THERAPY FOR DRUG ABUSERS WITH PSYCHIATRIC COMORBIDITY

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Cocaine abuse is common among schizophrenic patients in mental health treatment settings and results in poor clinical outcomes including increased hospitalizations, suicide attempts, emergency room visits, periods of homelessness, and episodes of violent behavior. Individuals with this comorbidity respond poorly to traditional drug abuse and psychiatric treatments. There exists a great clinical and research need to develop innovative and well defined behavioral therapies for this population which address both the psychiatric and substance abuse problems. This grant re-application proposes to develop and pilot test our Dual Diagnosis Relapse Prevention (DDRP) psychotherapy approach in the treatment of schizophrenic cocaine abusers. This already promising cognitive-behavioral approach integrates and modifies traditional substance abuse relapse prevention and psychiatric social skills training (including psychiatric symptom and medication management). The specific aims of this grant proposal are to: 1. Develop a DDRP Therapist Training Manual & Patient Workbook; 2. Develop Competence & Adherence Rating scales; 3. Develop and conduct a Didactic Training Program; and 4. Perform a Pilot Study of the DDRP Treatment, Training, and Rating Scales. At the end of this three year Stage One behavioral psychotherapy study, we anticipate to have the methods and pilot data to support a Stage Two efficacy trial.