STAGE 5. Defining the action plan

What steps should be completed?

Step 1: Specify intervention actions

EVIDENCE FOR ANALYTICAL AND PSYCHODYNAMIC THERAPIES¹

Few studies have assessed the efficacy of these therapies in people with addictive disorders. A recent meta-analysis² examining the evidence for the effectiveness of dynamic therapy using American Psychological Association critera³ concluded that there is insufficient scientific evidence of its results in the field of addictive disorders.

However, a review of the few controlled studies available on these therapies leads to the conclusion that they are more effective than no treatment, and that prolonged treatments are more effective than short-term interventions.⁴

Luborsky’s supportive-expressive therapy

This treatment has been used in the field of addictive disorders with patients in methadone maintenance with cocaine use,⁵ although little assessment has been made of its effectiveness, as it is impossible to formulate evidence-based statements.

Interpersonal therapy

This type of therapy was adapted in the 1980s to treat cocaine dependence and it has been widely used in the U.S.A., combined with other treatments, including psychopharmacological therapy, and also in the context of outpatient treatment in methadone programmes.⁶ When used to treat addictive disorders, it focuses both on stopping use and improving personal functioning. The American Psychiatric Association⁷ provides for this form of therapy, and other psychodynamic therapies, for addictive disorders, although with a low degree of recommendation.

 

References:

1 Becoña E & Cortés MT. (2011). Manual de adicciones para psicólogos especialistas en psicología clínica en formación [Manual of addictions for psychologists in training specialising in clinical psychology]. Barcelona: Socidrogalcohol.

2 Connolly MB, Crits-Christoph P & Hearon B. (2008). The empirical status of psychodynamic therapies. Annual Review of Clinical Psychology. 4: 93-108.

3 Chambless DL & Hollon SD. (1998). Defining empirically supported therapies. Journal of Consulting and Clinical Psychology. 66: 7-18.

4 Leichsenring F. (2005). Are psychodynamic and psychoanalytic therapies effective?: A review of empirical data. International Journal of Psychoanalysis. 86: 841-868.

5 Woody GE et al. (1995). Psychotherapy in community methadone programs: a validation study. American Journal of Psychiatry. 152: 1302-1308.

6 Rounsaville BJ & Carroll K. (1993). Interpersonal psychotherapy for patients who abuse drugs. In: Klerman GL & Weissman MM. New applications of Interpersonal Psychotherapy, Washington, DC: American Psychiatric Press.

7 American Psychiatric Association (1997). Directrices para la práctica clínica en el tratamiento de pacientes con trastornos por consumo de sustancias [Clinical practice guidelines for the treatment of patients with substance use disorders]. Barcelona: Edika Médica.