Dual Diagnosis : Practice in Context

, by Phillips, Peter; McKeown, Olive; Sandford, Tom

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ISBN: 9781405180092 | 1405180099
Cover: Paperback
Copyright: 11/9/2009

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Dual Diagnosis: Practice in Context is a practical evidence-based guide for practitioners working in multi-disciplinary mental health and substance misuse service settings. Divided into three sections, this comprehensive and international text first explores the contemporary contextual issues surrounding the subject area. It then goes on to review dual diagnosis in some of the 'special' populations (including people diagnosed with personality disorders, women, young people, and older adults) and contemporary issues (e.g. crystal methamphetamine and mental health). Part three reviews the development of international service responses to dual diagnosis and discusses the development and commissioning of service models, research and practice development. The text concludes with a chapter outlining priorities for the development of interventions, service approaches, research and education.KEY FEATURES: A authoritative in-depth review of both theoretical, clinical and policy issues within a single text Draws together a range of established contributors from a variety of disciplines, including mental health nurses, occupational therapists, social workers and psychiatrists International in focus, with contributors from the UK, USA, Europe and Australia

Contributors
Foreword
Contemporary Context
Definition, Recognition and Assessment
Introduction
Definition and terminology
General considerations in the recognition and assessment of dual diagnosis
How significant is the problem of dual diagnosis?
Recognition and assessment
Hypotheses
Conclusion
Explanatory Models for Dual Diagnosis
Introduction
Is substance misuse more prevalent among people with psychotic illnesses than in the general population?
Which problem generally develops first in dual diagnosis?
Does dual diagnosis have a neurobiological basis?
Is dual diagnosis mediated by personality disorder?
Do people with schizophrenia use substances as a form of self-medication?
Have changes in the care and social circumstances of people with schizophrenia, particularly deinstitutionalisation, led to a rise in substance misuse in this population?
Do the social situations and social difficulties of people with schizophrenia lead to substance use?
Do people with schizophrenia tend to begin using drugs and alcohol within mental health service settings or in the company of other users of such services?
Conclusion
Consumer Perspectives
Introduction
Human experience and medicine
Diagnosis, treatment and human rights
Two worlds
Significant contrasts
Diagnosis
Treatment
Dual diagnosis and policy
Conclusion
Common Presentations and Special Populations
Risk Assessment and Dual Diagnosis
Introduction
Clinical risk assessment
Principles of risk assessment and management
The process of risk assessment and management
Conclusion
Reducing Drug-Related Harm Among Mentally Ill People
Introduction
Interventions and approaches
Harm reduction
Using harm reduction approaches with mentally ill individuals
Dual diagnosis and harm reduction: the future?
Conclusion
Motivational Interviewing
Introduction
What is MI?
Conclusion
Psychological Interventions
Introduction
The nature and type of psychological interventions
The evidence for psychological interventions in dual diagnosis
Individual therapies
Group therapies
Cognitive behaviour therapy and relapse prevention
Family interventions
Contingency management
Conclusion
Alcohol and Mood Disorders
Introduction
Harm, alcohol and mental illness
Presentation: alcohol and mental illness
Medication and dual diagnosis
Conclusion
Polysubstance Use and Personality Disorder
Introduction
Prevalence
Service delivery
What is personality disorder?
Treatment and intervention approaches
Assessment
Stages of change
Therapeutic principles
Conclusion
Older People and Dual Diagnosis
Introduction
An increasing population
Policy framework
Media representation of information on alcohol
Perception of old age
Alcohol use in older people
Complications of excessive alcohol use
Assessment and screening
Under-reporting
Over-the-counter medication (OTC)
Prescribed medication
Conclusion
Stimulant Use and Psychosis
Introduction
Stimulant use in the United Kingdom
Stimulants and drug-induced psychosis
Stimulants and mental illness
Stimulants and their use by people with existing psychotic illnesses
Implications for practice
Conclusion
Women and Dual Diagnosis
Introduction
Gender differences in dual diagnosis
The impact of dual diagnosis on families
Dual diagnosis and domestic violence
Dual diagnosis within the female prison service
A case for gender-specific services
Conclusion
Drug-Induced Psychosis
Introduction
Dual diagnosis: a common problem
The relationship between substance use and psychosis: aetiology
A model of relationships between psychotic illness and drug and alcohol use
Conclusion
Cannabis Use and Psychosis
Introduction
What is cannabis?
How is it used?
Legal issues
How it affects the user
Psychological effects
Physical effects
Safety issues
The links between cannabis and psychosis
Interventions for cannabis and psychosis
Conclusion
Methamphetamine and Mental Health
Introduction
Initiation and continuation of methamphetamine use: missed opportunities
Methamphetamine and mental health: intoxication, withdrawal and psychiatric illness
Methamphetamine addiction: treatment and outcomes
Conclusion
Acknowledgements
Public Health and Dual Diagnosis
Introduction
Epidemiology
Causal relationship
Treatment for BBV
Other co-infections
Conclusion
Comorbidity or Complexity: A Primary Care Perspective on Dual Diagnosis
Introduction
Policy framework
Epidemiology
Key features of general practice care
Physical health care
Mental health and substance misuse care
Limitations and potential in primary care
Conclusion
International Perspectives, Policy and Development
Dual Diagnosis North America
Introduction
Prevalence
Historical context
Socio-cultural and public policy considerations
Approaches to treatment
Research
Issues and challenges
Conclusion
Dual Diagnosis Australasia
Introduction
Drivers for system change
Consumer and carer demand
Prevalence
Harms and unwanted outcomes strongly associated with dual diagnosis
Opportunity to provide more effective treatment of target
disorders via improved recognition and more effective responses to co-occurring disorders
Barriers to better outcomes for persons with dual diagnosis
Indigenous Australians
Rural and remote regions of Australia
Australi's responses to dual diagnosis
Structure of the Australian health care system
National level responses to dual diagnosis
The National Comorbidity Initiative
Improved Services for People with Drug and Alcohol Problems and Mental Illness Measure
Can Do
Managing Mental Health and Substance Use in General
Practice
Headspace
State level responses to dual diagnosis
Conclusion
Dual Diagnosis Europe
Introduction
The historical and social context
Elements of dual diagnosis in the region
Alcohol
Other psychoactive substances
Care and treatment responses
Problems and solutions
Conclusion
Commissioning Services for Users with Dual Diagnosis
Introduction
Background
The history of commissioning
Implications for commissioning dual diagnosis services
Conclusion
Practice, Research and Education Development
Introduction
Research
Education development
Practice
Conclusion
Index
Table of Contents provided by Publisher. All Rights Reserved.

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Dual Diagnosis : Practice in Context

Summary

Author Biography

Table of Contents

Supplemental Materials