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DOCUMENT 2012 HTM file
Alcohol problems in the criminal justice system: an opportunity for intervention
Based largely on prior research analyses and guidelines from the UK, these international guidelines offer an integrated model of best practice care for problem-drinking prisoners, grounded in research specific to prisons and in potentially applicable research in other settings.
DOCUMENT 2013 HTM file
Delivering recovery. Independent expert review of opioid replacement therapies in Scotland
An expert committee responds to the Scottish government’s concerns over the role of methadone prescribing in helping patients along the Road to Recovery signposted in the national strategy. On the ground, that road was often barely constructed but methadone was not the problem, rather the failure to optimise programmes for recovery.
REVIEW 2014 HTM file
Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence
Authoritative analysis of clinically relevant trials of buprenorphine versus methadone maintenance for heroin dependence confirms that buprenorphine has less ‘holding power’, and that among patients who are retained, there are equivalent reductions in illegal drug use. But is methadone’s ‘stickiness’ an advantage or a liability?
DOCUMENT 2014 HTM file
Should dependent drinkers always try for abstinence?
For many alcohol treatment services in the past and now, the only acceptable and feasible drinking goal for alcoholics is abstinence. That mould was decisively cracked when in 1973 researchers showed that even physically dependent drinkers could learn to drink in moderation. Controversy was fierce, reaching to the US Congress, TV networks and the courts.
STUDY 2012 HTM file
Delivering service quality in alcohol treatment: a qualitative comparison of public and private treatment centres by service users and service providers
This small English study poses fundamental questions about alcohol treatment services: whether private services suffer from an ‘empathy gap’ and NHS services from poor systems; whether opening up treatment choice to patients with a record of bad decision-making is a good thing; and whether there can be universal criteria for what counts as quality provision.
REVIEW 2012 HTM file
Effect of buprenorphine dose on treatment outcome
How much buprenorphine does it take to keep patients in treatment and suppress illicit use of heroin or other opiate-type drugs? This review concludes that on average higher is better than lower, but that individualising dose and a preparedness to go high if needed are the keys to effective treatment.
STUDY 2008 HTM file
The impact of worker values on client outcomes within a drug treatment service
From England, findings suggesting the intriguing but for the moment tentative possibility that non-conformist drug workers who value hedonism and stimulation help socially excluded clients improve most because their values match those of their clients.
DOCUMENT 2013 HTM file
Sometimes best to break the rules
Motivational interviewing’s ‘Do not dos’ like avoiding confrontation were intended to sidestep the traps which provoke clients to dig in their heels or disengage. Imagine then the upset of discovering that in certain circumstances, the opposite is the case; the explanation appeared to lie in coming across as ‘genuine’.
DOCUMENT 2013 HTM file
When confrontation was challenged
Focus is on a seminal study from motivational interviewing’s originator which more than any other heightened the profile of the therapist’s interpersonal style in substance use counselling, seeming to confirm that heavy drinkers react best to non-confrontational nudging rather than the more bludgeoning style typical of the time.
STUDY 2005 HTM file
How does motivational interviewing work? Therapist skill predicts client involvement within motivational interviewing sessions
Analysis of counselling session recordings from therapists trained in motivational interviewing suggests that the important quality of seeming 'genuine' can suffer if training mandates unnaturally withholding normal responses; however, departing from these tenets is risky unless done by a socially skilled therapist.
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