substance abuse with antisocial personality disorder (Abram, 1989(Abram, , 1990Collins, Schlenger, &Jordan, 1988); the likelihood of successful treatment is diminished in these cases (see Rogers & Mitchell,199 1). Clinical management of patients with dual diagnoses (i.e., substance abuse and a mental disorder) often has a poor outcome (Hanson, Kramer, & Gross, 1990;McLellan, Luborsky, Woody, O'Brien, & Druley, 1983;Safer, 1987). * Moreover, treatment outcome studies with forensic patients (e.g., Cohen, Spodak, Silver, & Williams, 1988;Rodenhauser & Khamis, 1988) typically address their discharge from maximum security hospitals and have little relevance to diversion recommendations.…”

Section: Arguments Against Diversionmentioning

confidence: 99%

Diversion of mentally disordered offenders: A legitimate role for clinicians?

Rogers

Bagby

1992

Behavioral Sci & The Law

View full text Add to dashboard Cite

Consultations to the courts often extend beyond criminal competencies and may include implicit statements regarding the diversion of mentally disordered offenders to treatment facilities. Arguments for diversion are based on humanitarian interests and treatment needs. Arguments opposing diversion recommendations emphasize (a) the variability of opinions regarding treatability, (b) the lack of sufficient outcome data, and (c) the potential for negative consequences in offering unsolicited opinions on diversion. Initial data from 271 pretrial evaluations underscore the range in psychiatric use of diversion recommendations, although inpatient referrals in particular appear to be based on clinical status.

show abstract

Outpatient treatment of adults with coexisting substance use and mental disorders

Cited by 24 publications

References 20 publications

Protocols of Dual Diagnosis Intervention in Schizophrenia

Protocols of Dual Diagnosis Intervention in Schizophrenia

The Interaction of Co-Occurring Mental Disorders and Recovery Management Checkups on Substance Abuse Treatment Participation and Recovery

Diversion of mentally disordered offenders: A legitimate role for clinicians?

Contact Info

Product

Resources

About