Twelve-month follow-up of psychotherapy for opiate dependence [published erratum appears in Am J Psychiatry 1989 Dec;146(12):1651]

Ge, Woody; At, McLellan; Luborsky, Lester; Cp, O'Brien

doi:10.1176/ajp.144.5.590

Cited by 64 publications

(12 citation statements)

References 17 publications

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“…They came to the conclusion that all three groups showed a partial remission after seven months, but the group that received psychotherapy in addition to being under methadone maintenance treatment showed more improvement. The results of the studies by Woody et al suggest that psychotherapy can certainly be used effectively with drug therapy 6,7…”

Section: Introductionmentioning

confidence: 99%

Pattern and Trend of Substance Abuse in Eastern Rural Iran: A Household Survey in a Rural Community

Ziaaddini

Nakhaee

2013

Journal of Addiction

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BackgroundA significant number of opioid-dependent patients in Iran are now being treated by methadone maintenance therapy (MMT). One of the social complications of substance dependency is family disorganization and a decrease in marital satisfaction. This study aimed to determine the effect of group therapy based on the transtheoretical model of change on family functioning of the patients under MMT.MethodsIn this open clinical trial, 48 married people who were between the ages of 19 and 40, and under methadone maintenance therapy had been assigned to two random groups of test and control. In the intervention group, group therapy was held based on the transtheoretical model of behavior change, for 29 sessions (two times a week). To assess the overall health and pathology of the family, the two questionnaires Family Assessment Device (FAD) and Marital Conflict Questionnaire (MCQ), both with approved reliability and validity, were used.FindingsA total of 24 patients in the control group and 23 patients in the intervention group (one person withdrew from the study in the early meetings) were evaluated. The mean ± SD of age of the control and intervention groups, respectively, were 33.9 ± 4.8 and 32.8 ± 4.3 (P = 0.40). Before the intervention began the average score of FAD and MCQ questionnaires between the two groups was comparable. After the intervention was over the score of each of the two questionnaires, with the adjustment of the baseline score, was lower in the treatment group than the control group, the difference was marginally significant (P < 0.10).ConclusionThe family functioning of the MMT treated patients showed improvement. Therefore, with the use of stage-of-change and group therapy, steps can be taken for improving family functioning of these patients. Due to the relatively long duration and frequency of treatment sessions the feasibility of this intervention needs further research.

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Section: Introductionmentioning

confidence: 99%

Pattern and Trend of Substance Abuse in Eastern Rural Iran: A Household Survey in a Rural Community

Ziaaddini

Nakhaee

2013

Journal of Addiction

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“…Depressive and anxiety disorders, which are collectively referred to as Common Mental Disorders [CMD], are typically encountered in primary health care settings [1,2]. One of the biggest challenges to the effective treatment of the disorders at the primary care setting is the low rate of recognition of CMD by primary health care workers.…”

Section: Introductionmentioning

confidence: 99%

The explanatory models of depression and anxiety in primary care: a qualitative study from India

et al. 2012

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BackgroundThe biggest barrier to treatment of common mental disorders in primary care settings is low recognition among health care providers. This study attempts to explore the explanatory models of common mental disorders (CMD) with the goal of identifying how they could help in improving the recognition, leading to effective treatment in primary care.ResultsThe paper describes findings of a cross sectional qualitative study nested within a large randomized controlled trial (the Manas trial). Semi structured interviews were conducted with 117 primary health care attendees (30 males and 87 females) suffering from CMD. Main findings of the study are that somatic phenomena were by far the most frequent presenting problems; however, psychological phenomena were relatively easily elicited on probing. Somatic phenomena were located within a biopsychosocial framework, and a substantial proportion of informants used the psychological construct of ‘tension’ or ‘worry’ to label their illness, but did not consider themselves as suffering from a ‘mental disorder’. Very few gender differences were observed in the descriptions of symptoms but at the same time the pattern of adverse life events and social difficulties varied across gender.ConclusionOur study demonstrates how people present their illness through somatic complaints but clearly link their illness to their psychosocial world. However they do not associate their illness to a ‘mental disorder’ and this is an important phenomenon that needs to be recognized in management of CMD in primary settings. Our study also elicits important gender differences in the experience of CMD.

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“… 2) Ongoing engagement Twelve months after the intervention ended there was a decline in employment gains for the experimental group, which, according to the researchers suggests “the need for [an] additional intervention in order to maintain employment gains” (p. 21). Woody et al 1987 . Three groups were compared: 1) A Supportive-expressive Therapy (SE) group; 2) A Cognitive-behavioral Therapy (CB) group; and, 3) A drug counseling group.…”

Section: Resultsmentioning

confidence: 99%

“…The evaluations also varied in terms of the groups targeted for the intervention or the inclusion and exclusion criteria. For example, some interventions targeted men only (McLellan et al 1993 ), male veterans (Woody et al 1987 ), or women only (Najavits et al 2007 ). In one study, individuals were “ineligible if they were dependent on alcohol or benzodiazepines to the point of requiring medical withdrawal” (Farabee et al 2002 , p. 344) or eligible if dependent on alcohol (Cohen et al 1982 ).…”

Section: Resultsmentioning

confidence: 99%

“…However, there are suggestions that engagement over some period of time may be necessary, in some instances, but not in others (Table 4 ). Woody et al ( 1987 ), for example, found that improvements in employment and psychiatric status were maintained (and in some cases there was increased improvement) when clients were evaluated 12 months after the baseline for the intervention. (During months 7 and 12 of this study there were no intervention supports in place).…”

Section: Resultsmentioning

confidence: 99%

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Improving psychosocial health and employment outcomes for individuals receiving methadone treatment: a realist synthesis of what makes interventions work

et al. 2014

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BackgroundFor over 50 years, methadone has been prescribed to opioid-dependent individuals as a pharmacological approach for alleviating the symptoms of opioid withdrawal. However, individuals prescribed methadone sometimes require additional interventions (e.g., counseling) to further improve their health. This study undertook a realist synthesis of evaluations of interventions aimed at improving the psychosocial and employment outcomes of individuals on methadone treatment, to determine what interventions work (or not) and why.MethodsThe realist synthesis method was utilized because it uncovers the processes (or mechanisms) that lead to particular outcomes, and the contexts within which this occurs. A comprehensive search process resulted in 31 articles for review. Data were extracted from the articles, and placed in four templates to assist with analysis. Data analysis was an iterative process and involved comparing and contrasting data within and across each template, and cross checking with original articles to determine key patterns in the data.ResultsFor individuals on methadone, engagement with an intervention appears to be important for improved psychosocial and/or employment outcomes. The engagement process involves attendance at interventions as well as an investment in what is offered. Three intervention contexts (often in some combination) support the engagement process: a) client-centered contexts (or those where clients’ psychosocial and/or employment needs/issues/skills are recognized and/or addressed); b) contexts which address clients’ socio-economic conditions and needs; and, c) contexts where there are positive client-counselor and/or peer relationships. There is some evidence that sometimes ongoing engagement is necessary to maintain positive outcomes. There is also some evidence that complete abstinence from drugs (e.g., cocaine, heroin) is not necessary for engagement.ConclusionsIt is important to consider how the contexts of interventions might elicit and/or support clients’ engagement. Further research is needed to explore how an individual’s background (e.g., involvement with different interventions over an extended period) may influence engagement. Long-term engagement may be necessary to sustain some positive outcomes although how long is unclear and requires further research. Engagement can occur without complete abstinence from such drugs as cocaine or heroin, but additional research is required as engagement may be influenced by the extent and type of drug use.Electronic supplementary materialThe online version of this article (doi:10.1186/s40359-014-0026-3) contains supplementary material, which is available to authorized users.

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Twelve-month follow-up of psychotherapy for opiate dependence [published erratum appears in Am J Psychiatry 1989 Dec;146(12):1651]

Cited by 64 publications

References 17 publications

Pattern and Trend of Substance Abuse in Eastern Rural Iran: A Household Survey in a Rural Community

Pattern and Trend of Substance Abuse in Eastern Rural Iran: A Household Survey in a Rural Community

The explanatory models of depression and anxiety in primary care: a qualitative study from India

Improving psychosocial health and employment outcomes for individuals receiving methadone treatment: a realist synthesis of what makes interventions work

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