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Set in Sweden, the first study among psychiatric outpatients to test brief alcohol interventions against screening alone found worthwhile extra drinking reductions after brief motivational advice. Use of a telephone-based intervention was another innovation.
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.
Australian study provides the first evidence that integrated treatment may be superior to alcohol- or depression-focused treatment for depressed heavy drinkers, but the lack of extra benefit in respect of depression and gender differences suggests a more complicated picture.
Confirmation from the US Project MATCH alcohol treatment trial that too explicitly imposing structure on therapy risks relatively poor outcomes among patients reluctant to relinquish control and who react against direction – and a further indication that this pattern is not universal, but depends on the context.
US students who broke college drinking rules and were required to undertake an alcohol programme responded better to three hours of group motivational interviewing than six of alcohol education; enhanced confidence that they could resist risky drinking was the key. For colleges it offers an effective but economical response to problem drinkers.
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.
This US study found that different types of heavy-drinking college students responded best to different types of brief intervention to promote moderation; a novel finding was that the thinkers among them were most affected by being led to reflect on how their drinking compared to that of the average student.
Reanalysis of the huge US Project MATCH alcohol treatment trial confirms that patients with pro-drinking social circles gained greater remission in drink problems when 'matched' to a therapy focused on generating a social circle (in the form of AA) with the opposite characteristics.
This huge US study set out to test whether widespread screening and brief intervention for illegal drug use (not just heavy drinking) could be implemented in a variety of general medical settings and whether it was effective. Both tests seem to have been passed, but with some important caveats.
STUDY 2008 HTM file
Still hard to find reasons for matching patients to therapies
The UK Alcohol Treatment Trial has confounded expectations that a motivational approach would be preferable for unmotivated or hostile patients, while supportive social networks would be particularly important for patients lacking these to begin with.
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