Gender differences in the assessment of specialized treatments for substance abuse among people with severe mental illness.

A recent study examined the relative cost-effectiveness of three specialized interventions for treating people with both severe mental illness and substance abuse disorders: behavioral skills training, intensive case management, and 12-Step recovery. This article reports the changes in client psychosocial outcomes, psychiatric and substance abuse symptomatology, and service utilization and costs for the 31 women involved in the study, and compares these results to similar data on the men in the study sample and to the existing literature. Also presented are the most salient clinical impressions of the treating staff of issues affecting the course of treatment and outcomes for these women. Similarities were found in treated prevalence, service utilization, and related clinical issues in women with dual disorders compared to those reported in the existing psychiatric or substance abuse literature. Compared to men in the same sample, the women had higher functioning scores, more psychiatric symptomatology, and greater reductions in 24-hour acute or subacute treatment services used during the first six months of the specialized intervention programs. These results provide some insight into ways of serving dually diagnosed women more effectively in community-based treatment programs and of investigating these services more fruitfully.