A New Beginning – A Dramatherapy Group for Participants with Co-Occurring Mental Illness and Substance Abuse in a Mental Health Setting

Abstract

Rehabilitation for people with dual diagnosis (co-existing mental illness and substance dependence) has existed in many forms over the past thirty years and has become more urgently needed over time. Treatment for this population inevitably requires a team effort (Schwartz & Lehman, 1998). These people are difficult to engage in treatment and it takes time to unravel the interacting effects of substance abuse and their mental illness. Social relationships may also be problematic, particularly once the person has decided to discontinue drug or alcohol abuse. Often such clients find it easier to communicate socially with people who have similar problems (Hatfield, 1993).Improvements in self-esteem and reduced intake of drugs and alcohol are rarely monitored in the one community psychiatric facility, as in this study. The method of treatment in this case was to run a small group for participants over an extended period with support from multidisciplinary teams, using a Dutch model for drug and alcohol rehabilitation. By targeting psychiatric relapse prevention and people's life stories, using a biographical developmental framework and dramatherapy interventions, the intention was to achieve outcomes of higher self esteem and reduced intake of recreational drugs. In fact the pre and post measures chosen did not show significant variance. For all participants, including those who were already abstinent, changes in lifestyle and achievement of life goals were sought. As a result, there was reported enjoyment of mutual support, sharing and understanding of individual life stories, together with strategies to increase resilience. Further research is needed to identify how best to measure outcomes.Hatfield, A. (1993) ‘Dual Diagnosis and Mental Illness’, Journal of National Alliance for the Mentally Ill, (Online), retrieved 11.1.08Schwartz, R. & Lehman, A. (1995) in ‘Overview of Treatment Principles’ in Lehman, A. & Dixon, L. (eds.) Double Jeopardy, Harwood Academic Publishers, Chur, Switzerland, p.77