Harrison Jennifer, Cousins Linwood, Spybrook Jessaca, Curtis Amy
a School of Social Work, Western Michigan University , Kalamazoo , Michigan , USA.
b Department of African American and Africana Studies , Western Michigan University , Kalamazoo , Michigan , USA.
J Evid Inf Soc Work. 2017 May-Jun;14(3):201-215. doi: 10.1080/23761407.2017.1316220. Epub 2017 May 1.
Adults with co-occurring mental illness and substance use disorders have poor outcomes in important quality of life areas, including hospitalization, incarceration, employment, and community housing. Integrated dual disorder treatment (IDDT) is a research-supported intervention for individuals with co-occurring disorders associated with improvements in outcome measures when implemented with high fidelity. Research-supported intervention IDDT was not designed with peer services, provided by people with lived experience with mental illness, but the practice has been altered to include peers.
IDDT fidelity data were evaluated from 20 teams that also reported on peer services on their team in one state over a 7 year period, and paired with their fidelity data for the most recent review to analyze the relationship between peers and IDDT fidelity. Analysis of variance was utilized to determine a dose effect peers on fidelity.
Of these IDDT teams, 85% of teams incorporated a peer and 40% of teams had a full-time peer. Having a full-time peer (M = 4.22, SD = .41) was associated with significantly higher fidelity compared to teams with a part-time (M = 3.68, SD = .56) or no peer (M = 3.21, SD = .18, F(2, 17) = 5.88, p = .01).
Peers on IDDT teams are associated with higher fidelity, leading to important possibilities about the incorporation of those with lived experience into research-supported interventions. Implications for team composition, implementation measurement, policy, and funding are discussed.
患有精神疾病和物质使用障碍的成年人在包括住院、监禁、就业和社区住房等重要生活质量方面的结果较差。综合双相障碍治疗（IDDT）是一种经研究支持的干预措施，适用于患有双相障碍的个体，当以高保真度实施时，与改善结果指标相关。经研究支持的干预措施IDDT并非设计为由有精神疾病生活经历的人提供的同伴服务，但这种做法已有所改变，纳入了同伴服务。
对20个团队的IDDT保真度数据进行评估，这些团队还报告了其所在州在7年期间团队中的同伴服务情况，并将其与最近一次评估的保真度数据配对，以分析同伴与IDDT保真度之间的关系。采用方差分析来确定同伴对保真度的剂量效应。
在这些IDDT团队中，85%的团队纳入了同伴，40%的团队有一名全职同伴。与有兼职同伴（M = 3.68，标准差 = 0.56）或没有同伴（M = 3.21，标准差 = 0.18）的团队相比，有全职同伴（M = 4.22，标准差 = 0.41）的团队保真度显著更高（F(2, 17) = 5.88，p = 0.01）。
IDDT团队中的同伴与更高的保真度相关，这为将有生活经历的人纳入经研究支持的干预措施带来了重要可能性。讨论了对团队组成、实施测量、政策和资金的影响。
