Substance use disorders (SUD) in persons with severe mental illness (SMI) are common and have a profound effect on the course of psychiatric illness. Despite the prominence of """"""""dual disorders"""""""" among the SMI, no manualized, empirically validated treatments exist. There is a particular need for family work in this area because most dually diagnosed clients maintain contact with relatives, and the loss of family support is associated with housing instability and homelessness in this population. The proposed research will be a controlled evaluation of a new family intervention for dual disorders (FIDD) program, described in a treatment manual and supported by a pilot study. The study will take place at two typical public mental health centers, the North Suffolk Mental Health Association in Massachusetts and the San Fernando Mental Health Center in California. The research will be conducted by the joint effort of two well-established centers for mental health services and clinical trials research, the New Hampshire-Dartmouth Psychiatric Research Center and the UCLA Intervention Research Center. A total of 140 clients and their families (N=70 at each site) will be randomly assigned to either the FIDD program for 2 years (N=70), which includes both single family and multiple-family group formats, or family psychoeducation including 6 weekly sessions (N=70). Fidelity of clinicians to the FIDD program will be monitored with standardized measures. Routine assessments will be conducted over 2 years on all clients and relatives to evaluate a wide range of outcomes, including substance abuse, hospitalizations, psychiatric symptoms, legal problems, aggression, housing and homelessness, family burden, social support, and quality of life. Process measures of the FIDD program will include family knowledge of dual disorders and problem-solving skill. The results of the proposed research have important implications for improving the long-term outcomes of clients with dual disorders and lessening the impact of SUD on relatives. Enhancing the skills of families for coping with dual disorders is expected to be an effective strategy for treating SUD, decreasing hospitalizations, and decreasing caregiver burden. Improvements in these areas may the have long-term benefit of maintaining family involvement with dually diagnosed clients, thereby reducing housing instability and homelessness.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH062629-03
Application #
6639223
Study Section
Special Emphasis Panel (ZMH1-ITV-D (01))
Program Officer
Oliver, Karen Anderson
Project Start
2001-07-03
Project End
2006-06-30
Budget Start
2003-07-01
Budget End
2004-06-30
Support Year
3
Fiscal Year
2003
Total Cost
$547,532
Indirect Cost
Name
Dartmouth College
Department
Psychiatry
Type
Schools of Medicine
DUNS #
041027822
City
Hanover
State
NH
Country
United States
Zip Code
03755
Mueser, Kim T; Glynn, Shirley M; Cather, Corrine et al. (2013) A randomized controlled trial of family intervention for co-occurring substance use and severe psychiatric disorders. Schizophr Bull 39:658-72
Mueser, Kim T; Gottlieb, Jennifer D; Cather, Corrine et al. (2012) Antisocial Personality Disorder in People with Co-Occurring Severe Mental Illness and Substance Use Disorders: Clinical, Functional, and Family Relationship Correlates. Psychosis 4:52-62
Gottlieb, Jennifer D; Mueser, Kim T; Glynn, Shirley M (2012) Family therapy for schizophrenia: co-occurring psychotic and substance use disorders. J Clin Psychol 68:490-501
Mueser, Kim T; Glynn, Shirley M; Cather, Corinne et al. (2009) Family intervention for co-occurring substance use and severe psychiatric disorders: participant characteristics and correlates of initial engagement and more extended exposure in a randomized controlled trial. Addict Behav 34:867-77
Niv, Noosha; Lopez, Steven R; Glynn, Shirley M et al. (2007) The role of substance use in families'attributions and affective reactions to their relative with severe mental illness. J Nerv Ment Dis 195:307-14
Gold, Paul B; Glynn, Shirley M; Mueser, Kim T (2006) Challenges to implementing and sustaining comprehensive mental health service programs. Eval Health Prof 29:195-218
Mueser, Kim T; McGurk, Susan R (2004) Schizophrenia. Lancet 363:2063-72
Mueser, Kim T; Fox, Lindy (2002) A family intervention program for dual disorders. Community Ment Health J 38:253-70