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About this book

In the UK it is estimated that a third of patients in mental health services have a substance abuse problem, and that half of patients in drug and alcohol services have a mental health problem. Part of Palgrave's Foundations of Mental Health series, this book explores the intertwined issues of substance use and mental health as a social phenomenon and offers a critical, informative guide to understanding dual diagnosis.

Written by authors with extensive experience within mental health and drug treatment services, Working with Dual Diagnosis explores areas that are key to understanding the relationship between the two, including:
models for understanding substance use, mental health and the correlation of complex social and psychological factors;
treatment processes for working with individuals, groups and families and within a community setting;
the historical social, political, economic and legislative context of mental health and substance use;
practice implications for dual diagnosis, including how practitioners can work with and promote better treatment, after care and support for those experiencing dual diagnosis issues.Enriched with reflective exercises, case studies and key points, this book will inform all work related to dual diagnosis populations within health, social and criminal justice service, and is an essential text for social work, nursing, occupational therapy and probation students.

Table of Contents

History, Politics and Concepts

Frontmatter

1. The Historical Context of Substance Use, Mental Health and Dual Diagnosis

Chapter Summary
In this chapter we will begin to:
  • explore the definition and context of dual diagnosis;
  • observe the prevalence and correlation of mental health & substance use;
  • understand the social conditions under which substance use is created — normalisation.
Darren Hill, William J. Penson, Divine Charura

2. The Socio-Politics of Dual Diagnosis: Psychiatry, Law and Economics

Chapter Summary
In this chapter we will begin to:
  • explore the historical development of mental health and substance use as social phenomenon;
  • develop an understanding of the political and economic forces that have shaped both the understanding of mental health and substance use.
Darren Hill, William J. Penson, Divine Charura

3. Key Models for Understanding Dual Diagnosis

Chapter Summary
This chapter will:
  • outline the main areas of critique for learners, lecturers, the helping professions and their disciplines;
  • outline the main models that are applied in the treatment of poor mental health and dual diagnosis;
  • describe and discuss the social model, with roots in disability discourse that offers a practice orientation.
Darren Hill, William J. Penson, Divine Charura

Working in Practice

Frontmatter

4. Working with Individuals: The Broader Picture and Getting Started

Chapter Summary
The aims of this chapter are to outline and explore:
  • the varied and complex nature of the relationship between substance use and mental health problems when working with individuals;
  • factors impacting on motivation to change;
  • the importance and essential skills needed in risk assessment when working with individuals with dual diagnoses;
  • problem formulation and conceptualization;
  • the contemporary psychosocial interventions employed in working with dual diagnosis and their efficacy;
  • the Care Programme Approach (CPA);
  • relapse prevention and issues and complexities;
  • strength-based approaches;
  • the importance and centrality of the therapeutic relationship.
Darren Hill, William J. Penson, Divine Charura

5. Psychosocial Interventions

Chapter Summary
The aims of this chapter are to outline and explore:
  • the different evidence-based and recommended psychosocial interventions employed in working with dual diagnoses (these include motivational interviewing, brief interventions and self-help, contingency management, cognitive behavioural therapy, psychodynamic therapy);
  • the basic principles of psychosocial interventions;
  • the varied and complex nature of psychosocial interventions;
  • the facilitative interventions required in creating a therapeutic environment;
  • the generic recommendations for inpatient settings and the criminal justice system;
  • the contemporary mindfulness and technology-based interventions.
Darren Hill, William J. Penson, Divine Charura

6. Working with Groups and Families

Chapter Summary
This aims of this chapter are for the reader to develop an understanding of:
  • working with groups and the different group interventions for clients presenting with dual diagnoses;
  • the range of group approaches, including 12-step approaches/programmes;
  • the wide range of group dynamics that may emerge from working with groups;
  • key protocols informing family work;
  • useful family interventions when working with dual diagnosis, such as a five-step approach and basic family systemic therapy concepts;
  • family work models for working with severe mental health problems;
  • social behaviour and network therapy (SBNT);
  • the challenges of working in different settings.
Darren Hill, William J. Penson, Divine Charura

7. Working in Community Settings: Dual Diagnosis and the Recovery Movement in a Community Context

Chapter Summary
This aims of this chapter are for the reader to develop an understanding of:
  • the lived experience of challenges faced by professionals working in the community with clients who have a dual diagnosis;
  • the recovery movement within the community;
  • the importance of the integration of harm reduction and recovery-oriented practices;
  • the social model of disability as a route towards access.
Darren Hill, William J. Penson, Divine Charura

Conclusion

Conclusion

Abstract
The aim of this book is to orientate the practitioner working in health and social care, statutory or third sector, to the most helpful ways of thinking and doing work with people with problems that arise out of the label dual diagnosis. We are also hoping that this book contributes to the critical discourse and learning in the field, and so it may well be appealing to scholars and learners alike. In this final chapter we will summarise where we have travelled and leave the reader with some further points for thought. Figure C.1 below summarises the ground we have covered.
Darren Hill, William J. Penson, Divine Charura
Additional information