STAGE 5. Defining the action plan

What steps should be completed?

Step 1: Specify intervention actions

EVIDENCE FOR MULTICOMPONENT THERAPIES

Matrix Model

Numerous studies have shown that participants treated with this modality of drug treatment (including elements of relapse prevention, family therapy, drug education and participation in self-help activities) show a statistically significant reduction in drug use, an improvement in psychological indicators and a decrease in sexual risk behavior associated with the transmission of HIV¹.

Therapeutic Communities

Insufficient evidence is available today to establish whether therapeutic communities are more effective than other treatments to reduce drug use and improve social and health indicators associated with drug abuse and dependence1. However, all the evidence available on this modality of treatment makes it possible to point out some conclusions²:

• Treatment in therapeutic communities has shown effectiveness mainly in the first few months after the abandonment of drug use.
• Therapeutic communities obtain significant improvements in the patient's general clinical status (drug use and associated psychopathology), as well as in criminal behavior and in the work situation.
• The accomplishments obtained by the treatments in therapeutic community are maintained in long-term follow-ups of one to five years.
• Treatment in therapeutic communities is effective for heroin addiction, as long as the patient remains in the programme for a long enough time. Permanence in the programme is a good predictor of treatment success, so that people who complete six months of treatment have significantly better results than those that remain less time. In the same way, the ones that finish the treatment achieve better results than those that leave it prematurely.

In addition, treatment in in-prison therapeutic communities (a specific modality) present significantly better results in the rate of recidivism (new arrests and incarcerations) and drug use 12-months after getting out of prison than the absence of intervention and than mental health treatment programmes in prison¹.  

 

References:

1 Smith LA, et al. (2006). Therapeutic communities for substance related disorder, Cochrane Database of Systematic Reviews, Issue 1, Art. No. CD005338, DOI: 10.1002/14651858.CD005338.pub2.

2 Becoña E and Cortés MT. (2011). Manual de adicciones para psicólogos especialistas en psicología clínica en formación. Barcelona: Socidrogalcohol.