Recent studies suggest that a motivational intervention designed for individuals with schizophrenia and substance use disorders may improve substance use and psychiatric outcomes for individuals with a dual diagnosis. Two recent studies found that brief interventions incorporating motivational and behavioral techniques to treat substance use disorders contributed to reductions in substance use among individuals with schizophrenia spectrum diagnoses (95,96). Specifically, Graeber et al. (95) found higher abstinence rates among individuals with schizophrenia and alcohol use disorders who were involved in a three-session motivational enhancement program relative to those involved in an educational intervention. Similarly, James et al. (96) found that individuals involved in a six-session, manualized group intervention with motivational enhancement and relapse prevention showed greater improvements in drug-related consequences and reductions in marijuana, alcohol, and polydrug use at follow-up relative to individuals who attended a one-session drug education class. Sigmon and Higgins (97) used a within-subjects reversal design to test the impact of a voucher-based contingent reinforcement intervention to reduce marijuana use in seven participants (86% having a schizophrenia diagnosis). Participants completed 4 weeks of baseline monitoring, during which they received $10 vouchers per urine specimen independent of result, followed by 12 weeks of intervention, during which they received $10 per urine specimen that was negative for marijuana, followed by another 4 weeks of baseline monitoring. The percentage of negative tests was significantly greater during the intervention weeks. However, two studies did not find that involvement in a substance use intervention contributed to lower rates of substance use (98,99). Although there is variability in research methodology and findings, motivational and behavioral interventions targeting substance use for individuals with dual diagnoses appear to be feasible and beneficial.


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