A Brief Treatment Engagement Intervention for Individuals with Co-occurring Mental Illness and Substance Use Disorders: Results of a Randomized Clinical Trial
- 1.3k Downloads
Study objectives were to evaluate a brief intervention designed to facilitate outpatient engagement following an inpatient psychiatric stay for individuals with mental illness and substance use. A total of 102 veterans were randomly assigned to one of two conditions: (1) Time Limited Care-Coordination (TLC), an eight-week co-occurring disorders intervention or (2) a matched attention (MA) control condition in the form of health education sessions. Both groups also received treatment as usual in inpatient and outpatient settings. Sixty-nine percent of TLC participants attended an outpatient appointment within 14 days of discharge, compared to only 33% of MA participants (P < 0.01). TLC participants were also more likely to be engaged in outpatient services at the end of the intervention period (44 vs. 22%, P < 0.01). This study provided evidence that an eight-week intervention could improve treatment engagement. Research is currently underway to examine impact of TLC intervention beyond the 8 week study period.
KeywordsSubstance abuse Mental illness Behavioral therapy Case management Peer support Treatment engagement
This research was supported by grants from the Department of Veterans Affairs-Health Services Research and Development Service: IIR-020-145 (Dr. Smelson). The authors wish to acknowledge the support by veterans who participated in this research.
- Bellack, A. et al. (2009). Behavioral therapy along with critical time intervention for co-occurring disorders. Presented at NIAAA R 13 Conference, Fairlee, VT.Google Scholar
- Kreyenbuhl, J., Nossel, I. R., & Dixon, L. B. (2009). Disengagement from mental health treatment among individuals with schizophrenia and strategies for facilitating connections to care: A review of the literature. Schizophrenia Bulletin, 35, 696–703.Google Scholar
- Latimer, E. (1999). Economic impacts of assertive community treatment: A review of the literature. Canadian Journal of Psychiatry, 44, 443–454.Google Scholar
- Morgenstern, J., Neighbors, C. J., Kuerbis, A., Riordan, A., Blanchard, K. A., McVeigh, K. H., et al. (2009b). Improving 24-month abstinence and employment outcomes for substance-dependent women receiving temporary assistance for needy families with intensive case management. American Journal of Public Health, 99, 328–333.PubMedCrossRefGoogle Scholar
- Nidecker, M., DiClemente, C. C., Bennett, M. E., & Bellack, A. S. (2008). Application of the transtheoretical model of change: Psychometric properties of leading measures in patients with co-occurring drug abuse and severe mental illness. Addictive Behaviors, 33, 1021–1030.PubMedCrossRefGoogle Scholar
- Smelson, D. A., Kline, A., Hills, S., Mizzeli, A., & Trip, J. (2007a). The MISSION consumer workbook. Substance Abuse and Mental Health Service Administration.Google Scholar
- Smelson, D.A., Kline, A., Hills, S., & Ziedonis, D. (2007b). The MISSION treatment manual. Substance Abuse and Mental Health Service Administration.Google Scholar
- Smelson, D. A., Losonczy, M., Castles-Fonseca, K., Stewart, P., Kaune, M., & Ziedonis, D. (2005). Preliminary outcomes from a booster case management program for individuals with a co-occuring substance abuse and a persistent psychiatric disorder. Journal of Dual Diagnosis, 3, 47–59.CrossRefGoogle Scholar
- Smelson, D. A., Losonczy, M., Ziedonis, D., Castles-Fonseca, K., & Kaune, M. (2007b). Six month outcomes from a booster case management program for individuals with a co-occuring substance abuse and a persistent psychiatric disorder. European Journal of Psychiatry, 21, 143–152.Google Scholar
- Ziedonis, D., & Stern, R. (2001). Dual recovery therapy for schizophrenia and substance abuse. Psychiatric Annals, 31, 255–264.Google Scholar