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One of the few 'matches' found by the huge US Project MATCH alcohol treatment trial was that motivational therapy bettered CBT for clients prone to anger. One of the clinics has shown why – because motivational therapists were less directive.
By selecting clients at the very edge of ethically requiring referral to residential care, this US study confirms that unless there are pressing contraindications, intensive non-residential options deliver equivalent outcomes. Often of course, there ARE pressing contraindications.
Reanalysis of the huge US Project MATCH alcohol treatment trial confirms that patients with pro-drinking social circles gained greater remission in drink problems when 'matched' to a therapy focused on generating a social circle (in the form of AA) with the opposite characteristics.
Analysis of videoed therapy sessions from a Project MATCH alcohol treatment trial clinic showed that whether therapists appropriately adjusted their interpersonal style to the patient mattered more than which therapy they practised.
In the US Project MATCH alcohol treatment trial, relatively brief motivational interviewing resulted in lower health care costs overall but costs incurred by poor prognosis patients were reduced most by the two more intensive (CBT and 12-step) therapies.
Three reports from the Los Angeles Target Cities Project suggest that attendance at mutual aid groups acts in synergy with formal treatment for stimulant dependence to improve and sustain outcomes.
A major US government attempt to refine drug-free treatments for cocaine addiction confounded expectations by showing that well structured counselling approaches can better professionally delivered psychotherapies.
A synthesis of studies which tested Alcoholics Anonymous groups or AA-based residential programmes against formal/no treatment suggests outcomes are similar to other treatments when the drinker chooses these options. Coercion may be counterproductive.
The limitations of US health insurance permitted this rare quasi-random test of whether 12-step treatment is effective for adolescents dependent mainly on cannabis or alcohol and of whether doing this in a residential setting improves outcomes.
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