Methods of changing patterns of substance use among individuals with co-occurring schizophrenia and substance use disorder

Individuals with a severe mental illness and substance use disorder tend to have medical and social problems and to make slower progress in treatment than those who have either disorder alone. Nevertheless, little attention h as been paid to the discovery of effective effective methods of modifying s ubstance use in the severely mentally ill (SMI). The purpose of this study was to collect qualitative data as a way to help identify techniques that m ight help to change patterns of substance use in the SMT. The participants were 21 men and women who were psychiatric clinic outpatients and who had a current schizophrenia spectrum diagnosis. A total of 18 participants had a lifetime diagnosis of alcohol abuse or dependence, and 21 lifetime other d rug diagnoses were recorded for the sample. These individuals participated in focus group discussions about topics related to substance cue and people 's experiences with trying to quit. The results showed that participants id entified several therapeutic and extratherapeutic factors that helped them to initiate and maintain changes in their,substance use, as well as factors that hindered change. The findings are related to knowledge about the effe ctiveness of substance use disorder treatment techniques in general, and im plications of the data are discussed for the conduct of integrated treatmen t of individuals with severe mental illness and a substance use disorder. ( C) 1999 Elsevier Science Inc. All rights reserved.