Motivational intervention to enhance post‐detoxification 12‐Step group affiliation: a randomized controlled trial

Vederhus, John‐Kåre; Timko, Christine; Kristensen, Øistein; Hjemdahl, Bente; Clausen, Thomas

doi:10.1111/add.12471

Cited by 39 publications

(37 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In addition to the formalized treatment options available, clinicians may recommend that patients seek abstinence-supportive help, for example, from peer-based groups [60], to maintain improvements in mental distress achieved during treatment.…”

Section: Discussionmentioning

confidence: 99%

Mental distress following inpatient substance use treatment, modified by substance use; comparing voluntary and compulsory admissions

Pasareanu

Vederhus

Opsal

et al. 2017

BMC Health Serv Res

Self Cite

View full text Add to dashboard Cite

BackgroundTreatment services to patients with substance use disorders (SUDs), including those mandated to treatment, needs to be evaluated and evidence based. The Norwegian Municipal Health Care Act (NMHCA) calls for compulsory treatment for persons with “severe and life-threatening substance use disorder” if these individuals are not otherwise willing to be voluntarily treated and consequently risk their lives over drug use. Mental distress is known to be high among SUD patients admitted to inpatient treatment. The purpose of this study is to describe changes in mental distress from admission to a 6-month follow-up in patients with SUDs, which underwent either voluntary or compulsory treatment.MethodThis prospective study followed 202 hospitalized patients with SUDs who were admitted voluntarily (VA; n = 137) or compulsorily (CA; n = 65). Levels of mental distress were assessed with SCL-90-R. Of 123 patients followed-up at 6 months, 97 (62 VA and 35 CA) had rated their mental distress at admission, discharge and follow-up. Sociodemographics and substance use severity were recorded with the use of The European Addiction Severity Index (EuropASI). We performed a regression analysis to examine factors associated with changes in psychiatric distress at the 6-month follow-up.ResultsThe VA group exhibited higher mental distress than the CA group at admission, but both groups improved significantly during treatment. At the 6-month follow-up, the VA group continued to show reduced distress, but the CA group showed increases in mental distress to the levels observed before treatment. The deterioration appeared to be associated with higher scores that reflected paranoid ideas, somatization, obsessive-compulsive symptoms, interpersonal sensitivity, and depression. Active substance use during follow-up was significantly associated with increased mental distress.ConclusionIn-patient treatment reduces mental distress for both CA and VA patients. The time after discharge seems critical especially for CA patients regarding active substance use and severe mental distress. A greater focus on continuing care initiatives to assist the CA patients after discharge is needed to maintain the reduction in mental distress during treatment. Continuing-care initiatives after discharge should be intensified to assist patients in maintaining the reduced mental distress achieved with treatment.Trial registrationClinicalTrials.gov NCT 00970372 December 02, 2016.

show abstract

Section: Discussionmentioning

confidence: 99%

Mental distress following inpatient substance use treatment, modified by substance use; comparing voluntary and compulsory admissions

Pasareanu

Vederhus

Opsal

et al. 2017

BMC Health Serv Res

Self Cite

View full text Add to dashboard Cite

show abstract

“…Patients in need of motivation to continue with further substance abuse treatment following detoxification may benefit from motivation interviewing (Vederhus, Timko, Kristensen, Hjemdahl, & Clausen, 2014), counseling (Rawson, Mann, Tennant, & Clabough, 1983) or development of a therapeutic alliance (Campbell et al, 2009). Such efforts may prove useful in assisting Alaska Native patients to reach the next phase on the continuum.…”

Section: Discussionmentioning

confidence: 99%

Alcohol detoxification completion, acceptance of referral to substance abuse treatment, and entry into substance abuse treatment among Alaska Native people

Bear

Beals

Novins

et al. 2017

Addictive Behaviors

View full text Add to dashboard Cite

Background Little is known about factors associated with detoxification treatment completion and the transition to substance abuse treatment following detoxification among Alaska Native people. This study examined 3 critical points on the substance abuse continuum of care (alcohol detoxification completion, acceptance of referral to substance abuse treatment, entry into substance abuse treatment following detoxification). Methods The retrospective cohort included 383 adult Alaska Native patients admitted to a tribally owned and managed inpatient detoxification unit. Three multiple logistic regression models estimated the adjusted associations of each outcome separately with demographic/psychosocial characteristics, clinical characteristics, use related behaviors, and health care utilization. Results Seventy-five percent completed detoxification treatment. Higher global assessment functioning scores, longer lengths of stay, and older ages of first alcohol use were associated with completing detoxification. A secondary drug diagnosis was associated with not completing detoxification. Thirty-six percent accepted a referral to substance abuse treatment following detoxification. Men, those with legal problems, and those with a longer length of stay were more likely to accept a referral to substance abuse treatment. Fifty-eight percent had a confirmed entry into a substance abuse treatment program at discharge. Length of stay was the only variable associated with substance abuse treatment entry. Conclusions Services like motivational interviewing, counseling, development of therapeutic alliance, monetary incentives, and contingency management are effective in linking patients to services after detoxification. These should be considered, along with the factors associated with each point on the continuum of care when linking patients to follow-up services.

show abstract

“…Those findings implied that improved QoL may not rely upon abstinence alone. In addition to reduced substance use, one should also focus on a broad range of factors that may underlie patient evaluation of QoL; most notably, important areas of recovery, like employment, housing, and means of social support; e.g., via mutual aid groups [ 45 ].…”

Section: Discussionmentioning

confidence: 99%

Quality of life improved following in-patient substance use disorder treatment

Pasareanu

Opsal

Vederhus

et al. 2015

Health Qual Life Outcomes

Self Cite

View full text Add to dashboard Cite

BackgroundQuality of life (QoL) is increasingly recognized as central to the broad construct of recovery in patients with substance use disorders (SUD). However, few longitudinal studies have evaluated changes in QoL after SUD treatment and included patients with SUD that were compulsorily hospitalized. This study aimed to describe QoL among in-patients admitted either voluntarily or compulsorily to hospitalization and to examine patterns and predictors of QoL at admission and at 6 months post treatment.MethodsThis prospective study followed 202 hospitalized patients with SUD that were admitted voluntarily (N=137) or compulsorily (N=65). A generic QoL questionnaire (QoL-5) was used to assess QoL domains. Regression analysis was conducted to identify associations with QoL at baseline and to examine predictors of change in QoL at a 6-month follow-up.ResultsThe majority of patients had seriously impaired QoL. Low QoL at baseline was associated with a high psychiatric symptom burden. Fifty-eight percent of patients experienced a positive QoL change at follow-up. Although the improvement in QoL was significant, it was considered modest (a mean 0.06 improvement in QoL-5 scores at follow-up; 95% confidence interval: 0.03 - 0.09; p<0.001). Patients admitted voluntarily and compulsorily showed QoL improvements of similar magnitude. Female gender was associated with a large, clinically relevant improvement in QoL at follow-up.ConclusionsIn-patient SUD treatment improved QoL at six month follow-up. These findings showed that QoL measurements were useful for providing evidence of therapeutic benefit in the SUD field.

show abstract

Motivational intervention to enhance post‐detoxification 12‐Step group affiliation: a randomized controlled trial

Cited by 39 publications

References 28 publications

Mental distress following inpatient substance use treatment, modified by substance use; comparing voluntary and compulsory admissions

Mental distress following inpatient substance use treatment, modified by substance use; comparing voluntary and compulsory admissions

Alcohol detoxification completion, acceptance of referral to substance abuse treatment, and entry into substance abuse treatment among Alaska Native people

Quality of life improved following in-patient substance use disorder treatment

Contact Info

Product

Resources

About