The role of the admission phase in the Italian treatment setting: A research on individuating shared practices in psychotropic substance users' communities.

There are various and diversified ways of admission of a substance user into a therapeutic community. When these ways result from actions that are inconsistent with the general objective of the service, they may lead to adverse outcomes that substantially impact both therapeutic interventions efficacy and services efficiency. Consequences are multiple, concerning the substance user, other users of the service, professionals working at the service, and the center's relationships with the service network to which the center belongs. This study aims to define and share major interactive and organizational problems concerning the admission process at CEAL accredited structures and to define and standardize a protocol of procedures aimed at managing and supervising the admission process, through specific and commonly agreed indicators. The research was carried out according to the focus group methodology and involved sixty directors of various health communities offering residential services for substance use treatment. The research was guided by a focus group moderator. The research has made it possible to identify the biases and errors in the admission process and selected those practices shared by the therapeutic communities and conducive to generating positive outcomes. The findings in the definition of a procedure, complete with precise indicators that are applicable across the therapeutic communities and to the shared activities that constitute and are conducive to the success of the admission process.

Dual Diagnosis and Application Problems in the Use of the Construct: A Review of Literature.

Dual diagnosis (DD) commonly identifies a condition of co-occurrence of substance use disorders and psychological or psychiatric disorders. Many scholars have tried to explain this phenomenon, yet no agreement has been found: methodologies of intervention and treatment are numerous, but there is no uniformity of methodology. Our work aims to search critical aspects linked to this fragmented framework, to facilitate those who use the construct of DD. We have elaborated a literary review focused on specific critical contributions to the theoretical and methodological complexity of the construct. Scopus, PubMed, and Scholar were used as search engines. Our research reveals significant problems around several thematic areas: Defining, Operative and Treatment; Economic and Policy; Pharmacological Approach; and Patients' Perspectives Issues. Consistent issues are discussed with regard to DD: innovation should start from its limits. Future research should look for alternative theoretical formulations and consequent intervention experiences to provide new perspectives.