Modified therapeutic community for mentally ill chemical "abusers": background; influences; program description; preliminary findings.
ABSTRACT This paper briefly surveys the literature that addresses the problem of co-occurring mental and "substance abuse disorders." It discusses several convergent influences on the development of modified therapeutic community (TC) approaches. The paper describes in some detail the modified TC program for mentally ill chemical "abusers" (MICAs). The paper also summarizes research data that establish positive retention rates and significant in-treatment change to support the effectiveness of the modified TC and to underscore the limited effect of treatment-as-usual approaches. Treatment approaches must be comprehensive, multidimensional, of relatively long duration, and must systematically address the interrelated problems of mental illness and substance use.
10/2007; 9(86):5536-5543. DOI:10.1016/S0211-3449(07)74693-3
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ABSTRACT: Comorbidity of Substance Abuse Disorders with Other Psychiatric Disorders in Mutual-Aid Residential Treatment Centers. Salud Mental 2013; 36(6):471-479 SUMMARY: Substance use disorders have a high degree of comorbidity with other psychiatric disorders; it has been reported that the prevalence of co-morbidity is higher in psychiatric (20-50%) and addiction (50-75%) treatment settings than in household or student populations. Because of limited treatment alternatives and greater treatment needs, Mutual-Aid groups have become relevant in the last decades. A modality of Mutual-Aid for addiction treatment that has proliferated in Mexico has taken the form of residential Mutual-Aid centers called "anexos" in Spanish. The objective of this study was to estimate the prevalence of lifetime comorbidity between substance use disorders and psychiatric disorders in those who attended these residential Mutual-Aid centers. The initial sample consisted of 535 male participants diagnosed with a substance use disorder, but only 346 fulfilled the inclusion criteria to continue with the evaluation. Only males were included as the partici-pating centers only admit males. Psychiatric diagnosis was evaluated with the Composite International Diagnostic Interview (WMH-CIDI) us-ing DSM-IV criteria. The results showed that 75.72% met criteria for any comorbid psychiatric disorder, the most frequent being attention deficit and conduct disorders, followed by anxiety disorders, separa-tion anxiety disorders, mood disorders, impulse control disorders and least frequently eating disorders. While the study is limited by its non-representative sample, the findings provide valuable information for a hidden population for which there is a dearth of information and points to the need for integrative services which address both addic-tion and comorbid psychiatric disorders simultaneously.Salud Mental 12/2013; 36(6):471-479. · 0.42 Impact Factor