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Byrne, Hanora (2009) A training programme in dual diagnosis. Drugnet Ireland, Issue 31, Autumn 2009, p. 24.

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The clinical nurse specialist (CNS) in addictions based in the Central Mental Hospital in Dublin has played a key role in developing a pathway of therapeutic group programmes for people with a dual diagnosis of mental illness and substance abuse.  

Dual diagnosis is a very recent concept in the Irish mental health service. The concept was highlighted by MacGabhann and colleagues,1 who recommended incorporating training for dual diagnosis into undergraduate and continuing education programmes for those working in addiction and mental health services. Because such training is not widely available in Ireland, an innovative five-day training programme was developed by Hanora Byrne, CNS in addictions at the Central Mental Hospital, and Dr Shobha Rani, lecturer in nursing at Trinity College Dublin. The programme has been awarded category 1 approval by An Bord Altranais.
The programme development was based on a six-step approach devised by Kern and colleagues.2 The six steps are:problem identification, needs assessment, objectives,implementation, educational strategies and evaluation. Analysis of a needs assessment involving 20 psychiatric nurses and 20 probation officers showed that it was clearly necessary to develop a training programme in dual diagnosis.
The main objectives of the programme were to provide information on dual diagnosis and the treatment programmes that can be applied in service delivery. The programme has four modules delivered through lectures, group discussions, role play, video recording and feedback, and vignettes. A workbook was developed to accompany the delivery of the training.
The first training programme was run on one day a week for five weeks at the end of 2008. It was delivered by the CNS and members of the multidisciplinary teams within the Central Mental Hospital, including Prof Harry Kennedy, the clinical director, and Paul Braham, the director of nursing. Participants were assessed using formative evaluation tools, such as questions and answers and three short written assignments. The course was evaluated using the following: pre- and post-test evaluation, daily evaluation by the participants, and a focus group carried out 12 weeks after the course completion. The programme co-ordinators envisage running an annual one-day refresher course.
The next training programme is scheduled for early October 2009 in the National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin 14. For more information, contact Hanora Byrne at 01-2157556; email: hanora.byrne@hse.ie
1. MacGabhann L, Scheele A, Dunne T et al. (2004) Mental health and addiction services and the management of dual diagnosis in Ireland . Dublin: Stationery Office.
2. Kern D, Thomas P and Howard D (1998) Curriculum development for medical education: a six-step approach. Baltimore, MD: Johns Hopkins University Press.
Item Type
Publication Type
Irish-related, Open Access, Article
Drug Type
All substances
Intervention Type
Education and training
Issue Title
Issue 31, Autumn 2009
October 2009
Page Range
p. 24
Health Research Board
Issue 31, Autumn 2009
Accession Number
HRB (Available)

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