Best Practices in Family Intervention for Serious Mental Illness

Family Intervention for Dual Disorders (FIDD)

Manual Title	Family Intervention for Dual Disorders (FIDD)
Creator	Kim T. Mueser, Ph.D.
Reference	Mueser, K.T.,Noordsy, D.L., Drake, R. E., & Fox, L. (in press). Integrated treatment for dual disorders: Effective intervention for severe mental illness and substance abuse. New York: Guilford.
Price	unknown
Contact Information:	Kim Mueser, Ph.D. New Hampshire-Dartmouth Psychiatric Center 105 Pleasant Street Main Building Concord, NH 03301 Phone: 603-650-5000 Email: Kim.Mueser@dartmouth.edu

Program Overview:

Rationale:
Although behavioral family therapy has been targeted primarily to patients with severe mental illness, its application to patients with dual diagnosis is warranted due to several factors: most dual diagnosis patients have contact with their families;patients with dual diagnoses often create high levels of tension and conflict in the home; and family psychoeducation has been demonstrated to be effective with substance use disorders. Mueser et al performed several focus groups (patients, families, staff) to determine the needs of families dealing with dual diagnoses.

Theoretical Orientation:
Program is based on a stage model of dual disorder treatment for patients (Osher and Kofoed, 1989); the 4 stages include: engagement; persuasion; active treatment; and relapse prevention.

Format:
Program has two components:

Single-family 60-minute sessions(including the patient) are the primary intervention (based on Falloon's behavioral family therapy (BFT). Sessions are held either at the patient's home or in the clinic.
Multiple-family groups (including the patient) are an adaptation of the Schooler et al (1997) model. Groups meet monthly for 60-90 minutes. Meetings include 3-15 families and have 2 facilitators. Meetings involve: brief "caring & sharing"; semi-didactic presentation; group discussion; and wrap up.

Phases of Family Treatment:

Connecting (1-3 sessions)
Assessment (2-5 sessions)
Psychoeducation (6-8 sessions)
.Problem-solving (5-15 sessions)
Termination( 1 session)

Frequency/Duration:

Single-family sessions meet on a declining frequency basis (weekly, then biweekly, then monthly)
Treatment lasts from 9 months to 2years (multiple family groups are time unlimited)

Research:

Mueser & Fox (2002).

Methods: Pilot study at a community mental health center of 6 families whose patient had a diagnosis of schizophrenia, schizoaffective, bipolar or major depression AND a substance use disorder. On average, 29 single-family sessions were provided (in the home or clinic) over the course of 1 year.

Results: All patients made progress in their stages of treatment AND all patients improved in their amount of substance use

Notes: A NIMH-supported randomized controlled trial of FIDD program is currently underway

Above description reviewed and approved by Dr. Mueser, 12-23-02

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