Psychosocial Treatment Programs for People With Both Severe Mental Illness and Substance Misuse

Over 50 % of people with a severe mental illness also use illicit drugs and/or alcohol at hazardous levels. This review is based on the findings of 25 randomized controlled trials which assessed the effectiveness of psychosocial interven-tions, offered either as one-off treatments or as an inte-grated or nonintegrated program, to reduce substance use by people with a severe mental illness. The findings showed that there was no consistent evidence to support any one psychosocial treatment over another. Differences across trials with regard to outcome measures, sample characteristics, type of mental illness and substance used, settings, levels of adherence to treatment guidelines, and standard care all made pooling results difficult. More quality trials are required that adhere to proper randomi-zation methods; use clinically valuable, reliable, and vali-dated measurement scales; and clearly report data, including retention in treatment, relapse, and abstinence rates. Future trials of this quality will allow a more thor-ough assessment of the efficacy of psychosocial interven-tions for reducing substance use in this challenging population. Key words: psychosocial interventions/cochrane review/ dual diagnosi