Publication Date


Document Type

Masters Thesis


School for Social Work


Dual diagnosis-Treatment, Mentally ill-Services for, Substance abuse-Patients-Rehabiliation, Integrated delivery of health care, Co-occurring disorders, Engagement, Retention, Integrated service, Reciprocity (Psychology)


Individuals with co-occurring mental health and substance use disorders typically have multiple impairments making them difficult to engage and retain in treatment. The most consistent finding across studies is that the most effective service delivery is integrated, i.e. the same clinician or clinical team provides appropriate mental health and substance abuse interventions in a coordinated fashion in a single setting with a goal of helping the client to manage both illnesses. While critical components of integrated service delivery have been identified, how these components are successfully integrated to engage and retain clients in a case has been more elusive. This qualitative study employed a sample of convenience to discern what could be learned from the practice wisdom of seasoned practitioners on an integrated co-occurring treatment unit about specific successful engagement and retention strategies. The major findings were that participants viewed engagement and retention as a seamless process and identified five categories of strategies that were used for both engagement and retention. All of these strategies had to do with the practitioner's use of self in relationship with the client. There was reciprocity in the valuing of the relationship and use of self with a client for engagement and retention on the part of participants, i.e., the relationship with clients was clearly one of the personally satisfying parts of the work.




iii, 61 p. Thesis (M.S.W.)-Smith College School for Social Work, Northampton, Mass., 2010. Includes bibliographical references (p. 44-45)