title: The challenge of implementing and sustaining integrated dual disorders treatment programs.
abstract: Integrated dual disorders treatment programs for people with severe mental illness and co-occurring substance use disorder have been implemented in a variety of community mental health center sites across the U.S. and in several other countries over the past 15 years. Consumers who receive services from programs that offer integrated dual diagnosis treatments that are faithful to evidence-based principles achieve significant improvements in their outcomes. Unfortunately, not all programs that attempt implementation are successful, and the quality of high-fidelity programs sometimes erodes over time. This article outlines implementation strategies that have been used by successful programs. As a general rule, success is achieved by involving all major participants (consumers, family members, clinicians, program leaders, and state or county mental health authorities) in the process and attending to the three phases of change: motivating, enacting, and sustaining implementation.
authors.affiliation: New Hampshire-Dartmouth Psychiatric Research Center, Lebanon 03766, USA. William.C.Torrey@Dartmouth.EDU
authors.forename: William C
authors.initials: WC
authors.lastname: Torrey
authors.forename: Robert E
authors.initials: RE
authors.lastname: Drake
authors.forename: Michael
authors.initials: M
authors.lastname: Cohen
authors.forename: Lindy B
authors.initials: LB
authors.lastname: Fox
authors.forename: David
authors.initials: D
authors.lastname: Lynde
authors.forename: Paul
authors.initials: P
authors.lastname: Gorman
authors.forename: Philip
authors.initials: P
authors.lastname: Wyzik
mesh_terms: D003156:Community Mental Health Services / Q000458:organization & administration* / Q000592:standards; D017831:Diagnosis, Dual (Psychiatry); D006801:Humans; D001523:Mental Disorders / Q000150:complications / Q000628:therapy*; D015397:Program Evaluation; D019966:Substance-Related Disorders / Q000150:complications / Q000628:therapy*