Client and service characteristics associated with addiction treatment completion of clients with co-occurring disorders.

The study examines client and service characteristics of addiction treatment completers and non-completers with co-occurring disorders (COD). On demographic variables, completers were more likely to be male and homeless. In the psychiatric domain, a greater proportion of completers received diagnoses of depression and generalized anxiety disorder, whereas non-completers were more often diagnosed with bipolar disorder and posttraumatic stress disorder. No group differences were found in client-reported psychiatric symptom severity; however, non-completers were rated by clinicians as having more severe symptoms in the areas of interpersonal sensitivity, depression, and hostility. In the area of substance use patterns, no differences were found in primary substance of abuse but completers reported more days of use during the month prior to treatment. Completers also had a greater history of both prior detox and non-detox treatment. At discharge, completers achieved higher rates of past month abstinence and AA attendance, but no differences were found in length of stay in treatment. Examination of recovery support services utilization revealed that completers more often received peer mentoring services. Greater proportions of the non-completer group received educational support, clothing, medical care, and employment assistance. These results suggest that future studies are needed in examining possible differential treatment response by diagnostic category and the potential role of peer mentoring in enhancing addiction treatment completion of COD clients.

Counselor and client characteristics in mental health versus substance abuse treatment settings providing services for co-occurring disorders.

The study compares counselor and client characteristics of state-funded co-occurring disorder (COPSD) programs in mental health (MH) versus substance abuse (SA) settings. SA counselors more often had graduate degrees and MH counselors rated their knowledge and skills lower on two of nine COPSD best practice principles. MH clients were more frequently diagnosed with schizophrenia, depression, and bipolar disorder, whereas SA clients displayed evidence of greater substance use severity and had higher rates of treatment completion and abstinence at discharge. Results reveal significant implications for workforce development and potential system changes to enhance COPSD services that are unique to each setting.

Integrated versus parallel treatment of co-occurring psychiatric and substance use disorders.

The study examines 1-year treatment outcomes of 216 individuals with co-occurring severe and persistent mental illness and substance use disorders who were assigned to an integrated or parallel treatment condition. Comparisons indicated that the integrated group achieved greater reductions in the incidence of psychiatric hospitalization and arrest. The results of this study support the enhanced effectiveness of integrated treatment in decreasing the use of higher cost crisis-oriented services in clients with severe mental illness and substance use disorders.