Abstract
This study explored training issues relevant to work with comorbid clients (those with both psychiatric and substance abuse diagnoses) among members of a psychiatric hospital clinical staff (N=147). Respondents reported that they had received limited training for working with comorbid or substance abusing clients; they perceived comorbid clients as presenting with particular concerns, especially regarding referral to treatment services and management of acting-out behaviors; and they attached great importance to the need for training in comorbidity. With high proportions of clients at psychiatric hospitals being comorbid, it is imperative that staff members receive training to deal with substance abuse and comorbidity. These results suggest that such training has not been available, but it is needed and wanted.
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REFERENCES
Alexander, M.J., Craig, T.J., MacDonald, J., & Haugland, G. (1994). Dual diagnosis in a state psychiatric facility. American Journal on Addictions, 3, 314-324.
Alverson, H., Alverson, M., & Drake, R.E. (2000). An ethnographic study of the longitudinal course of substance abuse among people with severe mental illness. Community Mental Health Journal, 36, 557-569.
Brems, C., & Johnson, M.E. (1997). Clinical implications of the co-occurrence of substance use and other psychiatric disorder. Professional Psychology: Research and Practice, 28, 437-447.
Brems, C., Johnson, M.E., & Namyniuk, L. (2002). Clients with substance abuse and mental health concerns: A guide for conducting intake interviews. Journal of Behavioral Health Services and Research, 29, 327-334.
Carey, K.B., & Correia, C.J. (1998). Severe mental illness and addictions: Assessment considerations. Addictive Behaviors, 23, 735-748.
Chappel, J.N. (1993). Training of residents and medical students in the diagnosis and treatment of dual diagnosis patients. Journal of Psychoactive Drugs, 25, 293-300.
First, M.B., & Gladis, M.M. (1993). Diagnosis and differential diagnosis of psychiatric and substance use disorders. In J. Solomon, S. Zimberg, & E. Shollar (Eds.), Dual diagnosis: Evaluation, treatment, training, and program development (pp. 23-36). New York: Plenum Medical Book.
Galanter, M., Kaufman, E., Taintor, Z., Robinowitz, C.B., Meyer, R.E., & Halikas, J. (1989). The current status of psychiatric education in alcoholism and drug abuse. American Journal of Psychiatry, 146, 35-39.
Goodman, H., Landsberg, G., Estrine, S., & Warga, C. (1994). Mentally ill chemically abusing clients: A survey of training needs of community residence staff in New York City. Adult Residential Care Journal, 8, 8-15.
Hoff, R.A., & Rosenheck, R.A. (1999). The cost of treating substance abuse patients with and without comorbid psychiatric disorders. Psychiatric Services, 50, 1309-1315.
Johnson, J. (2000). Cost-effectiveness of mental health services for persons with a dual diagnosis: A literature review and the CCMHCP. Journal of Substance Abuse Treatment, 18, 119-127.
Johnson, S. (1997). Dual diagnosis of severe mental illness and substance misuse: A case of specialist services? British Journal of Psychiatry, 171, 205-208.
Kavanagh, D.J., Greenaway, L., Jenner, L., Saunders, J.B., White, A., Sorban, J., & Hamilton, G. (2000). Contrasting views and experiences of health professionals on the management of comorbid substance misuse and mental disorders. Australian and New Zealand Journal of Psychology, 34, 279-289.
Lehman, A.F., Myers, C.P., Corty, E., & Thompson, J.W. (1994). Prevalence and patterns of dual diagnosis among psychiatric inpatients. Comprehensive Psychiatry, 35, 106-112.
Miller, N.S. (1995). Psychiatric diagnosis in drug and alcohol addiction. Alcoholism Treatment Quarterly, 12, 75-92.
Miller, N.S., Belkin, B.M., & Gibbons, R. (1994). Clinical diagnosis of substance use disorders in private psychiatric populations. Journal of Substance Abuse Treatment, 11, 387-392.
Mueser, K.T., Bennett, M., & Kushner, M.G. (1995). Epidemiology of substance use disorders among persons with chronic mental illnesses. In A.F. Lehman & L. Dixon (Eds.), Double jeopardy: Chronic mental illness and substance abuse (pp. 9-25). New York: Harwood Academic.
Primm, B. (1992). Alcohol and other drug abuse: Changing lives through research and treatment. Journal of Health Care for the Poor and Underserved, 3, 1-17.
Regier, D.A., Farmer, M.E., Rae, D.S., Locke, B.Z., Keith, S.J., Judd, L.L., & Goodwin, F.K. (1990). Comorbidity of mental disorders with alcohol and other drug abuse: Results from the Epidemiological Catchment Area (ECA) study. Journal of the American Medical Association, 264, 2511-2518.
Ridgely, M.S., Goldman, H.H., & Willenbring, M. (1990). Barriers to the care of persons with dual diagnoses: Organizational and financing issues. Schizophrenia Bulletin, 16, 123-132.
Ries, R., Mullen, M., & Cox., G. (1994). Symptom severity and utilization of treatment resources among dually diagnosed inpatients. Hospital and Community Psychiatry, 45, 562-568.
Stanton, A., Kennedy, M., Spingarn, R., & Rotheram-Borus, M.J. (2000). Developing services for substance abusing HIV-positive youth with mental health disorders. Journal of Behavioral and Health Services Research, 27, 380-389.
Williams, K. (1999). Attitudes of mental health professional to co-morbidity between mental health problems and substance misuse. Journal of Mental Health, 8, 605-613.
Young, N.K., & Grella, C.E. (1998). Mental health and substance abuse treatment services for dually diagnosed clients: Results of a statewide survey of county administrators. Journal of Behavioral and Health Services Research, 25, 83-92.
Zimberg, S. (1993). Introduction and general concepts of dual diagnosis. In J. Solomon, S. Zimberg, & E. Shollar (Eds.), Dual diagnosis: Evaluation, treatment, training, and program development (pp. 4-22). New York: Plenum Medical Book.
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Brems, C., Johnson, M.E., Bowers, L. et al. Comorbidity Training Needs at a State Psychiatric Hospital. Adm Policy Ment Health 30, 109–120 (2002). https://doi.org/10.1023/A:1022581001193
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DOI: https://doi.org/10.1023/A:1022581001193