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At three London hospitals 4% of inpatients completed a brief alcohol intervention after being screened for hazardous drinking by ward staff. Staff were positive and on one ward nearly half the patients were screened and one in ten counselled, but the overall results are unlikely to dent the public health burden imposed by risky drinking.
This review encapsulates the range of treatment assessment and improvement tools developed over decades by the Texas Christian University, widely recognised as the most comprehensive and systematic attempt to map the processes involved in treatment and to link these to interventions to improve outcomes for the client.
Applying a systematic and comprehensive framework to map the strategies trialled in attempts to implement screening and counselling for risky drinking primary care patients gives some clues to what it has taken to achieve a high screening rate, the essential first step in the process.
STUDY 2011 HTM file
Therapist effectiveness: implications for accountability and patient care
1 in 6 US therapists (mainly not specialising in substance use) typically ended up with clients whose substance use problems were significantly worse than when they started therapy, an indication perhaps that social workers and mental health counsellors find these issues especially hard to deal with.
When the English Department of Health's alcohol policy support team visited local areas, they found an improving but often muddled and uncoordinated attempt to improve public health through alcohol-related interventions which lacked consistent commitment.
STUDY 2006 PDF file 171Kb
Matching resources to needs is key to achieving 'wrap-around' care objectives
Linking treatment intake assessments to a computerised guide to local welfare and medical services transformed the assessments from redundant paperwork into a practical route to the reintegration services being advocated in Britain – and treatment completion rates doubled.
IN PRACTICE 2005 PDF file 813Kb
Wet day centres in Britain part 2: Care Control Challenge
Part 2 of our mini-series on wet day centres in Britain will ring bells not just for alcohol workers but also for drug workers in needle exchanges and drop-in services. Maureen Crane and Tony Warnes analyse what it takes to work productively in one of the most challenging of settings.
SERIES OF ARTICLES 2005 PDF file 1935Kb
Wet day centres in Britain
In drug and alcohol services, it doesn't get more difficult than this – offering street drinkers a place where they can start to reverse years of deterioration, without having first to stop drinking.
Comprehensive Australian review garners the lessons from across health promotion and medical care on how best to improve practice by introducing research-based innovations, and evaluates their applicability to substance misuse.
Comprehensive and thoughtful review of the UK-relevant literature warns that services which impose rigid and unrealistic expectations of abstinence or independent living on homeless addicts would deny treatment and housing to vulnerable adults with complex needs.
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