Dual Diagnosis Self-Help Referral

This study has been completed.
Information provided by (Responsible Party):
Department of Veterans Affairs
ClinicalTrials.gov Identifier:
First received: February 1, 2006
Last updated: October 16, 2014
Last verified: October 2014

This project will help counselors in substance abuse treatment programs make effective referrals of dually diagnosed patients (those with a co-occurring psychiatric disorder) to self-help groups.

Condition Intervention
Dual Diagnosis
Behavioral: Intensive referral to dual-focused self-help

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Dual Diagnosis Self-Help Group Referral: Outcomes and Services Use

Resource links provided by NLM:

Further study details as provided by Department of Veterans Affairs:

Primary Outcome Measures:
  • Psychiatric Functioning at 6 Months [ Time Frame: 6 months ] [ Designated as safety issue: No ]
    Addiction Severity Index psychiatric composite ranges from 0 to 1, with 1 indicating more severe problems.

Secondary Outcome Measures:
  • Mental Health Services Use and Costs at 6 Months, 1 Year, and 2 Years [ Time Frame: 6 months, 1 year, 2 years ] [ Designated as safety issue: No ]

Enrollment: 287
Study Start Date: April 2006
Study Completion Date: September 2010
Primary Completion Date: September 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Arm 1
Intensive referral to dual-focused self-help groups
Behavioral: Intensive referral to dual-focused self-help
4 group sessions to introduce patients to dual focused groups
No Intervention: Arm 2
Usual care

Detailed Description:


Dual diagnosis (psychiatric and substance use) patients' (DDPs) participation in 12-step mutual-help groups is linked to lower relapse and treatment utilization rates. However, under usual referral, many DDPs do not attend, or sustain attendance of, substance-focused groups (SFG). DDPs may benefit from dual-focused groups (DFGs).


(1) Implement and validate procedures to help counselors make effective referrals to DFGs. DDPs were assigned to a standard- or intensive-referral to DFG condition to determine the extent to which intensive referral, compared to standard referral, increased patients' mutual-help group participation. (2) Determine whether DDPs who received intensive referral had better substance use and psychiatric outcomes.


DDPs entering VA outpatient mental health treatment received either standard (N=145) or intensive (N=142) referral. Standard referral consisted essentially of the counselor recommending DFG participation. The keys to intensive referral were a DFG orientation and the counselor facilitating direct contact between the patient and a DFG member, and following up on recommendations for mutual help. Patients were followed at six months (80%), one year (81%) and two years (80%) to determine whether intensive referral resulted in more DFG and SFG participation, and better substance use and psychiatric outcomes.




Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Dually diagnosed veterans entering outpatient mental health treatment

Exclusion Criteria:

  • Unable to correctly answer the Orientation and Registration questions of the Mini-Mental State Examination
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00286728

United States, California
VA Palo Alto Health Care System
Palo Alto, California, United States, 94304-1290
Sponsors and Collaborators
Principal Investigator: Christine Timko, PhD VA Palo Alto Health Care System