Psychological treatments for comorbidity across the life course

Abstract

Background. The co-occurrence of substance use and mental illness (dual diagnosis) is a common clinical problem and one that is often not adequately addressed therapeutically.

Aims. To review the literature on psychological treatments for dual diagnosis, and make recommendations for clinicians regarding to deployment of such interventions tailored to the age and developmental stage of the individual.

Method. Selective literature review.

Results. Despite significant methodological problems in conducting research into treatments for dual diagnosis, a number of specific approaches have an emerging evidence base in this patient population. These include motivational interviewing, cognitive behavioural therapy, contingency management, social skills training, problem solving, psychosocial education, case management and family/carer support. A few studies have attempted to integrate some or most of these elements into a comprehensive intervention.

Conclusions. Existing psychological treatments for dual diagnosis can be effective and are best deployed as part of an integrated service model. However, much remains to be learnt regarding the optimal care of individuals with dual problems of substance use and a mental illness.

Keywords:

• psychological treatment
• co-occurrence
• literature review