ABSTRACT
The purpose of this study was to examine the evidence of psychotherapeutic integrated treatment (IT) programs for individuals with concurrent substance use disorders and trauma histories. Electronic searches of Cochrane Central Register of Controlled Trials, MEDLINE, Web of knowledge, PubMed, PsycINFO, CINAHL, PILOTS, and EMBASE identified 17 IT trials (9 controlled trials). Both narrative review and meta-analysis indicate that IT effectively reduces trauma symptoms and substance abuse from pretreatment to longest follow-up. However, IT and nonintegrated programs appear to produce similar declines in symptoms. Methodological issues limiting the current body of work and recommendations for future research are discussed. Well-designed randomized controlled trials are clearly needed, particularly large sample studies evaluating understudied IT programs and exposure-based approaches.
Subject(s)
Delivery of Health Care, Integrated/methods , Stress Disorders, Post-Traumatic/therapy , Substance-Related Disorders/rehabilitation , Diagnosis, Dual (Psychiatry) , Humans , Psychotherapy/methods , Stress Disorders, Post-Traumatic/complications , Substance-Related Disorders/complications , Time Factors , Treatment OutcomeABSTRACT
AIMS: To examine existing evidence on the effectiveness of interventions that are designed to prevent the illegal sale of tobacco to young people. The review considers specific sub-questions related to the factors that might influence effectiveness, any differential effects for different sub-populations of youth, and barriers and facilitators to implementation. METHODS: A review of studies on the impact of interventions on young people under the age of 18 was conducted. It included interventions that were designed to prevent the illegal sale of tobacco to children and young people. The review was conducted in July 2007, and included 20 papers on access restriction studies. The quality of the papers was assessed and the relevant data was extracted. RESULTS: The evidence obtained from the review indicates that access restriction interventions may produce significant reductions in the rate of illegal tobacco sales to youth. However, lack of enforcement and the ability of youth to acquire cigarettes from social sources may undermine the effectiveness of these interventions. CONCLUSIONS: When access interventions are applied in a comprehensive manner, they can affect young people's access to tobacco. However, further research is required to examine the effects of access restriction interventions on young people's smoking behaviour.
