Introducing behavior therapy into a disease-model dual-diagnosis treatment program

Abstract

Rates of alcohol and drug abuse among individuals seeking psychiatric treatment exceed those of the general population, and there has been increasing attention to meeting the treatment needs of such dually diagnosed persons. Social-skills training shows promise as one aspect of integrated treatment for dually diagnosed inpatients, but poses practical questions of implementing behavior therapy in settings where a disease model of addictive behavior and psychopathology dominates. A case is made for integration of behavior therapy within the prevailing medical model and supported by the author's experience providing skills training groups for inpatients. Clinical techniques for providing social skills training to patients with severe, heterogeneous presenting problems in the context of everbriefer hospitalizations are described, as are means for increasing the value of the behavioral approach in a medical-model setting.