Dual Diagnosis Self-Help Referral

Study Overview
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Brief Summary
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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.

Detailed Description
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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.

Official Title
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Dual Diagnosis Self-Help Group Referral: Outcomes and Services Use

Conditions
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Dual Diagnosis

Intervention / Treatment
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* Behavioral: Intensive referral to dual-focused self-help


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Dually diagnosed veterans entering outpatient mental health treatment Exclusion Criteria: Unable to correctly answer the Orientation and Registration questions of the Mini-Mental State Examination

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Arm 1<br>Intensive referral to dual-focused self-help groups | Behavioral: Intensive referral to dual-focused self-help<br>* 4 group sessions to introduce patients to dual focused groups<br>|
| No Intervention: Arm 2<br>Usual care | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Psychiatric Functioning at 6 Months | Addiction Severity Index psychiatric composite ranges from 0 to 1, with 1 indicating more severe problems. | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mental Health Services Use and Costs at 6 Months, 1 Year, and 2 Years |  | 6 months, 1 year, 2 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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self-help groups, referral and consultation