This project will help counselors in substance abuse treatment programs make effective referrals of dually diagnosed patients (those with a co-occurring psychiatric disorder) to self-help groups.
Background: Dual diagnosis (psychiatric and substance use) patients' (DDPs) participation in 12-step mutual-help groups is linked to lower relapse and treatment utilization rates. However, under usual referral, many DDPs do not attend, or sustain attendance of, substance-focused groups (SFG). DDPs may benefit from dual-focused groups (DFGs). Objectives: (1) Implement and validate procedures to help counselors make effective referrals to DFGs. DDPs were assigned to a standard- or intensive-referral to DFG condition to determine the extent to which intensive referral, compared to standard referral, increased patients' mutual-help group participation. (2) Determine whether DDPs who received intensive referral had better substance use and psychiatric outcomes. Methods: DDPs entering VA outpatient mental health treatment received either standard (N=145) or intensive (N=142) referral. Standard referral consisted essentially of the counselor recommending DFG participation. The keys to intensive referral were a DFG orientation and the counselor facilitating direct contact between the patient and a DFG member, and following up on recommendations for mutual help. Patients were followed at six months (80%), one year (81%) and two years (80%) to determine whether intensive referral resulted in more DFG and SFG participation, and better substance use and psychiatric outcomes. Status: Completed.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
287
4 group sessions to introduce patients to dual focused groups
VA Palo Alto Health Care System, Palo Alto, CA
Palo Alto, California, United States
Psychiatric Functioning at 6 Months
Addiction Severity Index psychiatric composite ranges from 0 to 1, with 1 indicating more severe problems.
Time frame: 6 months
Mental Health Services Use and Costs at 6 Months, 1 Year, and 2 Years
Time frame: 6 months, 1 year, 2 years
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