Mitchell Shannon Gwin, Monico Laura B, Lertch Elizabeth, Kelly Sharon M, Gryczynski Jan, Jaffe Jerome H, O'Grady Kevin E, Schwartz Robert P
Friends Research Institute, Inc., 1040 Park Avenue, Suite 103, Baltimore, MD, 21201, USA.
Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA.
J Behav Health Serv Res. 2018 Jul;45(3):506-515. doi: 10.1007/s11414-018-9603-1.
Conflicts with methadone program counseling staff and violations of program rules can contribute to patients leaving treatment prematurely. This qualitative study was conducted as part of a larger trial of patient-centered methadone treatment (PCM). In-depth, semi-structured interviews at baseline and 12-month follow-up were conducted with five counselors and three clinical supervisors from the programs participating in the PCM parent study. Data were analyzed using Atlas.ti. Counselors reported that, in some cases, PCM allowed them to focus on building a therapeutic alliance with patients because they were not addressing program rule issues. Some reported using more pro-active, innovative strategies for engaging PCM patients and that counseling sessions tended to include a broader range of individually tailored topics, compared to topics normally addressed in typical treatment sessions. Adjusting to the new counselor role was challenging for some counselors and required a shift in tactics to encourage patients' participation in counseling services.
Clinicaltrials.gov NCT 01442493.
与美沙酮项目咨询人员发生冲突以及违反项目规定可能导致患者过早离开治疗。这项定性研究是作为一项以患者为中心的美沙酮治疗（PCM）大型试验的一部分进行的。在基线和12个月随访时，对参与PCM母研究项目的五名咨询师和三名临床主管进行了深入的半结构化访谈。使用Atlas.ti软件对数据进行了分析。咨询师报告称，在某些情况下，PCM使他们能够专注于与患者建立治疗联盟，因为他们无需处理项目规定问题。一些咨询师报告说，他们采用了更积极、创新的策略来吸引PCM患者，并且与典型治疗课程中通常涉及的主题相比，咨询课程往往包含更广泛的个性化定制主题。对一些咨询师来说适应新的咨询师角色具有挑战性，并且需要转变策略以鼓励患者参与咨询服务。
Clinicaltrials.gov NCT 01442493。
