OUTPATIENT QUALITY STUDY OF INTEGRATED TREATMENT OF MENTAL ILLNESS AND

SUBSTANCE ABUSE
A DISSERTATION SUBMITTED
Malachi Oledibe
January, 2013
School of Professional Psychology/School of Organizational Leadership
UNIVERSITY OF THE ROCKIES
CHAPTER III
METHOD
The purpose of this chapter is to provide a discussion of the approach
used to measure the effectiveness of the combined therapy for mental
illness and substance use disorders. The details of the research design
including the sample selection, procedure for data collection and
analysis will be provided in this chapter. This chapter informs the
reader about the methods used acquire the data presented in chapter IV
of the current research. The methodology section fits in this
dissertation because it illustrates how the means through which the
objectives of the study were achieved. The chapter began with selection
and justification of the method of research. This was followed by the
establishment of the role of the researcher, study participants, methods
of data collection, and instruments of data collection, trustworthiness,
ethical issues, and procedure used in data analysis.
The qualitative technique was applied in pursuance of this theme to
provide a better understanding of the human behavior and the factors
governing the human actions (Chadwick, 2009). Qualitative method of
research was used in this research mainly because of the nature of the
data required to achieve the objectives of the study. It is the most
suitable technique used to acquire non-numerical data as for the case of
the current study Chadwick, B. (2009). The phenomenological technique of
qualitative research was selected as the most suitable for the current
research. According to Balls (2009) phenomenological research is a
technique that allows the researcher to examine the qualities of given
experience in order to identify its essence. It involves mainly involves
the interrogation of the subjects to obtain the qualitative data about
the feelings while or after going through a particular experience. This
technique was found suitable for undertaking the current research
because of its capacity to aid in data collection through direct
observation and in-depth interviews.
Methodology selection
The phenomenological technique was preferred for this research where
in-depth interviews and direct observation were used in data collection.
Phenomenological research involves the study of experience from the
perspectives of the research subjects. It aids in gathering deep
information through qualitative methods such as interviews, discussions
with the research participants, and direct observation (Colaizzi, 2010).
According to Balls (2009) the central concern of a phenomenological
research is to return to experiential meaning of a given topic of
research. The objective of the phenomenological research is to
investigate experiences lived by the participants and the meaning
attached to a given phenomenon.
Rationale
Phenomenology is one of the techniques of qualitative research that
helps the researcher in getting an in-depth understanding of individual
phenomena. This is mainly achieved through the direct interaction
between the researcher and the study participants. Through this
interaction, the researcher is able to collect the useful data from the
participant through in-depth interviews and direct observation
(Colaizzi, 2010). In addition, the study participants provide rich data
from their own experiences. This gives the researcher an opportunity to
collect valuable data of interest to a given research. Similarly,
phenomenological research is the most appropriate technique of choice to
be utilized in the current research. The technique helped in obtaining
in-depth experience of the study participants as they progressed with
the integrated treatment of co-occurring disorders. This was achieved
through direct observation and in-depth interview of the study
participants at different stages of treatment and recovery. One of the
alternative techniques of qualitative research that could have been
applied in the current research is the ethnographic research. However,
ethnographic research has several limitations including its reliance on
observation. Ethnographic researcher requires longer time to produce
reliable results (Mowatt, 2012). Thus, phenomenological method (direct
observation and in-depth interviews) is the most suitable approach for
answering the two main research questions including
How does integrated treatment of co-occurring disorders enhance
treatment outcomes and improve the quality of life?
What are the main challenges that patients suffering from co-occurring
substance abuse disorders and mental illness?
What are the key reasons for high prevalence of the co-occurring
substance abuse disorders and mental illness?
Which are the key barriers for the adoption of the integrated model for
treatment of co-occurring substance abuse disorders and mental illness?
The in-depth interviews and direct observation are the key techniques,
which help in monitoring the effectiveness of the integrated treatment
of co-occurring substance abuse disorders and mental illness.
Role of researcher
Qualitative research depends on the researcher as the primary instrument
of data collection and analysis. Similarly, the main participant in this
research project is responsible for data collection on the effectiveness
of the combined therapy for the co-occurring mental illness and
substance use disorders. Prior to the study, where the real subjects are
involved, the main researcher carries out the literature review, this
aided in the evaluation of the extent to which the theme has been dealt
with in other scholarly and research works. However, during the study,
my role as the researcher is divided into three main complex tasks,
including data collection, determination of the character of the data,
determination of the mode of data processing, administration of the
questionnaire and the data presentation. The high dependence of the
qualitative research on the researcher as the main tool for data
collection, processing, and presentation subjects the research to the
potential effect of bias and subjectivity (Lunt, Mitcalfe & Shaw 2010).
According to Turner (2010) qualitative research is subjected to bias at
three main levels namely moderator bias at the data collection,
formulation of biased research questions, biased review of literature
that supports the theme, biased sample selection, and biased reporting
of the research findings. In addition, since qualitative research
depends on techniques such as interviews and focus groups for data
collection, some people may either consciously or unconsciously provide
slant information. The effect of subjectivity will be reduced in this
research using three techniques. First the researcher has the duty to
check and separate the research from personal ideas, attitudes and
perceptions. Secondly, the researcher must include other information on
the relevant documentation about the research questions and target
results. Lastly, the researcher must collaborate with other research
instead of relying on a few key sources of information Turner (2010).
Study participants
In qualitative research, the selection of the study site and study
participants follows a strategy referred to as the purposeful sampling
Turner (2010). The strategy involves the selection of information-rich
cases, which facilitates an in-depth study without the need to
generalize all such cases. Similarly, the selection of samples and study
sites for the combined therapy for the success accomplishment of this
research was done skillfully to ensure that the necessary information is
obtained. All the patients include in the study are diagnosed with axis
1 diagnosis from the DMS-IV. The participants are selected from among
the patients admitted for treatment in a review of records of outpatient
setting, in behavioral health and information-rich database.
Three different groups of cases are studied to facilitate the
accomplishment of the research objectives. The first group of 86
subjects is selected from a population of 214 from the database of the
behavioral health department at Swope Health Services located in Kansas
City. The subjects are registered at the Health Center to receive
treatment for mental illness and substance use disorder. The patients
had been enrolled for treatment of co-occurring disorders at Swope
Health Services. Swope Health Services is a drug rehabilitation center
located in Kansas City with a primary focus on treatment of individuals
with substance use disorders and mental illness. Over 40,000 patients
are served at Swope`s 11 medical, behavioral and dental centers located
throughout Kansas City, MO., Independence, MO., Wyandotte Kansas, North
Kansas City and South Kansas City, MO. All the subjects in the study had
DMS-1V axis 1 dual diagnosis of co-occurring substance abuse disorders
and mental illness. The simple random selection process is applied to
ensure that all the subjects in the study population have an equal
chance (no bias) of being selected. The selected sample comprised of
active patients, both male and female aged 18-65 years. The research
applies simple random selection technique to avoid bias. All the
subjects in the population are given a three digit number starting from
001 to 214. The sample size of 86 out of 214 subjects, which is about
40.2 %, is an appropriate representation of the total population. The
sample size of 86 subjects is assigned letter n while the total
population is assigned letter N. The probability of each of the subjects
being selected is n/N. Selection of an appropriate sample size is
critical and has several benefits. The benefits include the production
of results among variables that are significantly different, reduced
chances of discovery failure, and reduced wastage of resources resulting
from unnecessary large samples (Chenail, 2011). A larger sample
represents the population under study would be better than a smaller
sample. In addition, a large sample broadens the range of possible data,
thus forming a better picture of the research analysis. An appropriate
sample size has both economical and ethical significance. An under-sized
sample results in wastage of resources because it has a reduced capacity
to produce reliable or valid results. On the other hand, an over-size
sample results in unnecessary appropriation of resources.
An in-depth research requires a sample size larger than 30, but less
than 500 was applied to determine the suitability of the sample size
used in this research, (Chenail, 2011). The sample size of 86 subjects
falls within this range. In addition, the suitability of this sample
size is determined based on the computed margin error. The margin error
is computed using the formula
Margin error = 1 / √N, where N represented the number of
participants.
Thus, margin error = 1 / √86
= 10.8 %
The value of 10.8 % of the margin error was within the acceptable value.
Chenail (2011) reported that the greater the value of N, the smaller the
margin error. This increases the usefulness of the measurable results.
In qualitative research, the researcher and the participants often have
an exceptionally close relationship because the research relies on the
researcher as the main tool for data collection, analysis, and
presentation. However, the relationship between the researcher and the
study participants in the current research was professional. This means
that relationship was predefined by the code of ethics, the violations
of which would result in legal actions. The researcher had the
obligation to ensure the safety of the study participants at all levels.
Manson (2011) suggested that qualitative researchers should separate
themselves out by declaring their feelings at the beginning of the
research. This research adhered to the four principals as the potential
measures of reducing the effect bias as a result of dual relation
between researcher and participants. First, the study respected the
autonomy of the participant during the data collection. The participants
were given the PGWBI questionnaires, and the freedom to fill them during
the process of assessment, interview and combined therapy. Secondly, the
application of non-malfeasance principal ensures that the research
process did not cause distress to the selected participants. Third, the
principal of beneficence ensured the researcher and the whole research
process strived to benefit the participants. Lastly, the principal of
justice ensured an equitable balance of responsibility between the
researcher and the participants. This reduced the effect of the
researcher gaining the benefit at the detriment of the research subjects
(Turner, 2010).
Data collection
Qualitative research is an enquiry that is aimed at describing and
clarifying people’s experience as it appears in human lives. The
selected methods of data collection should target at certain distilled
descriptions. The selection of the data collection techniques for the
purpose of this research considered several aspects such as the
complexity of the data collected and the relationship between experience
and language expression. This is because the data collected must be
transformed into written text for analytic use in qualitative research.
The collected data serves as the grounds on which the findings are
based. In the current study, the nature of the data and techniques of
data analysis to be used were considered in the selection of the methods
of data collection. Two principal techniques of data collection are
selected to facilitate the accomplishment of this research. A
combination of different methods can be used in qualitative research to
ensure that all the required amount of data is gathered (Hancock,
Ocklefprd, & Windridge, 2009). This research relies on a combination of
three methods of data collection. The direct observation and in-depth
interviews are used jointly during the administration of the combined
therapy while the review of records is used to extract data from
established databases. The direct observation and in-depth interviews
help in the collection of the qualitative data about the clients’
response on their feelings during the treatment and recovery process.
The researcher had to convert the qualitative data into specific codes
for the purpose of analysis, where the percentage of the clients’
response at every level would be computed.
Direct observation:
Direct observation is one of the most widely used methods of data
collection in qualitative research. Direct observation involves the
collection of data by watching the participants’ activities,
behaviors, events and noting the changes in the physical characteristics
in the natural settings of the subjects or participants. Direct
observation technique is selected to observe the physical changes in
cases of co-occurring disorders during the process of administration of
a combined therapy. There are four reasons, which necessitated the
selection of direct observation for data collection during this
research. First, the technique is suitable for an ongoing process
(Turner, 2010). The assessment of the effectiveness of the combined
treatment is a process, which will take place for 9 months. During this
period, the observation of the consumers’ behavioral changes is
significant. Secondly, direct observation is suitable for collection of
data on individual behaviors and their interactions with other people.
This is in line with the observation of the consumers’ change of
behavior during the administration of combined therapy. Third, direct
observation is necessary when assessing the given physical setting. This
is also important in this research because it helps in assessing the
suitability administrative facilities in which the treatment of
co-occurring disorders takes place. Lastly, direct observation is used
when the data collection from individuals is not a realistic option. In
most cases, consumers with mental illness may not be responsive thus
data collection from such category of participants may not have been
possible with other techniques such as personal interview. In such
situations, direct observation of their behavioral change is necessary.
In-depth interviews:
In-depth interviewing is an effective qualitative method because it
gives the human face to the problem being researched (Manson, 2011). The
technique is appropriate in this research to explore the perspectives of
the consumers on the integrated treatment of the co-occurring disorders
specifically the mental illness and substance use disorders. The
in-depth interview is preferred by a majority of qualitative researchers
because of its ability to provide detailed information compared to other
methods of data collection such as survey. In addition, in-depth
interviews provide a relaxed atmosphere, which facilitates data
collection from the interviewee in an uninterrupted conversation
(Hancock, Ocklefprd, & Windridge, 2009). In this research, the in-depth
interview will enable a smooth conversation with the consumers under the
combined therapy. Despite their mental illness, it is possible to
collect useful data on clients’ recovery progress. Moreover, the
in-depth interviewing technique aides in the enquiry for detailed
information about the subjects’ feelings, attitude, and behavior about
their treatment process. A continuous monitoring of such qualitative
characteristics is critical in assessing the recovery progress of the
consumers during the 9 months of administration of a combined therapy.
Review of records:
Review of records is a data collection technique that relies on the
existing records, which could be electronic or manual, as a source of
data. This research sourced some data for the analysis of the third
group from record of mental health, substance abuse, and criminal
justice record. The main objective of this source of data is to advance
skills, experience and knowledge of critical impact of co-morbidity on
behavior and the cycle of the disorders and crime to develop an
integrated model of treatment.
Instrument of data collection
Research instruments are measurement tools, which are designed to gather
data on a given research topic. Several factors are considered while
selecting a research instrument. The most crucial considerations during
the selection of research instruments for this research include the
appropriateness of the instruments towards the realization of research
objectives, their capacity to gather sufficient data in response to the
research questions, suitability of the instruments as evident in
previous studies. This research will utilize the Psychological General
Well-Being Index (PGWBI) questionnaire, direct observation, and personal
interviews as the main research instruments. PGWBI is a research
instrument that is used to measure the intra-personal affective or
emotional states that reflect the well-being or distress in a 22-item
uni-dimensional format (Grossi, Tavano, Luigi, & Buscema, 2011). PGWBI
was first developed in Spain and latter, in the United States as a
research tool for measurement of the general well being, which is then
expressed in summary scores.
The reliability, validity, and utilization of a given research
instrument can be assessed based on its application in the previous
studies. The instrument gained popularity during the United States
National Health Examination Survey in 1971 and the RAND health insurance
experiment in 1975. PGWBI is used in the evaluation of the individual
general well-being, but it does not evaluate the conditions of their
physical health. It can be used alone or jointly with other generic and
disease specific questionnaires (Grossi, Luigi, Tavano, Cerutti, 2010).
Utility of the PGWBI has been expanded over time through its translation
into about 36 languages in different countries. The PGWBI translated in
16 of these languages have been tested in 11 different studies at the
MAPI Institute in conjunction with independent investigators. One of the
recent applications of the PGWBI questionnaires was a study which
involved the measurement of the outcomes in allergic rhinitis. The study
used a sample size of 166 subjects and a control sample of 35
individuals, who completed the PGWBI questionnaire. The instrument
successfully collected the data, whose analysis was identified as
reasonable, sensitivity and specificity for detection of cases of nasal
congestion. In addition, the study successfully identified 55.7 % of the
patients experienced an improvement based on the global rating (Valero,
Mullol, Herdman, & Rosales, 2011). The instrument has been successful in
conducting the data collection and facilitating the achievement of the
objectives in the previous studies. This confirms that PGWBI can be
relied upon in measurement of the effectiveness of the combined therapy.
Thus, the instrument is valid and justified to be utilized in this
research.
The data collection procedure should ensure that the data collected is
accurate and sufficient to facilitate the accomplishment of the research
adjectives. Chadwick (2009) suggested that accurate data maintains the
integrity of research and ensures that the results generated are
reliable. In addition, the data collection procedure should facilitate
data gathering process and measurement of information on variable of
interest in a systematic fashion. The preservation of data integrity
makes it possible to detect errors in the data collection process
(Jerry, Nelson & Silverman, 2011). The data for this research is
collected from three groups of subjects using different procedures as
considered in this section.
For the first group, 214 clients, males and females, from 18 years and
older with co-occurring disorders of substance abuse and mental illness
(all clients have axis 1 diagnosis from the DMS-1V) are initially
evaluated and admitted for treatment in the Swope Health Services
outpatient facility located in greater Kansas City, MO. The clients are
screened by a team of clinicians consisting of multidisciplinary
healthcare providers, including masters’ and doctoral level
psychologists, social workers, psychiatrists, nurses, community support
workers, case managers and support team members. During the initial
screening and assessments, General Psychological Well-Being Index
(GPWBI) questionnaire is administered to each client to establish and
collect baseline information. The clients are assigned to masters’ and
doctoral level therapists who are trained in the treatment of both
substance abuse and mental illness. The clients are also assigned to
psychiatrists for medication screening and management. The clients are
scheduled for bi-weekly individual therapy, monthly group therapy, and
medication management and routine case management programs for 9 months.
The PGWBI questionnaire is administered to the clients consistently on a
quarterly basis, from January 3, 2012 to September 2012. The PGWBI tool
was administered to clients in March, June and September 2012. The goal
is that 50% of the individuals who received integrated therapy services
of mental illness and substance abuse would experience a 5 point
increase in their General Psychological Well-Being Index score.
Clients’ information are entered into excel spread sheet and clients
were assigned 3 digit numbers in the computer system. From the computer
database, a simple random sample of 86 clients from the population of
214 is selected for the study. These clients are interviewed, observed
and surveyed from the initial assessment and treatment through 9 months
period, and the survey tool of General Psychological Well-Being Index
(PGWBI) is administered to clients on a quarterly basis to determine any
changes in treatment. The results of the surveys are compared with the
baseline results to determine whether the integrated treatment makes a
difference.
The other group comprised of 553 clients who experienced high and low
integrated treatment results, and they are divided into four (4) groups
based on the outcomes of integrated treatment. All the adult clients are
suffering from co-occurring disorders and are admitted in outpatient
services from 1995-2002. All clients had axis 1 diagnosis of the DSM-1V.
The clients are selected and analyzed to support the evidence that
integrated treatment is effective with the population.
The data collection for the third group aims at the establishment of the
relationship between the co-occurring disorders, behavioral change, and
the criminal justice system. The data is collected from sample of 396
subjects, which is selected using the simple random technique from a
total population of 3,000 individuals. The research involved case
reviews of mental health and substance abuse records, including criminal
justice information. All co-occurring disorder cases in the study had
DMS-1V axis 1 diagnoses. Information collected from the study is used to
advance skills, experience and knowledge of critical impact of
co-morbidity on behavior and the cycle of the disorders and criminal
behavior to develop an integrated model of treatment. According to Renee
(2009) the DMS-1V prototype facilitates the elimination of the
personality disorders (such as schizoid personality disorder,
schizotypal personality disorder, and histrionic personality disorder),
which are classified as common Axis II disorders. The participants
included in the current research had the Common Axis I disorders
including the schizophrenia, bipolar disorders, anxiety disorders, and
depression.
Trustworthiness
The main goal of maintaining trustworthiness in qualitative research is
to attract the attention responsible stakeholders in the field of the
topic of research towards the research findings (Alfoldi, and Sinkovics,
2012). This research observed the four basic elements of trustworthiness
considered in this section. Credibility is the evaluation of the
capacity of the research findings to represent a credible conceptual
interpretation of the original data derived from the study participants
(Carlson, 2010). This study achieves credibility through one reliable
technique. The researcher regularly consulted university supervisor
throughout the research to ensure all the stages are credible. The main
stages at which the advice of the university supervisor is solicited
include the design of the research procedure, selection of the data
collection techniques, and data analysis. Transferability refers to
transfer or application of research findings beyond the bounds of the
research project (Carlson, 2010). This research will achieve
transferability in two ways. First, the research will provide the
procedure followed in a vivid and explicit manner. Secondly, the
statistical procedures and computations used in data analysis are all
included in the final document. The information provided in this
dissertation provides an opportunity to other researchers who wish to
transfer the conclusions of this research or closely repeat the
procedure to do it without doubt or fear.
Dependability refers to the assessment of the quality drawn from the
integration of the data collection, data analysis, and the process
theory generation. Confirmability, on the other hand, refers to the
determination of the support given to the research findings by the
collected data. Dependability and confirm-ability will be achieved in
this research through the process of independent peer audit. The
independent auditor in this research is a friend with equivalent
academic level pursuing the same course. His main roles as the
independent auditor are to review the written draft of this
dissertation, the completed PGWBI questionnaires, and the documents used
in the data analysis. The independent auditor aims at identification of
three main issues, which would affect the dependability and
confirmability of this research. These issues include the availability
of all the required documents, completeness of the available documents,
the effect of the researcher-participant relationship, and compliance
with the ethical regulations (Carlson, 2010).
Ethical issues
Observation of code of ethics of practice is vital in any research work.
Coleman & Chuan (2009) defined ethics as the correct rules of conduct,
which are necessary in a given research. There are two aspects of the
ethics code that are observed in this research, namely the
confidentiality of the information related to participants and the
measures taken to protect the participants. First, the participants’
protection is emphasized by ensuring that the combined therapy followed
the protocol approved by the relevant health and ethical bodies. This is
done to ensure that the administration of the individual therapy,
medication management, & substance abuse treatment followed ethical and
confidential procedures.
The consent of the participants in the current research will be obtained
following the United States guideline, which outlines the procedure for
obtaining the informed consent from the subjects (Plous, 2012). The
concept will be obtained from all the participants through a standard
consent form (as shown in Appendix 1) that will be issued to all the
participants. The letter will inform the subjects about the objective of
the research, duration of research, and the procedure to be followed. In
addition, the letter will inform the participants about the benefits and
potential discomforts that the research is might cause to them. The
consent letter will also contain a statement informing the subjects that
participation is voluntary.
All the personal information of the participants included in the
dissertation are protected to ensure that confidentiality is maintained
at the highest standard possible. In addition, the personal
indemnification details such as the names and identification numbers are
not included anywhere in this study. This would protect the
participants from the public identification during and after the
research.
Data analysis
Various techniques can be used in the statistical analysis of the data
collected for the purpose of a given research. However, the selection of
the most suitable techniques determines the successful interpretation of
the data and identification of its link with the research problem
(Onwuegbuzie, Leech, & Collins, 2010). However, the qualitative data
will be converted to digits through a systematic coding system to
facilitate the process of data analysis. The coding process will assign
a three digit value to each category of subject’s response, where each
of the twelve behavioral responses in investigated in the current study,
would be evaluated at six levels. The most positive response will be
assigned digit 5 while the most negative response will be assigned digit
0. All the responses will be recorded in PGWBS questionnaire. The
process of data analysis will begin after all the completed
questionnaires are collected. The percentage of the subjects who will
give a similar response at every category will be determined to evaluate
the effectiveness of the integrated treatment of co-occurring disorders
in improving the subjects’ recovery. The data will be further analyzed
using the excel software. During the analysis, the value for alpha error
will be set at 5 %. The relationships between consistence of the
research variables and reproducibility are indispensable tools for the
realization of reliability of the research findings. They will be
determined using the correlation coefficient. Reproducibility will be
assessed through repeated administration of the PGWBI questionnaires on
a quarterly basis for a period of 9 months.
This chapter aims at providing a discussion on the approaches to be used
in systematic evaluation of the effectiveness of the combined therapy
for the co-occurring mental illness and substance abuse disorders. The
research relies on qualitative method of research to evaluate the
effectiveness of the combined therapy based on non-quantitative data.
The study recruits the participants from three different groups, which
will improve the validity of research because the data is then collected
from three groups of subjects. The suitability of the sample size is
determined using the margin error, which ensured that the samples size
used is a representative of the total population. The selected
techniques of data collection should ensure that the data obtained is
capable of answering the research questions when analyzed. For that
reason, three data collection techniques are identified and utilized in
the collection of qualitative data for this research. The techniques
include direct observation, in-depth interviews, and review of records.
This research relies on three maim instruments of data collection
namely observation, interviews, and the Psychological General Well-Being
Index (PGWBI) questionnaire. The trustworthiness of the assessment of
the instrument is based on three recommended elements, which include
credibility, transferability, dependability, and confirmability.
Finally, the data will be analyzed using the excel software to establish
the effectiveness of the combined therapy in treatment of co-occurring
disorders. The results of the analyzed data are presented in chapter V
of this dissertation.
Reference
Alfoldi, E. & Sinkovics, R. (2012). Progressive focusing and
trustworthiness in qualitative research. Management International
Review, 56, 818-840.
Balls, P., (2009). Phenomenology in nursing research. Nursing Times,
105, 31.
Carlson, A. (2010). Avoiding traps in member checking. The Qualitative
Report, 15 (5), 1103-1113.
Chadwick, B. (2009). Methods of data collection in qualitative research
interviews and focus groups. British Dental Journal, 205, 300-315.
Chenail, J. (2011). Ten steps for conceptualizing and conducting
qualitative research studies in a pragmatic curious manner. The
Qualitative Report, 16 (6), 1713-1726.
Colaizzi, P., (2010). Psychological research as the phenomenologist
views it. New York: Oxford University Press.
Coleman, C. & Chuan, T. (2009). Research ethics in international
epidemics response. Geneva: WHO Technical Consultation.
Elifson, K. & Sterk, C. (2009). Understanding recreational ecstasy use
in the United States: A qualitative inquiry. The International Journal
of Drug Policy, 20 (1), 63-67.
Gogtay, J. (2010). Principals of sample calculation. Indiana Journal of
Ophthalmology, 58 (6), 517-518.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2993982/
Grossi, E., Tavano, G., Luigi, S. & Buscema, M. (2011). The interaction
between culture, health and psychological well-being: Data mining from
the Italian culture and well-being project. Rome: Springer.
Grossi, E., Luigi, S. Tavano, B. Cerutti, R. (2010). The Impact of
culture on individual subjects well-being of the Italian population: An
exploratory study. Rome: Springer.
Hancock, B., Ocklefprd, E. & Windridge, K. (2009). An introduction to
qualitative research. Yorkshire: National Institute for Health Research.
Jerry, T., Nelson, J. & Silverman, S. (2011). Research methods in
physical activity (ed). Champaign: Human Kinetics.
Lunt, N., Mitcalfe, M. & Shaw, I. (2010). Practitioner research in
social work: a knowledge review, evidence and policy. Journal of
Research, 6 (1), 188-207.
Manson, J. (2011). Design qualitative research. Thousand Oaks: Sage
Publications.
Mowatt, K., (2012). Advantages and disadvantages of ethnographic
research. Journal of advanced nursing, 39, 1486-1492.
Onwuegbuzie, J. Leech, L. & Collins, T. (2010). Innovative data
collection strategies in qualitative research. The qualitative Report,
15 (3), 697-715.
Plous, S., (2012). Social psychology network: United States Government
Guideline. Wesleyan: Wesleyan University.
Renee, B. (2009). Dual diagnosis and health-related quality of life.
Washington DC: Washington University.
Tewksbury, R. (2009). Qualitative versus quantitative methods:
Understanding why qualitative methods are super for criminology and
crime justice. Journal of Theoretical and Philosophical Criminology, 1
(1), 38-56.
Turner, W. (2010). Qualitative interview design: A practical guide for
novice investigators. The Qualitative report, 15 (3), 755-758.
Valero, A., Mullol, J. Herdman, M. & Rosales, M. (2011). Measuring
outcomes in allergic rhinitis: Psychometric characteristics of a Spanish
session. Health and Quality of Life Outcome, 9, 4.
Appendix 1
Informed Consent Form
Study
Principal Investigator:
Faculty
Please read the information contained in this form carefully and fill in
the blank spaces to provide your consent for participation in this
research. However, to take part in the research one must be 18 years of
age and above. Please be informed that your participation is voluntary,
and you have the right to withdraw you consent in the course of the
research without subsequent prejudice.
Description of the study:
This is a psychological research in which you will be requested to
complete the PGBS questionnaire about your feelings and attitude about
the treatment and recovery process. You will be requested to complete
the questionnaires in quarterly for a period of 9 months.
Purpose of the study:
This study aims at evaluating the effectiveness of the integrated model
for treatment of co-occurring substance abuse disorder and mental
illness. My main interest is to generate useful information that clearly
indicates the benefits of an integrated program over the fragmented
(parallel and sequential) programs.
Possible risks:
During the research process, you may fell that you performance regarding
the treatment and recovery process is poor. However, there are no
negative responses in this research. Please be informed that some
participants may perform better that others, but you honest response to
questions is highly appreciated.
Possible benefits:
Your participation in this research will give you an opportunity to
contribute to the reforms in treatment of co-occurring disorders, which
is currently an intriguing issue in the health sector.
Confidentiality:
The information giving you identity will be removed from the questions
once the participation is complete. Additionally, the PGBS
questionnaires will be kept in the most secure place to avoid access by
unauthorized persons.
Opportunity to Question and be informed:
You have the right to ask any question regarding your participation and
the research process. Kindly direct your questions to:
Principal Investigator: …………………………….
Phone: …………………………
Opportunity to withdraw:
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have the right to withdraw you consent of participation in this research
at no penalty.
……………………
Signature of participant: ………………
INTEGRATED TREATMENT OF CO-OCCURRING DISORDERS
INTEGRATED TREATMENT OF CO-OCCURRING DISORDERS
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