A preliminary evaluation of integrated treatment for co-existing substance use and severe mental health problems: Impact on teams and service users

Graham, Hermine L.; Copello, Alex; Birchwood, Max; Orford, Jim; McGovern, Dermot; Mueser, Kim T.; Clutterbuck, Ruth; Godfrey, Emma; Maslin, Jenny; Day, Ed; Tobin, Derek

doi:10.1080/09638230600902633

Cited by 28 publications

(12 citation statements)

References 19 publications

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“…outpatient mental health services [11,12] . No significant differences in client outcomes were reported after 18 months of treatment except for modest improvements in psychiatric symptoms for clients in the trained-staff group reported in a later paper [13] .…”

mentioning

confidence: 99%

Dual Diagnosis Competency among Addiction Treatment Staff: Training Levels, Training Needs and the Link to Retention

et al. 2010

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Background: Dually diagnosed clients are described as one of the most challenging treatment populations, often leading to staff frustration, helplessness and negative attitudes. As yet it is unclear whether dual diagnosis (DD)-specific competency and therapeutic optimism among staff are related to client outcomes. Methods: The study used a 3-month follow-up design involving 124 DD clients starting treatment at 6 UK addiction services. Practitioners (n = 46) treating these clients were assessed regarding their DD specialisation levels. Cox regression analyses were performed to examine predictors of clients’ 3-month retention rates. Results: Staff reported a median of 7 years work experience with DD clients, and 80% had received co-morbidity-specific training. Practitioners provided high average ratings on both the DD competency and the therapeutic optimism scale. Nevertheless, 78% of the sample indicated additional support needs in dealing with this client group. Higher levels of DD competencies among staff predicted better client retention. Conclusion: The increased provision of support packages for practitioners is vital for improving competency levels in dealing with DD clients, which in turn may lead to improved client outcomes.

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confidence: 99%

Dual Diagnosis Competency among Addiction Treatment Staff: Training Levels, Training Needs and the Link to Retention

et al. 2010

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“…The immediate stimulus to the present study was an observation made in an earlier study evaluating an integrated service for people with combined psychosis and substance-misuse problems in one UK city (Graham et al, 2006). The results of that study suggested that it might be more difficult to address cannabis use in people with psychosis than to address use of other illicit drugs or alcohol.…”

Section: Introductionmentioning

confidence: 95%

“…We hypothesized that staff may have been more uncertain and ambivalent about cannabis use by clients than might have been the case for other substances. Staff attitudes, in turn, might have been influenced by the confusion in the literature about the association with psychosis and the general societal ambivalence towards cannabis use (Graham, Copello, Birchwood, Orford, McGovern, Georgiou, et al, 2003;Graham, Copello, Birchwood, Mueser, Oxford, McGovern, et al, 2004;Graham, Copello, Birchwood, Orford, McGovern, Mueser, et al, 2006). In order to seek further evidence, the current qualitative study was designed in order to explore the attitudes, beliefs and experiences of mental health professionals working with clients who have severe mental-health problems and who also used cannabis problematically.…”

Section: Introductionmentioning

confidence: 98%

Exploring the attitudes of staff working within mental health settings toward clients who use cannabis

Clutterbuck

Tobin

Orford

et al. 2009

Drugs: Education, Prevention and Policy

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Aims: This study aimed to explore the attitudes of staff working within mental health settings toward cannabis in general and cannabis use in individuals with severe mental-health problems. Method: Twenty members of staff working within community mental health teams in Birmingham, UK, were interviewed using qualitative research methods. The overarching themes within the staff accounts are described and the interrelationship between themes explored. Findings: Staff use an 'individualized' approach when working with cannabis-using clients dependent on a number of key components, including the positive and negative effects of use, wider evidence base, client vulnerability, engagement, professional and personal views and harm reduction. It is suggested that any approach staff may take toward cannabis use at any one time is greatly dependent upon the above factors and these factors are highly client specific. Conclusions: The findings may help to explain why interventions aimed at reducing substance use in people with psychosis might prove less successful when targeting cannabis use.

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“…Mental health problems are common in drug and alcohol services, but are rarely documented (Graham, 2004;Graham et al, 2006). Recent dual diagnosis service innovations of note include the COMPASS service in Birmingham which combines psychosis and substance misuse treatment (Graham et al, 2003) and the Haringey dual diagnosis service which aims to bring dual diagnosis insights to mental health teams, and help transfer between services (Lowe & Abou-Saleh, 2004).…”

Section: Service Level Issuesmentioning

confidence: 99%

Substance misuse in depression and bipolar disorder: a review of psychological interventions and considerations for clinical practice

Richardson

2013

Mental Health and Substance Use

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A preliminary evaluation of integrated treatment for co-existing substance use and severe mental health problems: Impact on teams and service users

Cited by 28 publications

References 19 publications

Dual Diagnosis Competency among Addiction Treatment Staff: Training Levels, Training Needs and the Link to Retention

Dual Diagnosis Competency among Addiction Treatment Staff: Training Levels, Training Needs and the Link to Retention

Exploring the attitudes of staff working within mental health settings toward clients who use cannabis

Substance misuse in depression and bipolar disorder: a review of psychological interventions and considerations for clinical practice

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