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In the study of Swiss army conscripts, reflective listening emerged as possibly the key active ingredient in a brief alcohol intervention based on motivational interviewing.
This comprehensive review found strong evidence that some drugs can help treat cocaine dependence and that cognitive-behavioural therapy is a powerful tool to manage cravings and stresses, especially when allied with effective pharmacotherapies.
Set in Sweden, the first study among psychiatric outpatients to test brief alcohol interventions against screening alone found worthwhile extra drinking reductions after brief motivational advice. Use of a telephone-based intervention was another innovation.
Combining a randomised trial with a 'real-world' test, studies of the Dutch Drinking Less programme have gone further than any others to establish the beneficial impacts of web-based alcohol self-help interventions.
A successful group therapy programme at a large New York soup kitchen shows that welfare services with high concentrations of problem substance users can be transformed from environments which impede recovery into ones which promote it.
This major British trial found that an alcohol dependence therapy designed to improve on short motivational approaches led to no greater benefits for patients or cost-savings for society. Instead the study has been used to argue that alcohol treatment overall saves money.
Persuasive evidence from the US Project MATCH alcohol treatment trial that a non-directive therapeutic style suits clients prone anger or defensiveness or who like to take control, and more structured and directive approaches suit those who welcome being given a lead.
Better than 'treatment as usual' but not than other specific therapies are the headlines from the most comprehensive synthesis of motivational interviewing studies to date. Along the way are insights in to the equivocal value of manuals and of feeding back assessment results to patients.
Data from Britain's largest alcohol treatment trial is used to address possibly the most contentious issue in the field – whether services should offer moderation as well as abstinence goals to dependent clients. 'Let the patient choose' seems the general conclusion.
Substantial minorities of heroin and cocaine users identified while visiting a US hospital for medical care cut back after assessment and brief motivational counselling, extending the potential of this approach beyond heavy drinkers.
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