McKay James R, Hiller-Sturmhofel Susanne
Department of Psychiatry, University of Pennsylvania, and Philadelphia VAMC Center of Excellence in Substance Abuse Treatment and Education,Philadelphia, Pennsylvania.
Alcohol Res Health. 2011;33(4):356-70.
For many patients, alcohol and other drug (AOD) use disorders are chronic, recurring conditions involving multiple cycles of treatment, abstinence, and relapse. To disrupt this cycle, treatment can include continuing care to reduce the risk of relapse. The most commonly used treatment approach is initial intensive inpatient or outpatient care based on 12-step principles, followed by continuing care involving self-help groups, 12-step group counseling, or individual therapy. Although these programs can be effective, many patients drop out of initial treatment or do not complete continuing care. Thus, researchers and clinicians have begun to develop alternative approaches to enhance treatment retention in both initial and continuing care. One focus of these efforts has been the design of extended treatment models. These approaches increasingly blur the distinction between initial and continuing care and aim to prolong treatment participation by providing a continuum of care. Other researchers have focused on developing alternative treatment strategies (e.g., telephone-based interventions) that go beyond traditional settings and adaptive treatment algorithms that may improve outcomes for clients who do not respond well to traditional approaches.
对于许多患者而言,酒精和其他药物(AOD)使用障碍是慢性复发性疾病,涉及多个治疗、戒酒和复发周期。为了打破这一循环,治疗可包括持续护理以降低复发风险。最常用的治疗方法是基于12步原则的初始强化住院或门诊护理,随后是包括自助小组、12步团体咨询或个体治疗的持续护理。尽管这些项目可能有效,但许多患者会退出初始治疗或未完成持续护理。因此,研究人员和临床医生已开始开发替代方法,以提高初始治疗和持续护理中的治疗留存率。这些努力的一个重点是扩展治疗模式的设计。这些方法越来越模糊了初始治疗和持续护理之间的区别,旨在通过提供连续护理来延长治疗参与时间。其他研究人员则专注于开发超越传统环境的替代治疗策略(如基于电话的干预措施)以及可能改善对传统方法反应不佳的客户治疗效果的适应性治疗算法。