Commonwealth Research Center
Family Intervention for Severe Mental Illness (SMI) and Substance Use Disorders (FIDD)
Rationale – Research Objective and Specific Aims
Principal Investigator
Kim Mueser, Ph.D.
New Hampshire-Dartmouth Psychiatric Research Center
Main Bldg., State Office Park South
105 Pleasant Street
Concord, NH 03301
Tel: (603) 271-5226
Fax: (603) 271-5265
Email: [email protected]
Other Investigators
James Feldman, M.D. (MMHC site PI)
Medical Director
Massachusetts Mental Health Center
MMHC at the LSH Campus
180 Morton Street
Jamaica Plain, MA 02130
Tel: (617) 626-9483
Email: [email protected]
Margaret Guyer, Ph.D.
Outpatient Services Director
Massachusetts Mental Health Center
MMHC at the LSH Campus
180 Morton Street
Jamaica Plain, MA 02130
Tel: (617) 626-9338
Email: [email protected]
Daniel Beck, LICSW (Clinician)
North Suffolk Mental Health Association
Freedom Trail Clinic
25 Staniford Street
Boston, MA 02114
Tel: (617) 470-3900
Corinne Cather, Ph.D. (NSMHA Site PI)
North Suffolk Mental Health Association
Freedom Trail Clinic
25 Staniford Street
Boston, MA 02114
Tel: (617) 912-7891
Email: [email protected]
Michelle Friedman-Yakoobian, Ph.D.
North Suffolk Mental Health Association
Freedom Trail Clinic
25 Staniford Street
Boston, MA 02114
Tel: (617) 912-7848
Email: [email protected]
Ken Park, Ph.D.
North Suffolk Mental Health Association
Freedom Trail Clinic
25 Staniford Street
Boston, MA 02114
Tel: (617) 724-6300 #1340237
Email: [email protected]
Alcohol and drug use disorders are the most common comorbid condition in persons with severe mental illness (i.e., dual disorders), afflicting upwards of 50% of this population. Substance use disorders have a profound impact on worsening the course of psychiatric illness, including increased relapses and rehospitalizations, housing instability and homelessness, family burden, treatment noncompliance, violence and aggression, and increased vulnerability to infectious diseases. Although there have been some advances in integrating mental health and substance abuse treatment services, substance use disorders continue to be relatively stable and persistent over time, and take a heavy toll on clients, relatives, and providers. No specific, manualized interventions, including individual, group, or family modalities, have been demonstrated to be effective in treating dual disorders. There is a pressing need for more effective treatments to address this problem. This study will take an important step towards evaluating a recently developed program for collaborating with families who have a member with a dual disorder.
Family intervention for dual disorders is a promising but neglected treatment modality. Most dually diagnosed clients continue to have contact with their families, with substance abuse contributing to increased family burden and stress. Aggression in dual disorder clients is most likely to be directed at family members, and the loss of family support is a major cause of housing instability and homelessness. Finally, there is ample support for the effects of family collaboration in the treatment of severe mental illness, and for primary substance use disorders, but no research addressing its effects on dual disorders. The proposed research will be a randomized controlled trial of a family collaboration program for dual disorders, conducted at three community mental health centers to ensure replicability of the intervention. The family program was developed based on a model of the interactions between family factors and the course of dual disorders. The program has been manualized and pilot tested in a typical community mental health center setting.
Research Objective and Specific Aims
The proposed research is a randomized controlled trial to evaluate the Family Intervention for Severe Mental Illness (SMI) and Substance Use Disorders (FIDD) program for dually diagnosed clients with SMI, a recently developed program for collaborating with families who have a member with a dual disorder. We expect that the intervention will improve outcomes in several different areas. The effectiveness of this intervention will be tested with respect to the following specific aims and hypotheses:
Specific Aim 1 – To help client gain improvement in substance use remission.
We hypothesize that participants in the FIDD Intervention group, as opposed to those in the Psychoeducation group, will:
a) Demonstrate greater improvement in substance use diagnoses (SUD)
b) Demonstrate greater improvement in severity of substance abuse
c) Demonstrate greater improvement in motivational stage of treatment.
Specific Aim 2 – To reduce the number of hospitalizations clients experience.
We hypothesize that that participants in the FIDD Intervention group, as opposed to those in the Psychoeducation group will have:
a) Significantly fewer hospitalizations
b) Significantly fewer days in the hospital.
Specific Aim 3 – Demonstrate a positive effect on the family members involved in the study.
We hypothesize that the family members in the FIDD Intervention group, as opposed to those in the Psychoeducation group, will:
a) Report a significantly lower burden of care
b) Report more satisfaction with their relationship with the client
c) Report higher levels of social support.
The study is still recruiting. For more information, call Margaret Guyer at (617) 626-9338.