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[Consultation draft subject to amendment and correction.] Why, how, for whom, and under what circumstances do different strategies for increasing the delivery of screening and brief alcohol interventions work?
MATRIX CELL 2019 HTM file
Alcohol Treatment Matrix cell D1: Organisational functioning; Screening and brief intervention
Seminal and key studies on how organisational functioning affects screening and brief intervention. Highlights a striking illustration of the importance of organisational context emerging from the unprecedented implementation drive at the US health care system for ex-military personnel. See the rest of row 1 of the matrix for more on screening and brief interventions.
Findings amalgamated for the American Psychological Association show that outcomes usually improve when therapists are provided with real-time feedback from the client on their progress and on factors affecting it such as the client–therapist relationship. Especially among clients (including substance use clients) who would otherwise deteriorate or not improve, these systems are among the most effective ways available to services to improve outcomes.
Evidence that an earlier study feeding back client progress to counsellors did not find improved outcomes because data was aggregated across a caseload rather than identifying individuals doing poorly and recommending remedial actions. After remedying these deficits, a new system significantly improved mental health and reduced substance use.
MATRIX CELL 2018 HTM file
Drug Treatment Matrix cell D4: Organisational functioning; Psychosocial therapies
Key studies on how treatment organisations affect the implementation and effectiveness of psychosocial therapies for drug dependence. See if you agree that “organizational climate underlies the entire process of innovation adoption”, appreciate the obstructive effect of high staff turnover and how to reduce it, ask yourself, “Is my service even ready for change?” – and explore whether change driven by money is just as good for patients as that motivated by a desire to improve their lives.
MATRIX CELL 2018 HTM file
Alcohol Matrix cell D4: Organisational functioning; Psychosocial therapies
The most important studies on how treatment organisations affect the implementation and effectiveness of psychosocial therapies. One of 25 cells in the alcohol matrix. Also highlights the most useful reviews and practice guidelines and offers a customised one-click search for more on the Effectiveness Bank database.
STUDY 2008 HTM file
Does following research-derived practice guidelines improve opiate-dependent patients’ outcomes under everyday practice conditions? Results of the Multisite Opiate Substitution Treatment study
In everyday practice at methadone maintenance clinics and with the full range of patients, does implementing clinical guidelines lead to better outcomes for patients? Two sets of US clinics selected for high versus low adherence to guidelines provided evidence that the recommended high doses and intensive psychosocial services really do make the intended difference.
MATRIX CELL 2018 HTM file
Drug Treatment Matrix cell D3: Organisational functioning; Medical treatment
Seminal and key studies on how treatment organisations affect the implementation and effectiveness of medical interventions and treatment in medical settings. Focus is on UK and US understandings of what counts as a ‘recovery-oriented’ service and on US, Australian and Canadian studies which discovered and validated elements of these visions even before they were articulated.
From France the first study to randomly allocate patients to start methadone maintenance either in primary care or at a specialist centre found primary care more attractive to patients, and no less effective at reducing street-opioid use and promoting engagement and retention.
Trials challenge the need for the widely accepted policy of making opioid-dependent patients take their methadone or other opioid substitutes at the clinic or pharmacy, but ‘no difference’ findings may be due to the limitations of the research.
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