Effectiveness Bank bulletin 22 May 2013

Latest additions to the Effectiveness Bank show that practice improvements initiated by counsellors are strongly influenced by workplace context, that very good relationship-builders may not be the most effective counsellors, and that long-term effectiveness is improved by monitoring former clients. Lastly, a trial of an alternative to benzodiazepines for alcohol withdrawal was marred by seizures.

Leaders and service ethos set context for training to affect treatment practice
Message from this large US study is that 'bottom-up' practice improvements in treatment services initiated by counsellors are still strongly influenced by the climate-setting and support offered by an organisation's leadership and ethos, especially how far they foster professional development.

Can therapists be too good?
Rarely has counselling been so deeply analysed as in this US study of mainly alcohol and cocaine dependent patients. The far-reaching implications are that some counsellors generate relationships with clients which feed through to better outcomes – but also that the 'best' relationship builders are not on average the most effective.

Benefits of post-treatment check-ups extend to four years
Chicago studies have shown that quarterly check-ups on former patients can identify treatment need and pave the way for re-entry. Though extra substance use/problem reductions were modest, these remained significant four years after patients started treatment. Issue for the UK: how does this square with the stress on lasting treatment exit?

Anticonvulsants yet to better benzodiazepines for alcohol withdrawal
Drawbacks of the favoured benzodiazepine drugs used to ameliorate alcohol withdrawal have led to trials of anticonvulsants, but this German trial found one promising anticonvulsant effective only among less severe cases – and some patients seemingly doing well later developed seizures, one of the most severe consequences of alcohol withdrawal.

Sent by the Drug and Alcohol Findings Effectiveness Bank to alert you to site updates and UK-relevant evaluations and reviews of drug/alcohol interventions. Managed by DrugScope, Alcohol Concern and the National Addiction Centre. Supported by Alcohol Research UK and the J. Paul Getty Jr. Charitable Trust.