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This substudy from the seminal US Project MATCH alcohol treatment trial found evidence for the appealingly simple and plausible conclusions that "What therapists reflect back, they will hear more of," and that promoting talk about change promotes change itself.
STUDY 2011 HTM file
Shared decision-making: increases autonomy in substance-dependent patients
An innovative Dutch study tested a way of involving substance users as equals in decisions over issues addressed in their treatment. The effect was to give these typically submissive personalities a greater sense of control over their lives. Just as influential was the lead offered by the clinician's personality.
Does it help to add a structured internet-based therapeutic programme to web access to a mutual aid network also geared to moderate drinking? Sustained extra moderation in the form of fewer days drinking was the clearest positive effect; less clear was whether it led to greater reductions in drink-related problems.
For US problem drinkers and drug users not at the severest end of the spectrum, four sessions of group were as effective as four of individual therapy but took much fewer therapist hours per patient. The little research we have suggests this a common finding, commending group approaches on cost-effectiveness grounds.
Conducted in England, this first study to test positive psychology approaches focused on strengths and wellbeing in the treatment of substance use problems found that a small group of young drinkers and drug users responded well, with substantial remission in alcohol dependence despite the non-substance focus of the group therapy.
The contemporary recovery movement in addictions and the positive psychology movement in the broader field of psychological health have recently grown in prominence but almost entirely in parallel streams, yet the overlaps and possible synergies between them suggest that an integration could be a step forward in recovery from addiction.
REVIEW 2011 HTM file
Motivational interviewing for substance abuse
Across the most rigorous studies, this synthesis of the research finds therapies based on motivational interviewing better than doing nothing, but no more effective than usual/other treatments for problem drinkers and drugtakers – powerful further support for the 'Dodo bird' verdict that all bona fide therapies are equivalent.
Motivational interviewing’s originator has stressed how unexpected findings can force fruitful rethinking. This study may prove an example; designed to forefront the approach’s distinct active ingredients, other than fleetingly and non-significantly, these did not seem active at all among the stable, moderately dependent drinkers recruited to the trial.
Early US study uncovered for the Alcohol Treatment Matrix found a Rogerian client-centred therapy characterised by non-directive, empathic listening beneficially changed self-perceptions of alcohol-dependent patients and reduced relapse compared to approaches based on learning theory or psychoanalysis.
Cognitive-behavioural therapies are among the most widespread and influential approaches to substance use, yet this analysis found they conferred just a small advantage over other therapies. Perhaps other features are more important than the therapeutic 'brand'.
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