title: Behavioral Interventions for Individuals Dually-Diagnosed with a Severe Mental Illness and a Substance Use Disorder.
abstract: The prevalence of substance abuse among severely mentally ill individuals (SMI) with a schizophrenia-spectrum or bipolar disorder is about three times the rate of the general population. However, few effective interventions exist to address the problem. In this paper, we evaluate recent studies of behavioral interventions for substance abuse among SMI individuals. These include cognitive-behavioral, motivational interviewing, and contingency management interventions, as well as combinations thereof. Consistent with prior systematic reviews, ours indicates that no behavioral intervention has clearly demonstrated efficacy beyond that of usual care. Unfortunately, most of the reviewed studies suffer from methodological problems that hamper detection of treatment effects. Also, it can be argued that interventions tested thus far may not be well-suited for this cognitively-impaired population. A programmatic series of studies is needed to further develop and test behavioral interventions for treating substance abuse in this population.
authors.affiliation: Research Institute on Addictions University at Buffalo - State University of New York 1021 Main Street Buffalo, New York Tel. 716-887-2532 Fax. 716-887-2215 bradizza@ria.buffalo.edu.
authors.forename: Clara M
authors.initials: CM
authors.lastname: Bradizza
authors.affiliation: Research Institute on Addictions University at Buffalo - State University of New York 1021 Main Street Buffalo, New York Tel. 716-887-2596 Fax. 716-887-2477 stasiewi@ria.buffalo.edu.
authors.forename: Paul R
authors.initials: PR
authors.lastname: Stasiewicz
authors.affiliation: Research Institute on Addictions University at Buffalo - State University of New York 1021 Main Street Buffalo, New York Tel. 716-887-2492 Fax. 716-887-2477 dermen@ria.buffalo.edu.
authors.forename: Kurt H
authors.initials: KH
authors.lastname: Dermen
keywords: behavioral interventions; cognitive-behavioral therapy; contingency management; dual diagnosis; motivational interviewing; schizophrenia