dual diagnosis treatment model of treatment

Approaches to treatment and care of dual diagnosis
A model for the treatment of people with a dual diagnosis
Treatment of people with a dual diagnosis requires an integration of principles from the mental health and substance misuse fields. These authors propose a four-staged model: engagement, persuasion, active treatment and relapse prevention. These stages closely reflect Prochaska and DiClemente’s stages of change and provide a framework for thinking about more specific interventions. Motivational interviewing and relapse prevention have been linked to the persuasion and relapse prevention stages, respectively. Links with other substance misuse interventions can also be made. Figure 17.5 maps out these relationships. In practice, flexibility is required, movement between the stages can be fluid and aspects of the various interventions are likely to be utilized at each stage. The emphasis here is on substance misuse interventions but these should not be seen in isolation from mental health interventions (for example, medication management) which will also be crucial in working with people with a dual diagnosis. Relapse is usual rather than exceptional in people with substance misuse problems and work with people with a dual diagnosis requires a long-term perspective, often lasting several years.