Dual Diagnosis Self-Help Referral
Dual Diagnosis Self-Help Group Referral: Outcomes and Services Use
Study Overview
Status
Conditions
Intervention / Treatment
Detailed 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.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
California
-
Palo Alto, California, United States, 94304-1290
- VA Palo Alto Health Care System, Palo Alto, CA
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
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
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
|
Experimental: Arm 1
Intensive referral to dual-focused self-help groups
|
4 group sessions to introduce patients to dual focused groups
|
|
No Intervention: Arm 2
Usual care
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Psychiatric Functioning at 6 Months
Time Frame: 6 months
|
Addiction Severity Index psychiatric composite ranges from 0 to 1, with 1 indicating more severe problems.
|
6 months
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Mental Health Services Use and Costs at 6 Months, 1 Year, and 2 Years
Time Frame: 6 months, 1 year, 2 years
|
6 months, 1 year, 2 years
|
Collaborators and Investigators
Investigators
- Principal Investigator: Christine Timko, PhD, VA Palo Alto Health Care System, Palo Alto, CA
Publications and helpful links
General Publications
- Timko C, Cronkite RC, McKellar J, Zemore S, Moos RH. Dually diagnosed patients' benefits of mutual-help groups and the role of social anxiety. J Subst Abuse Treat. 2013 Feb;44(2):216-23. doi: 10.1016/j.jsat.2012.05.007. Epub 2012 Jul 3.
- Timko C, Sutkowi A, Moos R. Patients with dual diagnoses or substance use disorders only: 12-step group participation and 1-year outcomes. Subst Use Misuse. 2010 Mar;45(4):613-27. doi: 10.3109/10826080903452421.
- Timko C. Detoxification history and two-year outcomes of substance use disorder treatment and mutual-help group participation. Journal of drug issues. 2013 Jun 17; 20(10):1-18.
- Makin-Byrd K, Cronkite RC, Timko C. The influence of abuse victimization on attendance and involvement in mutual-help groups among dually diagnosed male veterans. J Subst Abuse Treat. 2011 Jul;41(1):78-87. doi: 10.1016/j.jsat.2011.02.001. Epub 2011 Mar 10.
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- IIR 05-014
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