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MATRIX CELL 2020 HTM file
Alcohol Treatment Matrix cell C3: Management/supervision; Medical treatment
Seminal and key studies on the impact of management on medical interventions and treatment for problem drinking in medical settings. Asks how we can identify effective clinicians and effective medications, and highlights the remarkable transformation brought about in the 1950s at a US clinic which few referred patients attended and fewer still engaged with.
MATRIX CELL 2020 HTM file
Alcohol Treatment Matrix cell B3: Practitioners; Medical treatment
The most important seminal and key studies and reviews shedding light on the impact of the practitioner in medical interventions and treatment for alcohol problems in medical settings.
MATRIX CELL 2019 HTM file
Alcohol Treatment Matrix cell B2: Practitioners; Generic and cross-cutting issues
At the front line the practitioner is to the patient the face of treatment. They can matter enormously – not so much in their formal credentials, but their manner with patients. Tour seminal and key studies which probe the heart of addiction treatment: relationships. See the remaining four cells in row 2 of the matrix for more on generic features of medical and psychosocial therapies.
What do primary care clinicians think would help them bridge the ‘implementation gap’ in screening for risky drinking and brief advice, and extend the potential benefits to a greater proportion of the population? A European trial found the answer differed depending on distinctive national circumstances.
Simulation study calculated health care cost savings and benefits for patients in England which make routine GP-based screening and brief advice for excessive drinking look an unmissable bargain, but the key assumptions derived from studies divorced from how interventions would routinely be implemented.
In the context of current UK policy, this is a key study, testing the ambition to extend recovery beyond formal treatment by systematically linking patients to mutual aid groups, the main way it is being suggested commissioners can square the circle of doing more (recovery is seen as a whole-life transformation) with less.
This impressive assessment of what evaluation research means for alcohol dependence treatment in Britain is distinguished by reviews of the latest literature on the sub-topics it covers; in some cases these starkly reveal the inadequacies of the evidence base.
Patient interviews provide insight into low levels of engagement and retention in alcohol treatment services, hindering the effective provision of treatment for dependent drinkers. Findings suggest that treatment pathways should better reflect the capacity and capabilities of people with alcohol dependence.
STUDY 1970 HTM file
Frontiers of alcoholism
Later to become founding director of the US National Institute on Alcohol Abuse and Alcoholism, in the late 1950s Dr Morris Chafetz of the Massachusetts General Hospital conducted a remarkable series of studies which proved that an alcohol clinic's intake and performance can be transformed by the simple application of empathy and organisation.
Seminal English study which turned the spotlight on organisational factors in the development of a positive attitude to working with problem drinkers, in particular the availability of experience in working with these patients and the support of experienced colleagues. Without these the effects of training are less and less well sustained.
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