Family-inclusive approaches in the context of a dual diagnosis
A systematic review of relational and individual wellbeing outcomes
Authors: Kuntsche, S., Vuong, A., Cloud, Z., Cosgrove, M., Pradel, M., Hameed, M., McIntosh, J.E.
Published by: Clinical Psychology Review
Citation: Kuntsche, S., Vuong, A., Cloud, Z., Cosgrove, M., Pradel, M., Hameed, M., & McIntosh, J. E. (2026). Family-inclusive approaches in the context of a dual diagnosis: A systematic review of relational and individual wellbeing outcomes. Clinical Psychology Review, 128, 102762. https://doi.org/10.1016/j.cpr.2026.102762
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This research is relevant to practitioners working across:
- Alcohol and other drug (AOD) services,
- Mental health services, and
- Child, youth and family services.
It is also relevant to family members supporting someone with a dual diagnosis (co-occurring mental health and substance use conditions).
We conducted a systematic search of evidence to better understand family-inclusive approaches in the treatment of dual diagnosis. We looked at research from 2000-2026, specifically exploring:
- Family-inclusive interventions available for the treatment of dual diagnosis,
- How families are involved in care,
- What effect family-inclusive approaches have on relational wellbeing, mental health, and substance use outcomes.
Our search found 28 studies involving family-inclusive treatment of clients with a dual diagnosis, generally focusing on adolescent and adult client populations.
Family-inclusive models were varied across studies, with examples including structured family therapies, behavioural family approaches, integrated family interventions, psychoeducation combined with skills-building, and multidimensional family approaches.
Across both groups (adolescents and adults), family-inclusive approaches generally performed as well as or better than treatment-as-usual, with reported benefits including improved:
- mental health and substance use outcomes,
- global and family functioning,
- family communication,
- family conflict,
- parenting and caregiver skills (particularly in adolescent studies).
- The review highlights the value of family-inclusive practice as a meaningful component of dual diagnosis treatment, and points to a need for greater prioritisation and further research into it.
- It shows that family-inclusive practice can contribute both to improvements in individual symptoms and to stronger relational wellbeing within families.
- Service models should consider strengthening integration across mental health and AOD sectors, building workforce capacity in family-inclusive practice and actively engaging families in assessment, treatment and recovery planning.