title: Dual diagnosis competency among addiction treatment staff: Training levels, training needs and the link to retention.
abstract: BACKGROUND
  Dually diagnosed clients are described as one of the most challenging treatment populations, often leading to staff frustration, helplessness and negative attitudes. As yet it is unclear whether dual diagnosis (DD)-specific competency and therapeutic optimism among staff are related to client outcomes.
  
  
  METHODS
  The study used a 3-month follow-up design involving 124 DD clients starting treatment at 6 UK addiction services. Practitioners (n = 46) treating these clients were assessed regarding their DD specialisation levels. Cox regression analyses were performed to examine predictors of clients' 3-month retention rates.
  
  
  RESULTS
  Staff reported a median of 7 years work experience with DD clients, and 80% had received co-morbidity-specific training. Practitioners provided high average ratings on both the DD competency and the therapeutic optimism scale. Nevertheless, 78% of the sample indicated additional support needs in dealing with this client group. Higher levels of DD competencies among staff predicted better client retention.
  
  
  CONCLUSIONS
  The increased provision of support packages for practitioners is vital for improving competency levels in dealing with DD clients, which in turn may lead to improved client outcomes.
authors.affiliation: Department of Psychology, Manchester Metropolitan University, UK. stahboubschulte@aus.edu
authors.forename: S J
authors.initials: SJ
authors.lastname: Schulte
authors.forename: P S
authors.initials: PS
authors.lastname: Meier
authors.forename: J
authors.initials: J
authors.lastname: Stirling
authors.forename: M
authors.initials: M
authors.lastname: Berry
mesh_terms: D000328:Adult; D002983:Clinical Competence / Q000592:standards*; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008503:Medical Staff / Q000193:education*; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D015397:Program Evaluation; D016320:Substance Abuse Treatment Centers / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000628:therapy*; D006113:United Kingdom