Wayne State researcher tests new, comprehensive therapy for mental illness and co-occurring substance abuse
For people suffering with both severe mental health and substance use disorder, the best treatment could be a combination of patient-centered therapies, according to a Wayne State researcher.
Eugene P. Schoener, Ph.D., professor of pharmacology and psychiatry and behavioral neurosciences in WSU’s School of Medicine and resident of Farmington Hills, Mich., received a $250,000 grant from the Flinn Foundation to determine the effectiveness of combined Motivational Interviewing (MI), Cognitive Behavioral Therapy (CBT) and substance abuse treatment on the recovery of patients with severe mental illness and substance abuse problems. The study will take place at Kadima, a non-profit mental health services agency with Jewish roots based in Southfield, Mich.
“MI and CBT are complementary approaches based on the notion that patients have to own and resolve their own problems,” Schoener said. “MI helps the individual appreciate the nature of their problem and develop the motivation to change their behavior, and CBT provides a comprehensive set of tools to do it. We’re hoping that these two elements, along with the knowledge and skills of treating substance abuse will help to promote not just clinician skill levels, but actually change the way Kadima delivers services.”
Previous studies strongly suggest that both MI and CBT are highly effective for a wide range of mental illnesses including substance abuse. However, most studies were conducted in laboratory settings and addressed the problems separately. Schoener’s study offers the opportunity to observe the influence of MI and CBT when treating mental illness and substance abuse concurrently in a real-life setting.
“About 60 percent of patients with severe mental illness have a co-occurring substance abuse problem,” Schoener said. “If you don’t deal with both problems concurrently, one disorder can sabotage progress made with the other. Our combined therapy approach is designed to address the reality of all these problems together, the way they occur in the real world.”
MI is a non-judgmental, non-confrontational method of engaging patient motivation to change their thoughts and behavior. Past studies have shown that MI builds a greater sense of trust and a stronger overall alliance between therapist and client and redefines the patient as having a more active role in their recovery. “This isn’t the clinician giving the patient a pep talk; in fact it’s just the opposite,” Schoener said. “It’s eliciting the motivation within that person. The therapist is no longer there to “fix” somebody, but rather to facilitate and assist the client in achieving their best.”
CBT is a goal-oriented, systematic approach in which patients work to identify the underlying causes for dysfunctional thoughts, feelings or behaviors then restructure their thoughts to be healthier and more productive. Shown to be effective in the treatment of mood disorders, anxiety disorders, personality disorders, substance abuse disorders, and psychotic disorders, CBT requires focused and deliberate participation of the patient. “It’s not simply meeting every week to chat. There is homework involved, and patients really have to work at it. The reward for all their hard work, however, is being far better equipped to maintain wellness, undertake new challenges and achieve more in their lives.”
The study will be based around clinicians and their patients at Kadima, a prominent mental health provider for more than 25 years with a heavily empirical, best practice approach to therapy. Schoener will study whether the clinician’s MI, CBT and substance abuse training significantly enhances their patients’ recovery. Evaluation techniques will include patient and clinician assessments, session monitoring and standardized measures of program performance, such as number of patient hospital visits and patient retention.
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