IIR 05-014
Dual Diagnosis Self-Help Group Referral: Outcomes and Services Use
Christine Timko, PhD VA Palo Alto Health Care System, Palo Alto, CA Palo Alto, CA Funding Period: April 2006 - September 2010 Portfolio Assignment: Mental and Behavioral Health |
BACKGROUND/RATIONALE:
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). OBJECTIVE(S): (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. FINDINGS/RESULTS: To date, analyses have focused on six-month follow-up results. Compared to patients in the standard condition, those in the intensive referral intervention were more likely to attend and be involved in DFGs and SFGs, and had better psychiatric outcomes at follow-up. Attending more intensive-referral sessions was associated with more DFG and SFG meeting attendance. More need fulfillment in DFGs, and more readiness to participate in SFGs, were associated with better alcohol and psychiatric outcomes at six months. IMPACT: This project is helping to specify clinical practices to enhance dually diagnosed veteran patients' chances of recovery. The intensive referral procedures validated in this project should be efficient, inexpensive, and generalizable for use by mental health clinicians in and outside the VA. External Links for this ProjectDimensions for VADimensions for VA is a web-based tool available to VA staff that enables detailed searches of published research and research projects.Learn more about Dimensions for VA. VA staff not currently on the VA network can access Dimensions by registering for an account using their VA email address. Search Dimensions for this project PUBLICATIONS:Journal Articles
DRA:
Substance Use Disorders, Health Systems Science, Mental, Cognitive and Behavioral Disorders
DRE: Treatment - Efficacy/Effectiveness Clinical Trial, Treatment - Observational Keywords: Dual diagnosis – substance abuse and mental health, Outcomes, Utilization patterns MeSH Terms: none |