Avants S K, Margolin A, Kosten T R, Rounsaville B J, Schottenfeld R S
Substance Abuse Center, Yale University School of Medicine, New Haven, Connecticut 06529, USA.
J Consult Clin Psychol. 1998 Dec;66(6):924-31. doi: 10.1037//0022-006x.66.6.924.
In response to a need to match drug users to the most appropriate and cost-effective level of care, it was hypothesized the socially anxious methadone-maintained patients would attain greater benefit from coping skills training provided in the context of a low-intensity enhanced standard methadone maintenance intervention (E-STD) than in the context of a high-intensity, socially demanding day treatment program (DTP). Social anxiety was assessed in 307 methadone-maintained patients using the Social Anxiety and Distress Scale prior to randomization to either E-STD or DTP. The hypothesis was supported: Socially anxious patients were drug free longer during treatment, were more likely to be abstinent at treatment completion, and had greater reductions in HIV risk behaviors if assigned to the lower intensity intervention, which was provided at 1/3 the cost of the DTP.
为了满足将吸毒者与最合适且最具成本效益的护理水平相匹配的需求，研究假设社交焦虑的美沙酮维持治疗患者，在低强度强化标准美沙酮维持治疗干预（E-STD）环境中接受应对技能培训，比在高强度、对社交要求较高的日间治疗项目（DTP）环境中能获得更大益处。在307名接受美沙酮维持治疗的患者被随机分配到E-STD或DTP之前，使用社交焦虑与痛苦量表对其社交焦虑进行了评估。该假设得到了支持：如果被分配到强度较低的干预组，社交焦虑患者在治疗期间保持无毒品状态的时间更长，在治疗结束时更有可能戒除毒瘾，并且在降低艾滋病毒风险行为方面有更大幅度的减少，而这种低强度干预的成本仅为DTP的三分之一。
