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MATRIX CELL 2020 HTM file
Alcohol Treatment Matrix cell D2: Organisational functioning; Generic and cross-cutting issues
Key studies on the how the characteristics and functioning of treatment organisations affect implementation and effectiveness. See the remaining four cells in row 2 of the matrix for more on generic features of medical and psychosocial therapies.
STUDY 1962 HTM file
The abstinent alcoholic
Classic description of the patient who has sustained abstinence after treatment but is still unhappy, unfulfilled and/or nervously hanging on – in other words, not really ‘recovered’. They formed the majority of patients seen at Connecticut’s alcohol clinics in the 1950s who were not drinking at follow-up.
Around the world, programmes which take a spiritual or overtly religious route to overcoming substance use problems are extremely common and in some countries dominant – but do they work any better than the alternatives? This review systematically sifted the evidence from the past 30 years.
People with co-occurring mental health and substance use problems are often unable to access the care they need. This 2017 guide from Public Health England describes what better care would look like, underpinned by the principles that there is ‘no wrong door’ for accessing support, and it is ‘everyone’s job’ the other side of the door to help.
Has enough high-quality evidence accumulated over the past five years to improve confidence in the effectiveness of residential treatment?
While drug recovery wings were specifically designed to facilitate recovery from drug and alcohol problems among prisoners, this small study found that the sharp drop-off in support when they returned to the community ended many recovery journeys prematurely.
STUDY 2019 HTM file
Efficacy and cost-effectiveness of an adjunctive personalised psychosocial intervention in treatment-resistant maintenance opioid agonist therapy: a pragmatic, open-label, randomised controlled trial
Instead of a set programme, a clinic in London tried offering methadone or buprenorphine patients still using heroin or cocaine a selection from a suite of well-supported psychological interventions tailored to the patient and then systematically re-tailored in the light of how they responded. It worked – but did it work well enough, and would the findings be replicated in more typical circumstances?
REVIEW 2018 HTM file
Psychotherapy relationships that work III
Research findings amalgamated in 16 reviews for an American Psychological Association task force led them to authoritatively assess many dimensions of the client–psychotherapist relationship as important determinants of patients’ progress. “The relationship can heal,” is the overall conclusion – one likely to be highly relevant to recovery from addiction.
REVIEW 2018 HTM file
The real relationship and its role in psychotherapy outcome: a meta-analysis
Findings amalgamated for the American Psychological Association indicate that patient progress and treatment quality are strongly related to the strength of the personal (‘real’) relationship between client and therapist – more strongly than the working relationship focused on the therapy. Showing that you like, value and care for someone may be therapeutic in itself.
REVIEW 2018 HTM file
The alliance in adult psychotherapy: a meta-analytic synthesis
Comprehensive review for the American Psychological Association concludes that the working relationship between clients and their counsellors or therapists is one of the largest and most consistent determinants of outcomes. Practice recommendations aim to help practitioners foster strong relationships.
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