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Co-Occurring Schizophrenia and Substance Dependence/Abuse

Future Research and Barriers to Service

Substance Dependence
Substance Abuse
Assessment of Co-occurring Disorders
Motivational Interviewing
Applying MI: Express Empathy
Applying MI: Develop Discrepancy
Applying MI: Avoid Argument
Applying MI: Roll With Resistance
Applying MI: Support Self-Efficacy
Evidence Based for Motivational Interviewing
Future Research and Barriers to Service
Web sites of Interest


Need for Future Research


Motivational interventions have been successfully used with a variety of problems, client populations, and settings, and the methodology appears to be generally applicable, although it was developed primarily with heavy alcohol drinkers and cigarette smokers. 


Research should consider some of the following questions when planning and developing future research studies:


           What are the active ingredients of motivational interviewing?

           Can motivational interventions be standardized and taught?

           What types of clients are most amenable to motivational interventions?

           What types of outcomes can be defined and measured?

           What clinician characteristics affect the outcomes of motivational interventions?

           Are stage-matched interventions appropriate?

           How do motivational interventions compare with other substance abuse treatments in terms of cost-effectiveness?

           How do culture and context influence the effectiveness of motivational interventions?

           How can motivational interventions be applied successfully to an even broader variety of problems, and settings?


Three major barriers to effective treatment for co-occurring disorders


1.         Uncoordinated treatment programs, separate programs for substance abuse and serious and persistently mentally ill.


2.         staff in treatment facilities not adequately trained to treat co-occurring disorders of MICA clients


3.         failure to detect substance abuse problems resulting in one sided (disorder) interventions





Nicole & Colleen