Integrated Treatment for Dual Disorders

A Guide to Effective Practice

Kim T. Mueser, Douglas L. Noordsy, Robert E. Drake, and Lindy Fox Smith

A Paperback Originale-bookprint + e-book
A Paperback Original
April 25, 2003
ISBN 9781572308503
Price: $61.00 $51.85
470 Pages
Size: 8⅜" x 10⅞"
Convenient Lay-Flat Binding
May 18, 2015
Price: $61.00 $51.85
470 Pages
Convenient Lay-Flat Binding
print + e-book
A Paperback Original + e-Book (PDF) ?
Price: $122.00 $67.10
470 Pages

This comprehensive clinical handbook provides virtually everything needed to plan, deliver, and evaluate effective treatment for persons with substance abuse problems and persistent mental illness. From authors at the forefront of the dual disorders field, the book is grounded in decades of influential research. Presented are clear guidelines for developing integrated treatment programs, performing state-of-the-art assessments, and implementing a wide range of individual, group, and family interventions. Also addressed are residential and other housing services, involuntary interventions, vocational rehabilitation, and psychopharmacology for dual disorders. Throughout, the emphasis is on workable ways to combine psychiatric and substance abuse services into a cohesive, unitary system of care. Designed in a convenient large-size format with lay-flat binding for ease of photocopying, the volume contains all needed assessment forms, treatment planning materials, and client handouts, most with permission to reproduce.

“This book is not written specifically for or by social workers; however, it provides clear, contemporary discussions of practice principles with great relevance and applicability to the social work profession....One of the great strengths of this book lies in its presentation of conceptual frameworks and models related to substance abuse and psychiatric illness....Overall, this book is interesting, well written, and well researched. It would be useful for social work educators seeking basic tools for MSW practice/field courses and for specialized doctoral-level social work education. It is also a good resource for social work students and social work practitioners who want up-to-date training about substance abuse, severe mental illness, and to know what happens when these are experienced together.”

Journal of Social Work Practice in the Addictions

“A professor designing a graduate course to investigate how the criminal justice system deals with mentally ill people should certainly include [this book]....Provide[s] basic technical knowledge about service delivery in general, information on specific groups of people, and information about specific disorders and treatments. Correctional staff members who need information about service delivery are well advised to consult [this book]....Provide[s] a wealth of technical information and also provide[s] a good staring point by which to understand correctional health care....Provide[s] needed, valuable information about the mental health and criminal justice interface.”

Criminal Justice Review

“Offers a comprehensive guide to the unified treatment of an often overlooked population. The information contained in this publication will enable mental health professionals and facilities to design and implement a treatment program tailored to the special needs of the dual-disordered individual. The authors provide uncommon insight into the challenges of comorbid psychiatric and substance use disorders front the differing perspectives of the client, the family, and the clinician.”

Journal of Cognitive Psychotherapy

“An outstanding resource for clinicians. The text is remarkable for its comprehensiveness, clarity, practical suggestions, and wealth of reproducible forms and handouts. Social workers will find the book especially useful, as it covers many aspects of treatment that are frequently overlooked, such as case management, family work, residential programs, and employment. This book will serve as a blueprint for providing integrated treatment for dual disorders.”

—Susan Gingerich, MSW, independent consultant and trainer, Narberth, Pennsylvania

“Mueser and his colleagues—all internationally recognized experts in their field—have given us a comprehensive, state-of-the-art volume to address empirically validated treatment for co-occurring disorders. With its treatment fidelity checklist and implementation guidelines, this book should be required reading for all program managers and mental health administrators who seek to design an effective, integrated system of care or improve existing service delivery. Grounded in practical clinical experience and well informed by first-rate scholarship, the text includes a variety of client handouts and detailed, step-by-step advice on adopting 'best practice' standards. This outstanding book is an invaluable resource for administrators, supervisors, clinicians, and trainers in social work and other mental health fields. I find it to be very valuable in training new staff. In addition, I highly recommend this book as a text for advanced practice courses in social work, psychology, psychosocial rehabilitation, and psychiatric nursing.”

—Margaret V. Sherrer, MSW, Project Director, Co-Occurring Addictive and Mental Disorders Program, South Shore Mental Health Center, Charlestown, Rhode Island; designated trainer, RI Council of Community Mental Health Centers, Inc.

“Providing meaningful help to the addicted client with major mental illness is the most difficult and challenging task that mental health clinicians face. Mueser and colleagues have provided us with a truly helpful and empowering guide. It is the best book in its field”

—George E. Vaillant, MD, Harvard Medical School

“Individuals with severe mental illness and substance abuse are the most neglected group of psychiatric patients. This comprehensive textbook fills a major void and will be infinitely useful to clinicians, administrators, and clinicians-in-training. The authors have a national reputation for pioneering efforts to develop treatment models, and they have laid out a detailed plan for the rest of us to follow. Finally, clinicians have a cure for their dual diagnosis despair!”

—E. Fuller Torrey, MD, The Stanley Medical Research Institute, Bethesda, MD

“Helping clients with dual disorders represents one of the most challenging tasks for mental health clinicians and administrators. While there is an extensive scientific literature on the topic, few programs offer integrated, evidence-based treatment. This book has the potential to change that. Written by the experts on the topic, it is a comprehensive, well-written, state-of-the-art manual that explains what needs to be done and then describes how it should be done. This book should find a home in every mental health program that works with dually diagnosed clients, and should be required reading for every new clinician and program administrator.”

—Alan S. Bellack, PhD, ABPP, Mental Illness Research Education Clinical Center (MIRECC), VA Capitol Health Care Network, Baltimore, MD; Department of Psychiatry, University of Maryland School of Medicine

Table of Contents

I. Basics

1. Substance Abuse and Severe Mental Illness

2. Principles of Integrated Treatment

3. Basic Organizational Factors

II. The Assessment Process

4. Assessment I: Detection, Classification, and Functional Assessment

5. Assessment II: Functional Analysis and Treatment Planning

III. Individual Approaches

6. Stage-Wise Case Management

7. Motivational Interviewing

8. Cognitive-Behavioral Counseling

IV. Group Interventions

9. Persuasion Groups

10. Active Treatment Groups

11. Social Skills Training Groups

12. Self-Help Groups

V. Working with Families

13. Family Collaboration

14. Behavioral Family Therapy

15. Multiple-Family Groups

VI. Other Treatment Approaches

16. Residential Programs and Other Housing Options

17. Involuntary and Coerced Interventions

18. Vocational Rehabilitation

19. Psychopharmacology

VII. Research

20. Research on Dual-Disorder Treatment

Epilogue: Avoiding Burnout and Demoralization


A. Dual-Disorder Treatment Fidelity Scale

B. Educational Handouts

C. Assessment Instruments and Other Forms

About the Authors

Kim T. Mueser, PhD, is Executive Director of the Center for Psychiatric Rehabilitation and Professor in the Department of Occupational Therapy at Boston University. Dr. Mueser's clinical and research interests include psychiatric rehabilitation for persons with severe mental illnesses, intervention for co-occurring psychiatric and substance use disorders, and the treatment of posttraumatic stress disorder. He has served on numerous editorial boards, has published many journal articles and book chapters, and has coauthored over 10 books. His book The Complete Family Guide to Schizophrenia (with Susan Gingerich) received the National Alliance on Mental Illness NYC Metro Ken Book Award.

Douglas L. Noordsy, MD, is Associate Professor of Psychiatry and Associate Director of Education and Training in the Department of Psychiatry, Dartmouth Medical School. He is also Chief of Clinical Research at the Mental Health Center of Greater Manchester and Medical Director of Westbridge, Inc., a private nonprofit organization providing services to individuals with dual disorders and their families. Dr. Noordsy has provided clinical care and leadership across the New Hampshire community mental health system, including active work with dual-diagnosis treatment teams, since 1990. He has lectured and published extensively, especially in the areas of comorbid substance abuse and mental illness and recovery-oriented treatment for people with severe mental illness.

Robert E. Drake, MD, PhD, is a community psychiatrist, Professor of Psychiatry at Dartmouth Medical School, and Director of the New Hampshire-Dartmouth Psychiatric Research Center. He has worked with community mental health teams developing and refining approaches to integrated dual-disorder treatments for over 20 years.

Lindy Fox Smith, MA, MAC, MCAP, operates her own consulting firm, L. B. Fox and Associates, since retiring as a Research Associate at the New Hampshire-Dartmouth Psychiatric Research Center. She has worked extensively on research projects examining the effectiveness of integrated treatment for people with serious mental illnesses and substance use disorders, including involvement in assessments, treatment, and clinical teaching. Ms. Fox’s expertise has been gained through a combination of formal education, personal experience, and professional focus. She has been a recipient of the services she now participates in designing and evaluating. Ms. Fox has consulted throughout the United States and in other countries including Australia, Canada, England, and Sweden. She has also coauthored several articles, and served on the faculty at Dartmouth College in the Department of Family and Community Medicine.


Psychiatrists, psychologists, social workers, and other mental health practitioners working in agency or community settings; addictions treatment professionals.

Serves as a text in professional development initiatives as well as graduate-level courses in addictions treatment, dual diagnosis, and community psychiatry.

Course Use

Serves as a text in professional development initiatives as well as graduate-level courses in addictions treatment, dual diagnosis, and community psychiatry.