Emotional factors&personal resources in

comorbidity patients:
adapted Therapeutic Community model for
dual pathology

A. J. Molina- Fernández &

M. Reyes-Requena ;
PH Granada
 OBJECTIVES
• Spanish situation is (in 2006 studies with clinical populations)
prevalence rates of dual diagnoses range from 20 / 60% of all
patients with a psychiatric disorder (even in some cases 85%). The
data set and characters come to pose a previous set of difficulties
for its approach and treatment, including characteristics of these
patients , lack of specific training and resources, as well as the
absence of a comprehensive model for specific treatment.

• Our hypothesis is: The educative- therapeutic program Proyecto

Hombre has proved to be very effective response to all kinds of
addictions during last 20 years in Spain (since 1984). Their
approach uses multidisciplinary teams and humanistic philosophy,
so this method may be useful for DP patients
 METHODOLOGY
Action plan :
Initial Interviews: emphasis on legal and medical issues (especially psychiatric problem& dyagnosis )
and necessary medication on treatment. Instruments: FIBAT, PH Futura and a Therapeutic
Contract before beginning the treatment.
Motivation Phase : Combination of group and individual therapy and assesment. First step in
abstinence of substance, stability in the medication or psychiatric treatment, adapting to a system
of rules and responsibilities using a series of training seminars. Instruments: EuropASI, Íter
toxicological and alcohol.
TC Phase : Therapeutic Itinerary, this schedule is raised and concerted together with the patient.
Group and Individual therapy are used to improve personal knowledge and empowerment of
personal resources, goals achieved (on the behavioural, cognitive, medical and psychological
aspects), self-esteem, emotional and social skills. Emotional Therapies: Rational-Emotive &
Accept and Compromise Therapy. Elaboration of a Personal Life Project (PLP) in several
areas (family, social, recreational/ leisure time,, etc)
Social Reintegration Stage: gradual return to society& stablishment of sustenible livelihoods, specific
works in stereotypes and prejudices (Irrational Ideas Schedule), and implementation of the Action
Plans of PPV(including job-seeking), as well as a specific job in prevention and detection of
relapses. It was done through workshops and specific groups of Rational Emotive therapy,
especially detection irrational ideas and change of thinking in real situations.
 DATA& RESULTS

• Results with 2007 Data (N=75):

• 30% Mood disorders; 24% Schizophrenia& other psychotic
disorders; 24% Personality disorders; 16% DAHD
• 45% COC+MOP users; 35% COC users: 30% Cannabis users
• Improvement in adherence to treatment: 20% of patients didn´t
finish treatment.
• Improvement in relapse prevention: 25% relapsed in use of drugs
and all of them returned to treatment.
• No patients suffered any hospital confinement or psychotic crisis
during 2007.
• All the patients expressed their quality of life was improved and their
own responsability about their medical& social problems has been
increased with the program.
 LEARNED LESSONS &
LESSONS TO LEARN
 - Importance of the process, not just the outcome.
- Respect for other treatment strategies and other styles.
- Interdisciplinary Treatment is fundamental: biomedical
objectives and biopsychosocial rehabilitation.

 - Specific training should be provided for all professionals

involved in addictions on dual diagnosis.
-Continuous-Learning for professionals: each case is different,
should be analyzed on an individual basis. There are no
miracles but daily work facilitates them.
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