Integrating substance abuse treatment for the seriously mentally ill into inpatient psychiatric treatment.

This paper offers guidelines for the assessment and treatment of substance abuse problems in seriously mentally ill persons who are admitted into inpatient psychiatric treatment. This approach has been used successfully by the authors and may be most useful in settings where a specialized dual-diagnosis treatment program is not feasible. The first step consists of identifying potential substance abusers using several sources of information including the patient's record, a brief patient interview, and an interview with the patient's family and caseworker. Patients who have a confirmed or suspected substance abuse problem undergo a substance abuse assessment designed to evaluate consumption patterns, the negative consequences of substance use, and high-risk situations for alcohol and drug use. Patients are then presented with individualized feedback in a non-coercive manner, which is intended to increase their motivation to change their substance-use behavior. Treatment consists of a structured coping skills group which covers nine specific topics. The topics covered in the group treatment include both general social skills and specific drug and alcohol coping skills intended to assist individuals in coping effectively with high-risk situations. The content of each group session is described along with guidelines for conducting coping skills group treatment with the seriously mentally ill.