Drug Treatment Matrix cell E4: Treatment systems; Psychosocial therapies

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Society for the Study of Addiction web site

Society for the Study of Addiction

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Includes brief interventions

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Treatment systems; Psychosocial therapies

Seminal and key studies on local, regional and national systems for effectively and cost-effectively providing psychosocial therapies and the place of those therapies within these systems. Asks whether mutual aid groups can bridge the widening gap between resources and recovery ambitions, whether residential rehabilitation should be a last resort, and how tightly commissioners should specify services.

S Seminal studiesK Key studiesR ReviewsG Guidancemore Search for more studies

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K Forging inter-service links to promote patient transition and aftercare (2012). Implementing psychosocial approaches to promoting patient transition between US services involved inter-organisational and operational analyses that forged stronger service networks and identified gaps in the continuum of care. Siting case managers at detoxification services has been (2006) one successful linkage tactic, discussed in cell E3’s bite.

K Cost-containment limits on offering individualised treatment associated with worse treatment outcomes (2008). Advanced US analysis of comprehensive data from a national treatment study found substance use outcomes were relatively poor at centres constrained by funders in the services they could offer and in their ability to individualise treatment, but relatively good in services subject to quality accreditation.

K Active referral significantly promotes NA/AA attendance in UK but not abstinence (2012). Tests the ambition to extend recovery beyond formal treatment by systematically linking patients to mutual aid groups. Being encouraged by a doctor or peer (especially the latter) substantially improved attendance at 12-step groups, but impacts on abstinence were much smaller and not statistically significant. Corresponding US study below. For discussion click and scroll down to highlighted heading.

K Post-treatment substance use reduced by actively linking patients to mutual aid groups (2007). Among patients treated by the US medical service for ex-military personnel, persistent and practical efforts strengthened 12-step group involvement after treatment and modestly improved substance use outcomes. Corresponding British study above. For discussion click and scroll down to highlighted heading.

K Determining who needs residential care (2001). US study’s criteria and the methods used to develop them offer a way to reserve residential rehabilitation for those who need it, improving treatment completion rates for both residential and non-residential options. For discussion click and scroll down to highlighted heading.

R What promotes longer term care and aftercare (2011). Includes psychosocial strategies to help ensure patients who need it receive long-term care or aftercare. Discussion in cell D2’s bite.

R Peer-based recovery support services (2009). Compendious review from leading authority on recovery systems based on mutual aid. Remit is any form of mutual assistance involving people whose credentials rest on personal experience, whether offered informally or as part of a service, when the aim is long-term recovery from alcohol and other drug problems. Will inform (among others) planners and commissioners of services aiming to improve linkage to mutual aid groups and other peer-based recovery support resources. For discussion click and scroll down to highlighted heading.

R Varieties and impacts of case management (2019). An expert Euro-US collaboration examines the most common mechanism for transforming isolated treatment episodes into coherently staged and comprehensive recovery programmes – the appointment of a ‘case manager’ who remains a stable hub orchestrating service delivery. From some of the same team see earlier review (2006) published by Findings. Related guidance below.

R Severe cases differentially benefit from residential care (2003). Notes from Drug and Alcohol Findings on studies comparing residential with non-residential treatment. Concludes that for patients who accept and can safely be sent to either, on average there is little to choose between them. Severe cases may however differentially benefit from residential care. See also a review (2006) limited to randomised trials of therapeutic communities. For discussion click and scroll down to highlighted heading.

G Guidance for England on commissioning for recovery ([UK] National Treatment Agency for Substance Misuse, 2010). Includes recommended psychosocial services and linkages to mutual aid networks. For discussion click and scroll down to highlighted heading.

G NICE-recommended psychosocial interventions ([UK] National Institute for Health and Care Excellence [NICE], 2007). UK’s official health advisory body recommends contingency management, couples therapy and facilitating contact with mutual aid groups, and says residential treatment should be reserved for severe and complex cases not helped by non-residential care. Implementation guidance below. For discussions click here and here and scroll down to highlighted headings.

G Implementing NICE-recommended psychosocial interventions ([UK] National Treatment Agency for Substance Misuse, 2010). Commissioned by England’s National Treatment Agency from the British Psychological Society. Building on the psychosocial interventions recommended (see above) by the UK’s health service improvement authority, offers a framework for planning these interventions, commissioning them, developing required skills, and auditing provision.

G Coordinating services to meet individual needs ([UK] National Treatment Agency for Substance Misuse, 2006). Guidance on care planning and care coordination (“the processes that need to be in place to ensure that drug treatment [and other services] work together effectively to meet service users’ individual needs”) based on the good practice identified in a national review of the performance of treatment commissioning bodies in England. See also slightly earlier guidance ([UK] National Treatment Agency for Substance Misuse, 2006) on care planning from the same body.

G Organising integrated and holistic care in Scotland (Report Produced for the Scottish Advisory Committee on Drug Misuse, 2008). Treatment system guidance for Scotland on an “an approach that aims to combine and co-ordinate all the services required to meet the assessed needs of the individual”, requiring “collaborative working between agencies and service providers” to address the multiple difficulties often found among people who have drug or alcohol use problems.

G Case management ([US] Substance Abuse and Mental Health Services Administration, 1998). Based on research and experience indicating that “substance abusers have better treatment outcomes if their other problems are addressed concurrently,” US consensus guidance on case management to orchestrate the range of services often needed to promote lasting and multi-faceted recovery. Related review above.

more Search for all relevant Effectiveness Bank analyses or search more specifically at the subject search page. See also hot topics on computerised therapy and advice, residential rehabilitation and commissioning.

Matrix Bite Open Matrix Bite guide to this cell Open Matrix Bite guide and commentary. First ‘bites’ funded by Society for the Study of Addiction web site. Opens new window