Cognitive Behavioral Intervention for Individuals with Severe Mental Illness Who Have a Substance Misuse Problem

Abstract

There have been considerable advances in the use of psychological treatments for individuals with psychosis in the last 20 years or so. This paper describes an ongoing study in which these treatment approaches are being modified and combined for use with a particularly challenging client group–those with a diagnosis of schizophrenia who have a comorbid drug or alcohol problem. Prevalence rates for such individuals with “dual diagnosis” are high, with surveys indicating that from 20%-60% of clients with schizophrenia may have a substance use problem. More importantly, there is evidence that clinical outcomes are worse for this group and that persons in treatment present many difficulties for services, for example, frequent hospital admissions, violence, engagement problems, and noncompliance. Although there are accounts and evaluations of integrated treatment strategies in the U.S. (Drake et al., 1989; 1991), there is little published work from the UK demonstrating an integration of treatments targeted at both the mental health and substance use problems.