2 GROUP-THERAPY MODELS FOR CLIENTS WITH A DUAL DIAGNOSIS OF SUBSTANCE-ABUSE AND PERSONALITY-DISORDER

Objective: The relative effectiveness of two types of group therapy-th e disease-and-recovery model and the cognitive-behavioral model-was ex amined in a public inpatient and outpatient setting with consumers who had a dual diagnosis of a personality disorder and a substance use di sorder, Outcomes in four areas of problem severity were measured: alco hol use, drug use, social and family relations, and psychological func tioning, Methods: Using a quasiexperimental group design, 19 subjects in an inpatient mental health facility and 19 in a public outpatient f acility were randomly assigned to the two experimental groups, The gro ups met three times a week for 12 weeks, and specific group leadership protocols were used, A third group at each setting received usual gro up treatment, Diagnoses of all subjects were verified using the Struct ured Clinical Interview for DSM-III-R. The Addiction Severity Index me asured changes in problem severity. Results: In the inpatient setting, subjects in both experimental groups had significantly improved socia l and family relations compared with the usual-treatment group; no pos ttest changes in the other three areas were noted. In the outpatient s etting, cognitive-behavioral group therapy was significantly more effe ctive than the other two group approaches in reducing alcohol use, imp roving social and family relations, and enhancing psychological functi oning. Conclusions: Results suggest that the severity of mental health consumers' substance abuse problems can be substantially decreased in several areas in an outpatient public setting, In an inpatient settin g, the use of either group therapy model was more effect ive in reduci ng problem severity than using no specific model.