Family Intervention for Severe Mental Illness and Substance Use Disorder

  • Kim T. Mueser
  • Lindy Fox
  • Carolyn Mercer


Alcohol and drug use disorders (including both abuse and dependence) are a major problem that plagues the lives of many persons with severe mental illness (SMI) such as schizophrenia or bipolar disorder. Epidemiological research has repeatedly shown that individuals with SMI are at increased risk to develop substance use disorders (Cuffel, 1996; Regier et al., 1990). Surveys of the prevalence of substance abuse among the SMI population indicate that on average between 40 and 60 percent of clients have a disorder over their lifetime, and 25 to 40 percent have a current substance use disorder (Mueser et al., 1995a).


Substance Abuse Severe Mental Illness Family Intervention Dual Diagnosis Family Work 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Barry, K.L., Fleming, M.F., Greenley, J.R, Kropp, S., and Widlak, P. (1996): Characteristics of persons with severe mental illness and substance abuse in rural areas. Psychiatric Services 47: 88–90PubMedGoogle Scholar
  2. Butzlaff, R.L. and Hooley, J.M. (1998): Expressed emotion and psychiatric relapse. Archives of General Psychiatry 55: 547–552PubMedCrossRefGoogle Scholar
  3. Carey, K.B. (1989): Treatment of the mentally ill chemical abuser: Description of the Hutchings day treatment program. Psychiatric Quarterly 60(4): 303–316PubMedCrossRefGoogle Scholar
  4. Caton, C.L., Shrout, P.E., Eagle, P.F., Opler, L.A., Felix, A.F., and Dominguez, B. (1994): Risk factors for homelessness among schizophrenic men: A casecontrol study. American Journal of Public Health 84(2): 265–270PubMedCrossRefGoogle Scholar
  5. Caton, C.L. M., Shrout, P.E., Dominguez, B., Eagle, P.F., Opler, L.A., and Cournos, F. (1995): Risk factors for homelessness among women with schizophrenia. American Journal of Public Health 85: 1153–1156PubMedCrossRefGoogle Scholar
  6. Clark, R.E. (1996): Family support for persons with dual disorders. In: Dual diagnosis of major mental illness and substance abuse disorder II: Recent research and clinical implications. New directions for mental health services (Drake, R.E., Mueser, K.T., eds.), Vol. 70, pp. 65–77. San Francisco: Josssey-BassGoogle Scholar
  7. Clark, R.E. and Drake, R.E. (1992): Substance abuse and mental illness: What families need to know. Innovations and Research 1(4): 3–8Google Scholar
  8. Cournos, F., Empfield, M., Horwath, E., McKinnon, K., Meyer, I., Schrage, H., Currie, C., and Agosin, B. (1991): HIV prevalence among patients admitted to two psychiatric hospitals. American Journal of Psychiatry 148(9): 1225–1229PubMedGoogle Scholar
  9. Cresswell, C.M., Kuipers, L., and Power, M.J. (1992): Social networks and support in long-term psychiatric patients. Psychological Medicine 22: 1019–1026PubMedCrossRefGoogle Scholar
  10. Cuffel, B.J. (1996): Comorbid substance use disorder: prevalence, patterns of use, and course. In: Dual diagnosis of major mental illness and substance use disorder II: Recent research and clinical implications (Drake, R.E., Mueser, K.T., eds.), Vol. 70, pp. 65–77. San Francisco: Jossey-BassGoogle Scholar
  11. Dickey, B. and Azeni, H. (1996): Persons with dual diagnoses of substance abuse and major mental illness: their excess costs of psychiatric care. American Journal of Public Health 86: 973–977PubMedCrossRefGoogle Scholar
  12. Dixon, L., Adams, C., and Lucksted, A. (2000): Update on family psychoeducation for schizophrenia. Schizophrenia Bulletin 26(1): 5–20PubMedCrossRefGoogle Scholar
  13. Dixon, L., McNary, S., and Lehman, A. (1995): Substance abuse and family relationships of persons with severe mental illness. American Journal of Psychiatry 152: 456–458PubMedGoogle Scholar
  14. Drake, R.E., Bartels, S.B., Teague, G.B., Noordsy, D.L., and Clark, R.E. (1993): Treatment of substance abuse in severely mentally ill patients. Journal of Nervous and Mental Disease 181: 606–611PubMedCrossRefGoogle Scholar
  15. Drake, R.E., Mueser, K.T., Clark, R.E., and Wallach, M.A. (1996): The course, treatment, and outcome of substance disorder in persons with severe mental illness. American Journal of Orthopsychiatry 66(1): 42–51PubMedCrossRefGoogle Scholar
  16. Edwards, D.V., Nikkel, B., and Coiner, B. (1991): Final report of the National Institute of Mental Health Young Adult Dual Diagnosis Oregon Demonstration Project. Salem, OR: Oregon Mental Health and Developmental Disability DivisionGoogle Scholar
  17. Falloon, I.R.H., Boyd, J.L., and McGill, C.W. (1984): Family care of schizophrenia: A problem-solving approach to the treatment of mental illness. New York: GuilfordGoogle Scholar
  18. First, M.B., Spitzer, R.L., Gibbon, M., and Williams, J.B.W. (1996): Structured clinical interview for DMS-IV axis-I disorders - patient edition (SCID-IIP, Version 2.0). New York: Biometrics Research DepartmentGoogle Scholar
  19. Goldman, H.H. (1984): The chronically mentally ill: Who are they? Where are they? In: The chronically mentally ill: Research and services (Mirabi M., ed.), pp. 33–44. Spectrum PublicationsGoogle Scholar
  20. Hatfield, A.B. and Lefley, H.P. (1987): Families of the mentally ill: Coping and adaptation. New York: Guilford PressGoogle Scholar
  21. Haywood, T.W., Kravitz, H.M., Grossman, L.S., Cavanaugh, J.L., Jr., Davis, J. M., and Lewis, D.A. (1995): Predicting the ‘revolving door’: phenomenon among patients with schizophrenic, schizoaffective, and affective disorders. American Journal of Psychiatry 152: 856–861PubMedGoogle Scholar
  22. Johnsen, J.A, Hall, H.E., Rhoades, M., and Harris, N. (1992): OASIS: Final report to the National Institute of Mental Health. Columbus, OH: Ohio Department of Mental HealthGoogle Scholar
  23. Lefley, H.P. and Johnson, D.L. (1990): Families as allies in treatment of the mentally ill: New directions for mental health professionals. Washington, DC: American Psychiatric PressGoogle Scholar
  24. Mercer-McFadden, C., Drake, R.E., Brown, N.B., and Fox, R.S. (1997): The community support program demonstrations of services for young adults with severe mental illness and substance use disorders 1987-1991. Psychiatric Rehabilitation Journal 20(3): 13–24Google Scholar
  25. Miller, W.R. and Rollnick, S. (1991): Motivational interviewing: preparing people to change addictive behavior. New York: Guilford PressGoogle Scholar
  26. Miner, C.R., Rosenthal, R.N., Hellerstein, D.J., and Muenz, L.R. (1997): Prediction of compliance with outpatient referral in patients with schizophrenia and psychoactive substance use disorders. Archives of General Psychiatry 54: 706–712PubMedCrossRefGoogle Scholar
  27. Minkoff, K. (1991): Program components of a comprehensive integrated care system for serious mentally ill patients with substance disorders. In: Dual diagnosis of major mental illness and substance disorders (Minkoff, K., Drake, R.E., eds.). New Directions for Mental Health Services, Vol. 50, pp. 13–27. San Francisco: Jossey-BassGoogle Scholar
  28. Mueser, K.T., Bellack, A.S., Wade, J.H., Sayers, S.L., and Rosenthal, C.K. (1992): An assessment of the educational needs of chronic psychiatric patients and their relatives. British Journal of Psychiatry 160: 674–680PubMedCrossRefGoogle Scholar
  29. Mueser, K.T., Bennett, M., and Kushner, M.G. (1995a): Epidemiology of substance abuse among persons with chronic mental disorders. In: Double jeopardy: Chronic mental illness and substance abuse (Lehman, A.F., Dixon, L., eds.). pp. 9–25. New York: Harwood Academic PublishersGoogle Scholar
  30. Mueser, K.T., Drake, R.E., Clark, R.E., McHugo, G.J., Mercer-McFadden, C., and Ackerson, T. (1995b): Toolkit for evaluating substance abuse in persons with severe mental illness. Cambridge, MA: Evaluation Center at HSRIGoogle Scholar
  31. Mueser, K.T., Drake, R.E., and Noordsy, D.L. (1998): Integrated mental health and substance abuse treatment for severe psychiatric disorders. Journal of Practical Psychiatry and Behavioral Health 4(3): 129–139Google Scholar
  32. Mueser, K.T. and Gingerich, S.L. (1994): Coping with schizophrenia: A guide for families. Oakland, CA: New Harbinger PublicationsGoogle Scholar
  33. Mueser, K.T. and Glynn, S.M. (1999): Behavioral family therapy for psychiatric disorders. Oakland, CA: New HarbingerGoogle Scholar
  34. Noordsy, D.L., Drake, R.E., Biesanz, J.C., and McHugo, G.J. (1994): Family history of alcoholism in schizophrenia. Journal of Nervous and Mental Disease 186: 651–655Google Scholar
  35. Osher, F.C. and Kofoed, L.L. (1989): Treatment of patients with psychiatric and psychoactive substance use disorders. Hospital and Community Psychiatry 40: 1025–1030PubMedGoogle Scholar
  36. Regier, D.A., Farmer, M.E., Rae, D.S., Locke, B.Z., Keith, S.J., Judd, L.L., and Goodwin, F.K. (1990): Comorbidity of mental disorders with alcohol and other drug abuse: Results from the Epidemiologic Catchment Area (ECA) study. Journal of the American Medical Association 264: 2511–2518PubMedCrossRefGoogle Scholar
  37. Ridgely, M.S., Goldman, H.H., and Willenbring, M. (1990): Barriers to the care of persons with dual diagnoses: Organizational and financing issues. Schizophrenia Bulletin 16(1): 123–132PubMedGoogle Scholar
  38. Salyers, M.P., and Mueser, K.T. (in press): Social functioning, psychopathology, and medication side effects in relation to substance use and abuse in schizophrenia. Schizophrenia ResearchGoogle Scholar
  39. Schooler, N.R., Keith, S.J., Severe, J.B., Matthews, S.M., Bellack, A.S., Glick, I. D., Hargreaves, W.A., Kane, J.M., Ninan, P.T., Frances, A., Jacobs, M., Lieberman, J.A., Mance, R., Simpson, G.M., and Woerner, M.G. (1997): Relapse and rehospitalization during maintenance treatment of schizophrenia: The effects of dose reduction and family treatment. Archives of General Psychiatry 54: 453–463PubMedCrossRefGoogle Scholar
  40. Sokolove, R.L. and Trimble, D. (1986): Assessing support and stress in the social networks of chronic patients. Hospital and Community Psychiatry 37: 370–372PubMedGoogle Scholar
  41. Stanton, M.D. and Shadish, W.R. (1997): Outcome, attrition, and family-couples treatment for drug abuse: A meta-analysis and review of the controlled, comparative studies. Psychological Bulletin 122(2): 170–191PubMedCrossRefGoogle Scholar
  42. Steadman, H.J., Mulvey, E.P., Monahan, J., Robbins, P.C., Appelbaum, P.S., Grisso, T., Roth, L.H., and Silver, E. (1998): Violence by people discharged from acute psychiatric inpatient facilities and by others in the same neighborhoods. Archives of General Psychiatry 55: 393–401PubMedCrossRefGoogle Scholar
  43. Susser, E., Struening, E.L., and Conover, S. (1989): Psychiatric problems in homeless men: Lifetime psychosis, substance use, and current distress in new arrivals at New York City shelters. Archives of General Psychiatry 46: 845–850PubMedCrossRefGoogle Scholar
  44. Swartz, M.S., Swanson, J.W., Hiday, V.A., Borum, R., Wagner, H.R., and Burns, B.J. (1998): Violence and mental illness: The effects of substance abuse and nonadherence to medication. American Journal of Psychiatry 155: 226–231PubMedGoogle Scholar
  45. Talbott, J.A. (1990): Current perspectives in the United States on the chronically mentally ill. In: Recent advances in schizophrenia (Kales, A., Stefanis, C.N., Talbott, J., eds.). pp. 279–295. New York: SpringerCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Wien 2002

Authors and Affiliations

  • Kim T. Mueser
  • Lindy Fox
  • Carolyn Mercer

There are no affiliations available

Personalised recommendations