Despite its prevalence, cost, and association with high risk for negative outcomes, there is a lack of empirically-based procedures for effective treatment of dual diagnosis in adolescents. The present study attempts to address the need for research informing effective treatment of this population. Strengths have been found to predict positive outcomes in at-risk community and clinical samples of youth, but little is known about the treatment value of strengths in youths with dual diagnosis. This study examines the relative distribution of strengths and relationship between strengths and outcomes in adolescents with dual diagnosis. It controls for effects of diagnostic complexity versus dual diagnosis to clarify unique effects on outcomes of adding substance use to mental health problems. A geographically stratified random sample of adolescents ages 10-19 (N=902) receiving services in a continuum of care - 22.5% of whom had dual diagnosis - was drawn from a statewide mental health service system planning study. Retrospective chart review was used to generate ratings of participant needs and strengths at treatment admission with the Child and Adolescent Needs and Strengths for children and adolescents with mental health challenges (CANS-MH) and collect demographic, diagnostic, and discharge information. Participants were grouped based on: 1) presence versus absence of substance use problems, 2) single versus multiple mental health problems, and 3) positive versus negative discharge reason. Analysis of variance and regression analyses indicated that dual diagnosis was significantly associated with healthier interpersonal and relationship permanence strengths and multiple mental health problems were significantly associated with fewer strengths. Educational strengths significantly predicted positive discharge reason in dual diagnosis youth. The co-occurrence of substance use problems with mental health problem(s) had a unique, significant negative effect on outcomes. Results did not support the hypothesis that dual diagnosis youth have fewer strengths than youths with single or multiple mental health problems and suggest that the self-medication theory of etiology may not apply to clinical samples of this population. Findings suggest that interventions targeting educational strengths could improve treatment outcomes of dual diagnosis youth. Uses of strengths-based approaches to improve treatment engagement of this population and future research directions are discussed.

Last modified

• 09/01/2018

Creator

• Julia Cathcart Shabat

DOI

• https://doi.org/10.21985/N2K138

Subject

• Clinical Psychology

Keyword

• Psychology
• Clinical

Date created

• 2007-12-20

Resource type

• Dissertation

Rights statement

• In Copyright