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In this massive enterprise, analysts dissected 232 treatment-comparison studies to test the validity of the US government’s principles of effective treatment for problems related to illegal drug use. Principles relating to individualising treatment were consistently supported by the North American evidence.
Researchers have long suspected that pre-existing or drug/alcohol-induced cognitive deficits prevent patients making the most of treatments which rely on complex verbal communications and understandings. For the first time this US study has shown that psychological exercises to remedy these deficits do improve outcomes by helping patients get to grips with treatment.
STUDY 1981 HTM file
Interpersonal functioning of alcoholism counselors and treatment outcome
Seminal US study which found that the therapy-related social skills of alcohol counsellors were strongly related to how many of their patients relapsed in the two years after leaving inpatient treatment.
The title speaks of long-term effects but in fact there were none from sending young US substance users to a youth therapeutic community specialising in substance use problems compared to non-specialist group homes; early gains had all eroded, an instance of the general difficulty of sustaining youth treatment outcomes.
From the USA a rare randomised controlled trial of prison-based substance use treatment for women finds substantial benefits from replacing a standard prison therapeutic community programme with one based on extensive trauma-informed and gender-responsive elements delivered in an entirely woman-only environment.
REVIEW 2012 HTM file
Effectiveness of therapeutic communities: a systematic review
Methodological shortcomings in the original studies prevented this review from reaching a firm conclusion on the lasting benefits of residential therapeutic communities, though it was clear that while residents stayed, substance use was significantly reduced.
On several measures, the few drug dependent patients who accessed aftercare after treatment in Scotland in the early 2000s did better than the majority who chose to or were left to fend on their own – but could this be attributed to the aftercare, or would they have done well anyway?
Abstinence and recovery characterised by employment are priority UK policy objectives to which the extension of mutual aid is considered a major route. This US study illustrates that both the route and the objectives are not just compatible with, but may be promoted by opiate maintenance prescribing.
Compared to usual treatment, over the next 27 years introduction of a comprehensively serviced female-only alcohol treatment unit in Sweden substantially extended the lives of its patients – a uniquely convincing demonstration that improving treatment can save lives.
In Norway, long-term continuity of care by the same adults in a family-like setting outside the home (a specially funded foster home or residential centre) was the key to a better later life for severely troubled young teenage substance users.
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