Advances in Dual Diagnosis

Purpose Cannabis use in the context of psychosis has been shown to have a negative impact on prognosis and yet it is difficult to treat. Recent randomized controlled trials all have negative findings and novel approaches is sought after. This paper aims to use an embodied cognition framework to add to the understanding of cannabis use in psychosis. Design/methodology/approach The paper presents longitudinal, qualitative data on two individuals diagnosed with schizophrenia and using cannabis at least twice weekly prior to inclusion in the study. Factors influencing cannabis use were mapped in dialogue with the participants. Each participant was interviewed six times over the course of a year. The analysis was informed theoretically to describe processes maintaining or ameliorating cannabis use over time. Findings This study shows that a systems approach for understanding changes in cannabis use is meaningful; the richness of observations add to the understanding of differences in outcomes. Findings suggest that reductions in cannabis use in psychosis could be dependent on synergistic effects between contextual conditions. Attending closer to the experience of patients may help inform future interventions. However, interventions focusing on single mechanisms may be futile, if an array of individual, formative experiences are a prerequisite for change. A systemic understanding of dual diagnosis calls for tailored, individualized interventions. Originality/value The research tests a novel systemic perspective on cannabis use in psychosis by applying it to qualitative longitudinal data. Adding a systemic perspective may help develop future interventions addressing cannabis use in psychosis, which has long been considered a “hard problem” in dual diagnosis treatment.

Jonathan Led Larsen

Katrine Schepelern Johansen

Julie Nordgaard

Mimi Yung Mehlsen

Dual case study of continued use vs cessation of cannabis in psychosis: a theoretically informed approach to a hard problem

精神病中大麻持续使用与戒断的双案例研究：针对难题的理论指导方法

Purpose It is well established that the service system has a poor history of responding holistically to address the needs of children and families living with co-occurring complexities such as domestic violence, parental mental health and/or substance use. The purpose of this conceptual paper is to primarily describe the developmental process used to create guidelines to inform practice at the intersections of domestic violence, mental health and alcohol and other drug services, ensuring that the tactics of coercive control are visible in contexts of complexity. Design/methodology/approach The guidelines were developed through undertaking a literature review, followed by a practice-led research approach with practitioners from 33 organisations across three Australian states, Safe &amp; Together consultants and researchers. Communities of practice composed of practitioners providing interventions to children and families were central to the approach. Data that informed the development of the guidelines included a literature review, ethnographic notes, qualitative interviews, quantitative surveys and reflections. Findings Practice-led research engaged practitioners in the development of guidelines to promote an integrated response to working with families experiencing domestic violence, substance use and mental health issues. The integrated approach drew from the Safe &amp; Together model, emphasising partnering with women survivors, pivoting to the perpetrator, focusing on children’s safety and well-being, promoting worker safety, collaborating across agencies and influencing organisational change. The process demonstrated the usefulness of this integrated approach, using practitioner-based examples. Originality/value Successful iterative processes to develop the guidelines were undertaken to support cultural change towards holistic and collaborative work across multiple sectors and organisations.

Susan Lynn Heward-Belle

Margaret Kertesz

Cathy Humphreys

Menka Tsantefski

Jasmin Isobe

Participatory practice guideline development at the intersections of domestic and family violence, mental distress and/or parental substance use

参与式实践指南制定：家庭暴力、精神困扰和/或父母物质使用交叉领域的实践指南开发

Purpose Prevalence rates of older adults (OA, 50+) with high-risk alcohol use are rapidly growing. Barriers to intervention persist for OA. Mobile interventions, specifically short message service (SMS, also known as text messaging), provide an opportunity to overcome such barriers. The purpose of this paper is to explore the acceptability and preliminary effectiveness of four SMS intervention conditions compared to mobile assessment only among OA (50–65 years old, n = 49) who drink at high-risk levels compared to younger adults (YA, 21–49 years old, n = 102). Design/methodology/approach Within and between age group differences at baseline and end-of-treatment (12 weeks) were explored. Generalized linear modeling was used to test age by receipt of any SMS intervention (compared to assessment only) effects across health outcomes. Effect sizes and visual analyses were generated to assess for age by type of SMS interactions. Findings Both age groups reported intervention satisfaction. Two-thirds elected to continue receiving SMSs after treatment concluded. Descriptively, SMS groups demonstrated reduced drinking across age groups at end-of-treatment compared to mobile assessment only, though slightly larger effects were found for YA than for OA. Age significantly moderated the receipt of any SMS intervention only for depression (i.e., older age weakened the therapeutic effect). Of all the SMS types, tailored messages outperformed the other conditions on drinking outcomes for both age groups. Depression, craving and alcohol problems responded to gain-framed messages among OA and loss-framed messages among YA. Research limitations/implications The findings of this paper suggest that SMS is acceptable and potentially effective across age groups. Further adaptation of SMS across age groups could enhance its effectiveness. Originality/value This is the first paper to explore the impact of older age on the efficacy of text messaging as an intervention for hazardous alcohol use.

Alexis Kuerbis

Silke Behrendt

Varnica Arora

Frederick J. Muench

Acceptability and preliminary effectiveness of a text messaging intervention to reduce high-risk alcohol use among adults 50 and older: an exploratory study

50岁及以上成年人高风险饮酒减少短信干预的可接受性和初步有效性：一项探索性研究

Purpose This study aims to explore and describe staff working in a Norwegian supportive housing site’s experiences with promoting social community participation for residents with co-occurring problems. The research question addressed was: how does residential support staff experience promoting social community participation for residents with co-occurring problems? Design/methodology/approach Nine residential support staff participated in qualitative interviews. All interviews were recorded and transcribed verbatim. The transcripts were analysed using Braun and Clarke's approach to thematic analysis. Findings The analysis process resulted in two themes: “It is all about economics” and “Who will pay for it?” Practical implications Regarding the Nordic welfare system, the need for a redistribution of financial resources in health services is discussed. The authors recommend that further studies explore people outside the regular health-care system perspectives on how they can contribute to making community inclusion a reality for persons experiencing co-occurring problems. Originality This study provides a nuanced understanding of how financial resources can impede or support efforts and opportunities to promote community inclusion for residents experiencing co-occurring problems.

Esther Ogundipe

Knut Tore Sælør

Stian Biong

Social recovery and economy: a thematic analysis of staffs’ experiences with promoting social community participation for residents with co-occurring problems

社会康复与经济：促进共病居民社会社区参与的员工经验主题分析

Purpose This study aims to review the presentation of substance use disorders in older adults, how addiction intertwines with neurocognitive disorders and how to approach this vulnerable population. Design/methodology/approach Electronic data searches of PubMed, Medline and the Cochrane Library (years 2000–2021) were performed using the keywords “neurocognitive,” “dementia,” “substance use,” “addiction,” “older adults” and “elderly.” The authors, in consensus, selected pivotal studies and conducted a narrative synthesis of the findings. Findings Research about substance use disorders in older adults is limited, especially in those with superimposed neurocognitive disorders. Having dual diagnoses can make the identification and treatment of either condition challenging. Management should use a holistic multidisciplinary approach that involves medical professionals and caregivers. Originality/value This review highlights some of the intertwining aspects between substance use disorders and neurocognitive disorders in older adults. It provides a comprehensive summary of the available evidence on treatment in this population.

Aditi Agrawal

Rayah Touma Sawaya

Margaret Ojeahere

Vanessa Padilla

Samer El Hayek

Neurocognitive and substance use disorders in older adults: challenges and evidence

老年人神经认知和物质使用障碍：挑战与证据

Purpose The purpose of this paper is to examine recovery through lived experience. It is part of a series that explores candid accounts of addiction and recovery to identify important components in the recovery process. Design/methodology/approach The G-CHIME model comprises six elements important to addiction recovery (growth, connectedness, hope, identity, meaning in life and empowerment). It provides a standard against which to consider addiction recovery. It has been used in this series, as well as in the design of interventions that improve well-being and strengthen recovery. In this paper, a first-hand account is presented, followed by a semi-structured e-interview with the author of the account. Narrative analysis is used to explore the account and interview through the G-CHIME model. Findings This paper shows that addiction recovery is a remarkable process that can be effectively explained using the G-CHIME model. The significance of each component in the model is apparent from the account and e-interview presented. Originality/value Each account of recovery in this series is unique, and as yet, untold.

Dylan Suttie

Lisa Ogilvie

Addiction recovery stories: Dylan Suttie in conversation with Lisa Ogilvie

成瘾康复故事：迪伦·萨蒂与丽莎·奥格尔维对话

Purpose New psychoactive substance (NPS) use in mental health and addiction health-care services is a common co-morbidity. This paper aims to explore the survey responses with health-care professional’s (HCPs) engagements and experiences towards people who use NPS in five health-care services. Design/methodology/approach A theoretically adapted online survey design explored the engagements and experiences of participants towards people who use NPS across ( n = 3) community and ( n = 2) rehabilitation mental health and addiction health-care services consisting of ( n = 1,027) service users. Findings A total of 92 participants (of 120 participants) completed the survey and 28 did not. Most (56.33%) reported neutral to poor experiences and engagements and a lack of NPS-related policies, procedures and educational training. Participants (99%) recognised the harmful effects of NPSs and (87%) requested clinical assessment procedures. The participants are unable to identify and manage acute intoxication by NPS, lack knowledge of NPS adverse effects and requested NPS-specific training on drug legislation. Research limitations/implications The sample may not be representative with the broader UK population. The study’s methods are comparable to similar research surrounding NPS in health-care services. Similar studies may advance the findings. Practical implications The implications for practice include NPS awareness trainings, educational updates through seminars and conferences. Participants requested clearer NPS assessment, referral and management processes. Several policy-making and procedural opportunities exist to ensure a better health outcome for people who use NPS. Originality/value To the best of the authors’ knowledge, this is the first theoretically adapted survey to explore participant’s engagements and experiences with people who use NPS in addiction and mental health settings.

David Solomon

Amira Guirguis

Exploring healthcare professional’s engagements and experiences towards people who use new psychoactive substances in different addiction and mental healthcare services

探索不同成瘾和心理健康医疗服务中，医护人员与使用新型精神活性物质人群的互动与体验

Purpose The purpose of this paper is to examine recovery through lived experience. It is part of a series that explores candid accounts of addiction and recovery to identify important components in the recovery process. Design/methodology/approach The G-CHIME model comprises six elements important to addiction recovery (growth, connectedness, hope, identity, meaning in life and empowerment). It provides a standard against which to consider addiction recovery, having been used in this series, as well as in the design of interventions that improve well-being and strengthen recovery. In this paper, a first-hand account is presented, followed by a semi-structured e-interview with the author of the account. Narrative analysis is used to explore the account and interview through the G-CHIME model. Findings This paper shows that addiction recovery is a remarkable process that can be effectively explained using the G-CHIME model. The significance of each component in the model is apparent from the account and e-interview presented. Originality/value Each account of recovery in this series is unique, and as yet, untold.

Dee Hartley

Addiction recovery stories: Dee Hartley in conversation with Lisa Ogilvie

成瘾康复故事：迪伊·哈特利与丽莎·奥格尔维对话

Purpose This study aims to explore how people with concurrent mental health and substance use disorders and lived experience of deep social marginalization perceived barriers and facilitators to mainstream social participation. The purpose of this study is to identify meaningful and relevant learning content for a virtual reality-based intervention to promote social participation in this group. Design/methodology/approach This formative qualitative study was conducted in Norway during Autumn 2022. Nine in-depth individual interviews with adults recovering from dual diagnosis were conducted, audiotaped, transcribed and analysed using reflexive thematic analysis in a collaborative analysis process. Findings Results indicated that social alienation, poor social skills, stigma, low self-esteem and social anxiety were key barriers to social participation in this group. This study suggests a need to learn appropriate social behaviour in mainstream society, in addition to better employability skills, civic literacy and health literacy to improve utilization of social opportunities. Practical implications This study implies that virtual reality-based interventions for promoting social participation in people with dual diagnosis should primarily focus on learning and practising appropriate social behaviour in shared public spaces before practising advanced social skills such as employability skills in simulated work environments. Learning and practising social skills appears decisive for using more complex social opportunities, such as in education, health, social services and work. Originality/value This research provides suggestions for the content of a novel virtual reality-based intervention to promote social participation among people in recovery from dual diagnosis.

Jan Aasen

Fredrik Nilsson

Torgeir Sørensen

Lars Lien

Marja Leonhardt

Barriers and facilitators to social participation in people with mental health and substance use disorders: a formative qualitative study

精神健康和物质使用障碍人群社会参与的障碍与促进因素：一项形成性定性研究

Purpose Adolescence and emerging adulthood are key developmental stages with high risk for trauma exposure and the development of mental and substance-use disorders (SUDs). This study aims to compare the clinical profiles of adolescents (aged 12–17 years) and emerging adults (aged 18–25 years) presenting for treatment of posttraumatic stress disorder (PTSD) and SUD. Design/methodology/approach Data was collected from the baseline assessment of individuals ( n = 55) taking part in a randomized controlled trial examining the efficacy of an integrated psychological therapy for co-occurring PTSD and SUDs (PTSD+SUD) in young people. Findings Both age groups demonstrated complex and severe clinical profiles, including high-frequency trauma exposure, and very poor mental health reflected on measures of PTSD, SUD, suicidality and domains of social, emotional, behavioral and family functioning. There were few differences in clinical characteristics between the two groups. Research limitations/implications Similarity between the two groups suggests that the complex problems seen in emerging adults with PTSD + SUD are likely to have had their onset in adolescence or earlier and to have been present for several years by the time individuals present for treatment. Originality/value To the best of the authors’ knowledge, this is the first study to compare the demographic and clinical profiles of adolescents and emerging adults with PTSD + SUD. These findings yield important implications for practice and policy for this vulnerable group. Evidence-based prevention and early intervention approaches and access to care are critical. Alongside trauma-focused treatment, there is a critical need for integrated, trauma-informed approaches specifically tailored to young people with PTSD + SUD.

Natalie Peach

Ivana Kihas

Ashling Isik

Joanne Cassar

Emma Louise Barrett

Vanessa Cobham

Sudie E. Back

Sean Perrin

Sarah Bendall

Kathleen Brady

Joanne Ross

Maree Teesson

Louise Bezzina

Katherine A. Dobinson

Olivia Schollar-Root

Bronwyn Milne

Katherine L. Mills

Clinical characteristics of adolescents and emerging adults presenting for integrated posttraumatic stress and substance use treatment

青少年和成年初期个体接受创伤后应激障碍与物质使用综合治疗的临床特征

Abbreviation	Adv. Dual. Diagn.
Journal Impact	0.81
Quartiles(Global)	PSYCHOLOGY, CLINICAL(Q4)

ISSN	1757-0972, 2042-8324
h-index	15

Publication Information	Publisher: Emerald Group Publishing Ltd.，Publishing cycle: ，Journal Type: journal，Open Access Journals: No
Basic data	Year of publication: 2008，Proportion of original research papers: 94.44%，Self Citation Rate:50.00%， Gold OA Rate: 0.00%

Advances in Dual Diagnosis

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