title: Impact of robustness of program implementation on outcomes of clients in dual diagnosis programs.
abstract: Three types of treatment-behavioral skills training, a 12-step recovery model, and intensive case management-provided to 132 clients at four facilities were identified as being robustly or not robustly implemented, depending on whether core elements of these treatments were emphasized. Outcomes and costs of services to clients were examined over 18 months. Clients receiving robustly implemented behavioral skills training had significantly higher psychosocial functioning and lower costs for supportive services than those receiving nonrobustly implemented training. Clients receiving robustly implemented case management also exhibited significantly higher psychosocial functioning and lower costs for intensive services than those in the nonrobust intervention. To be effective, dual diagnosis programs should better manage the robustness of implementation of planned interventions.
authors.affiliation: University of South Carolina School of Medicine, Columbia 29203, USA. jerrell.jeni@sc.edu
authors.forename: J M
authors.initials: JM
authors.lastname: Jerrell
authors.forename: M S
authors.initials: MS
authors.lastname: Ridgely
mesh_terms: D000293:Adolescent; D000328:Adult; D001521:Behavior Therapy / Q000191:economics*; D019090:Case Management / Q000191:economics*; D003131:Combined Modality Therapy; D003362:Cost-Benefit Analysis; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008605:Mental Health Services / Q000191:economics; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D012559:Schizophrenia / Q000175:diagnosis / Q000191:economics / Q000534:rehabilitation*; D012657:Self-Help Groups / Q000191:economics*; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000191:economics / Q000534:rehabilitation*