Dual Diagnosis Self-Help Referral

VA Office of Research and Development

Status: Completed

Conditions: Dual Diagnosis

Treatments: Behavioral: Intensive referral to dual-focused self-help

Study type: Interventional

Funder types: Other U.S. Federal agency

Identifiers

NCT00286728

IIR 05-014

Details and patient eligibility

About

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.

Full description

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.

Enrollment: 287 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

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

Trial design

Primary purpose: Treatment

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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287 participants in 2 patient groups

Arm 1

Experimental group

Description:

Intensive referral to dual-focused self-help groups

Treatment:

Behavioral: Intensive referral to dual-focused self-help

Arm 2

No Intervention group

Description:

Usual care