Clinical Textbook of Addictive Disorders 3rd ed - R. Frances, S. Miller, A. Mack (Guilford, 2005) WW

12. Co-Occurring Substance Use Disorders and Other Psychiatric Disorders 283chiatric disorders. Adaptations to the stages-of-change model for SPMI dualdiagnosispopulations have also been developed, and some have been empiricallytested for reliability and validity (Carey, Carey, Maisto, & Purnine, 2002;Velasquez, Carbonari, & DiClemente, 1999) with promising results (Carey etal., 2002; Ziedonis & Trudeau, 1997). Pilot work of a family interventionadapted from the stages-of-change model for this population has also shownpromise (Mueser & Fox, 2002).Twelve-step drug counseling derives directly from the principles of AA andhas been adapted for use by professional alcohol and drug counselors (a necessaryadaptation, since AA was designed as a self-help group not led by professionals).Two types of treatment emphasize these principles: individual drugcounseling (Mercer & Woody, 1999) and 12-step facilitation (TSF) (Nowinski,Baker, & Carroll, 1995). TSF is used by all of the studies described below. Severaltrials have compared outcomes of dually diagnosed patients treated withTSF groups with outcomes among those treated with various other psychosocialtreatments (i.e., CBT, RPT, dialectical behavioral therapy [DBT], or behavioralskills group) (Brooks & Penn, 2003; Fisher & Bentley, 1996; Jerrell &Ridgely, 1995; Linehan, 1993; Linehan et al., 2002; McKay et al., 2002;Ouimette, Gima, Moos, & Finney, 1999). Among them, only one foundimproved SUD outcomes in TSF versus the comparison integrated treatment(Brooks & Penn, 2003). However, in that study, the TSF group also experiencedworsening health and employment status, and psychiatric hospitalization,compared to the group of patients receiving integrated treatment.Contingency management (CM) interventions reinforce behavior that meetsspecific, clearly defined, and observable goals (Petry, 2000) such as abstinence(Higgins et al., 1994), medication adherence (Liebson, Tommasello, &Bigelow, 1978), therapy attendance (Helmus, Rhodes, Haber, & Downey,2001), or completion of treatment goals (Petry, Martin, Cooney, & Kranzler,2000). Recent empirical evaluations using CM as an adjunctive treatment indually diagnosed populations suggest that it may offer some benefit in attendance,but its impact on SUD outcomes has been mixed (Helmus, Saules,Schoener, & Roll, 2003; Sigmon, Steingard, Badger, Anthony, & Higgins,2000).SELF-HELP GROUPSAND DUALLY DIAGNOSED INDIVIDUALSAs in other substance-using populations (Miller, Ninonuevo, Klamen, Hoffmann,& Smith, 1997; Ritsher et al., 2002), self-help group attendance has been associatedwith improved substance use outcomes in dually diagnosed populations(Brooks & Penn, 2003; Ritsher et al., 2002). Whether this is a reflection of selfhelpgroups’ improving outcomes directly or a self-selection bias (i.e., patients