The Challenge of Treating Forensic Dual Diagnosis Clients: Comment on “Integrated Treatment for Jail Recidivists with Co-occurring Psychiatric and Substance Use Disorders”

Excerpt

In the preceding paper, Chandler and Spicer raise a number of important and topical issues for the mental health and criminal justice fields. Before discussing these issues, we note that several methodological weaknesses in this study render its findings problematic. Among these are the lack of group equivalence, the extraordinarily high attrition rate among the experimental participants, the higher yet unknown attrition rate among the control participants, the reliance on administrative data, the minimal levels of key aspects of service utilization (e.g., medication services and group treatments) suggesting ineffective treatment, and the absence of controls for temporal changes in the local criminal justice system. An experiment degrades to a quasi-experiment as soon as heavy or differential attrition leads to non-equivalence of the comparison groups at follow-up, though statistical controls can sometimes allow analysis and interpretation of a quasi-experiment (Leff et al., 2005; Morrissey et al., 2005). …