Rapp Richard C, Otto Amy L, Lane D Timothy, Redko Cristina, McGatha Sue, Carlson Robert G
Center for Interventions, Treatment, and Addictions Research, Wright State University, Boonshoft School of Medicine, 3640 Colonel Glenn Highway, Dayton, OH 45435, USA.
Drug Alcohol Depend. 2008 Apr 1;94(1-3):172-82. doi: 10.1016/j.drugalcdep.2007.11.012. Epub 2008 Feb 1.
Poor linkage with substance abuse treatment remains a problem, negating the benefits that can accrue to both substance abusers and the larger society. Numerous behavioral interventions have been tested to determine their potential role in improving linkage.
A randomized clinical trial of 678 substance abusers compared the linkage effect of two brief interventions with the referral standard of care (SOC) at a centralized intake unit (CIU). Interventions included five sessions of strengths-based case management (SBCM) or one session of motivational interviewing (MI). A priori hypotheses predicted that both interventions would be better than the standard of care in predicting linkage and that SBCM would be more effective than MI. We analyzed the effect of the two interventions on overall treatment linkage rates and by treatment modality. Logistic regression analysis examined predictors of treatment linkage for the sample and each group.
Two hypotheses were confirmed in that SBCM (n=222) was effective in improving linkage compared to the SOC (n=230), 55.0% vs. 38.7% (p<.01). SBCM improved linkage more than MI (55.0% vs. 44.7%, p<.05). Motivational interviewing (n=226) was not significantly more effective in improving linkage than the standard of care (44.7% vs. 38.7%; p>.05). The three trial groups differed only slightly on the client characteristics that predicted linkage with treatment.
The results of this study confirm a body of literature that supports the effectiveness of case management in improving linkage with treatment. The role of motivational interviewing in improving linkage was not supported. Results are discussed in the context of other case management and motivational interviewing linkage studies.
与药物滥用治疗的联系不佳仍是一个问题，这使药物滥用者和整个社会无法获得应有的益处。已经对多种行为干预措施进行了测试，以确定它们在改善联系方面的潜在作用。
一项针对678名药物滥用者的随机临床试验，在一个集中收治单元（CIU）比较了两种简短干预措施与转诊标准治疗（SOC）的联系效果。干预措施包括五节基于优势的个案管理（SBCM）课程或一节动机性访谈（MI）课程。先验假设预测，两种干预措施在预测联系方面都将优于标准治疗，并且SBCM将比MI更有效。我们分析了这两种干预措施对总体治疗联系率以及按治疗方式的影响。逻辑回归分析检查了样本和每组治疗联系的预测因素。
两个假设得到证实，即与SOC（n = 230）相比，SBCM（n = 222）在改善联系方面有效，分别为55.0%和38.7%（p <.01）。SBCM在改善联系方面比MI更有效（55.0%对44.7%，p <.05）。动机性访谈（n = 226）在改善联系方面并不比标准治疗显著更有效（44.7%对38.7%；p>.05）。三个试验组在预测与治疗联系的客户特征上仅略有不同。
本研究结果证实了一系列文献，这些文献支持个案管理在改善与治疗联系方面的有效性。动机性访谈在改善联系方面的作用未得到支持。将在其他个案管理和动机性访谈联系研究的背景下讨论结果。
