Substance Misuse in Psychosis: Approaches to Treatment and Service Delivery / Edition 1

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The prevalence of substance abuse in the severely mentally ill is higher than that in the general population, making this a serious issue for clinicians. Integrated treatment, although the most widely adopted approach, is subject to tremendous variation in its operationalisation, especially throughout different parts of the world.

Substance Misuse in Psychosis presents the latest international developments and practical treatment interventions that can be used with co-morbid individuals and their families. Different social and cultural contexts are described and contrasted, along with treatment approaches that have been tailored to address the needs of the severely mentally ill. A final section considers sub-groups, e.g. the young, the homeless, outlining the special issues that need to be considered when providing services for these groups.

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Editorial Reviews

From the Publisher
“…Two books by psychologists have been praised in the Mental Health Category of the BMA Association’s 2003 book competition…” (The Psychologist, 1 Jan 2004)

“…an invaluable text that achieves its key objectives of reviewing the key clinical and research issues in the field well…” (Drug and Alcohol Review, 22 Dec 2003)

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Product Details

Meet the Author

Hermine L. Graham is a consultant clinical psychologist, Head of the Combined Psychosis and Substance Use (COMPASS) Programme in Northern Birmingham, UK, and an Honorary Research Fellow with the School of Psychology, University of Birmingham. In a managerial and clinical research capacity she is developing and evaluating an integrated treatment and service model for people with severe mental health problems who use alcohol/drugs problematically. She has published articles within this area and provides national and international consultancy/advice on service and policy developments for this client group. Her clinical and research interests include the application of cognitive therapy for people with combined psychosis and substance use. A publication that reflects this is her paper, “The Role of Dysfunctional Beliefs in Individuals Who Experience Psychosis and Use Substances: Implications for Cognitive Therapy and Medication Adherence” (1998), Behavioural and Cognitive Psychotherapy, 26, 193–208.

Alex Copello is a consultant clinical psychologist, Head of the Psychology Addiction Speciality within Northern Birmingham Mental Health Trust, and Lecturer in Clinical Psychology at the School of Psychology, University of Birmingham. He is a practising clinician and the lead professional for the Addiction Research and Development Programme for the Trust. In addition, he is one of the principal investigators on an MRC-funded UK multisite study evaluating alcohol treatment. He has been involved in developing a social network-based treatment that will be evaluated in this study. His research and clinical interests include the impact of addiction upon families; the evaluation of services for alcohol and drug users, both in primary care and specialist settings; and the use of qualitative research methods. He has also been involved in international cross-cultural research assessing the impact of addiction on families in Mexico and Australia. He publishes extensively in a number of scientific journals and has co-authored the book Living with Drink: Women Who Live with Problem Drinkers (1998).

Max J. Birchwood is Director of the Early Intervention Service and Director of Research and Development for Northern Birmingham Mental Health Trust, and Professor of Mental Health at the University of Birmingham, UK. His clinical and research interests have centred around the development of methods of promoting individuals’ control over their psychotic symptoms, including the application of cognitive therapy to psychotic symptoms, as in acute psychosis, and the recognition and control of early warning signs of relapse. He has published widely in these areas and is a prominent figure within this field. His books include Psychological Management of Schizophrenia (1994), Cognitive Therapy for Hallucinations, Delusions and Paranoia (1996), Early Intervention in Psychosis (2000) and Schizophrenia (2001). He is currently involved in the development of community-based early intervention for people with psychosis across the UK and is patron to the National Schizophrenia Fellowship in the UK.

Kim T. Mueser is a Professor in the Departments of Psychiatry and Community and Family Medicine at the Dartmouth Medical School in New Hampshire, USA. He is an active contributor to research and the development of clinical methods for the treatment of comorbid severe mental illness and substance use, has published numerous articles within this area, and provides research consultancy/advice to a number of services. His clinical and research interests include research on the treatment of persons with severe mental illness, and substance use disorders, family treatment and social skills training for severe mental illness, and other aspects of psychiatric rehabilitation. He has co-authored several books, including Social Skills Training for Psychiatric Patients (1989), Coping With Schizophrenia: A Guide for Families (1994), Behavioural Family Therapy for Psychiatric Disorders, 2nd edn, 1999), and Social Skills Training for Schizophrenia (1997).

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Table of Contents

About the Editors.

List of Contributors.



Part I Social and Psychological Perspectives of Problem Substance Use Among those with Psychosis.

Introduction(Max J. Birchwood).

Chapter 1 Substance Misuse in Psychosis: Contextual Issues (Jenny Maslin).

Chapter 2 Temporal Order and Aetiology (Martin Hambrecht and Heinz H¨afner).

Chapter 3 Substance Misuse and Psychosis in Context: The Influences of Families and Social Networks (Alex Copello).

Chapter 4 Sociological Aspects of Substance Misuse among People with Severe Mental Illness (Martin J. Commander).

Chapter 5 A Cognitive Conceptualization of Concurrent Psychosis and Problem Drug and Alcohol Use (Hermine L. Graham).

Part II Integrated Service Delivery Models.

Introduction (Kim T. Mueser).

Chapter 6 Integrated Dual Disorder Treatment in New Hampshire (USA) (Kim T. Mueser and Robert E. Drake).

Chapter 7 The Combined Psychosis and Substance Use (COMPASS) Programme: An Integrated Shared-care Approach (Hermine L. Graham, Alex Copello, Max J. Birchwood, Jenny Maslin, Dermot McGovern, Jim Orford and George Georgiou).

Chapter 8 An Integrated Treatment Approach to Substance use in an Early Psychosis Programme (Jean Addington).

Chapter 9 An Inpatient-Based Service Model (Richard N. Rosenthal).

Part III Treatments for Substance Misuse in Psychosis.

Introduction (Alex Copello).

Chapter 10 Assessment Considerations (Douglas L. Noordsy, Debra V. McQuade and Kim T. Mueser).

Chapter 11 Cognitive-Behavioural Integrated Treatment Approach for Psychosis and Problem Substance Use (Hermine L. Graham, Alex Copello, Max J. Birchwood, Jim Orford, Dermot McGovern, Jenny Maslin and George Georgiou).

Chapter 12 Relapse Prevention for Patients with Bipolar and Substance Use Disorders (Roger D. Weiss, Shelly F. Greenfield and Grace O’Leary).

Chapter 13 Family Intervention for Substance Misuse in Psychosis (Christine Barrowclough).

Chapter 14 Start Over and Survive: A Brief Intervention for Substance Misuse in Early Psychosis (David J. Kavanagh, Ross Young, Angela White, John B. Saunders, Natalie Shockley, Jeff Wallis and Anne Clair).

Chapter 15 Pharmacological Management of Substance Misuse in Psychosis (Ed Day, George Georgiou and Ilana Crome).

Part IV Special Populations.

Introduction (Hermine L. Graham).

Chapter 16 Cannabis and First-Episode Psychosis: The CAP Project (Jane Edwards, Mark Hinton, Kathryn Elkins and Olympia Athanasopoulos).

Chapter 17 Comorbid severe Mental Health Problems and Substance Abuse in Forensic Populations (Alison Beck, Tom Burns and Tim Hunt).

Chapter 18 Integrated Treatment Outcomes for Homeless Persons with Severe Mental Illness and Co-Occurring Substance Use Disorders (Susan A. Pickett-Schenk, Michael Banghart and Judith A. Cook).

Chapter 19 Issues in Comorbidity and HIV/AIDS (Lisa Razzano).

Part V The Evolving Evidence Base.

Chapter 20 Cochrane Review of Treatment Outcome Studies and its Implications for Future Developments (Ann Ley and David Jeffery).

Epilogue: Future Directions.

Concluding Remarks (Hermine L. Graham, Alex Copello, Max J. Birchwood and Kim T. Mueser).


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