Decisional Balance Regarding Substance Use Among Persons with Schizophrenia

State-of-the-science treatment of substanceabuse relies on decisional balance activities (weighingpros and cons of continued substance use) to enhancemotivation for change. Few data are available regarding the feasibility of these activities amongpersons dually diagnosed with schizophrenia andsubstance use disorder. To address this lacuna in theliterature, we completed focus groups with 21participants, all of whom had a schizophrenia-spectrumdiagnosis and lifetime substance abuse or dependence.These key informants discussed the pros and cons ofsubstance use as well as the pros and cons of quitting in response to a structured group interview.Our qualitative data indicate that persons living withschizophrenia can generate rich and diverse decisionalbalance information. We describe salient themes, contrast complementary perspectives (i.e., thepros of using and cons of quitting), and suggesttreatment implications based on thesefindings.