The effects of telephone prompting on attendance for starting treatment and retention in treatment at a specialist alcohol clinic.

OBJECTIVE: To examine the effects of telephone prompting on attendance for the start of treatment and retention in treatment in a specialist alcohol clinic. METHOD: The study setting was a specialist alcohol treatment clinic. Participants were 172 clients attending as out-patients. An ABABAB design was used with planned alternating conditions, respectively, with or without a telephone prompt the day before the client was due to attend, over a succession of six consecutive 4-week periods. RESULTS: Clients who were prompted were more likely to start treatment and attend further treatment sessions than clients who were not prompted. CONCLUSIONS: Telephone prompting is a simple and effective way to improve attendance for the start of treatment and retention in alcohol treatment.

Minimal intervention as a preparation for the treatment of alcohol dependency.

OBJECTIVE: To investigate the use of a minimal intervention as a preparation for treatment of alcohol dependency. METHOD: A randomized-controlled trial with 361 treatment seekers in an alcohol treatment unit in Northwest England. Study variables included recent alcohol intake, participants' views of their drinking problem, and several self-report scale scores. Experimental group participants received an advance leaflet containing advice on reducing alcohol intake. RESULTS: At follow-up participants in the leaflet group were more likely to view their drinking problem as a learnt behaviour. There was a non-significant tendency for more of the leaflet group to attend for assessment by comparison with controls. Significant improvements occurred over time in readiness to change (recognition subscale), self efficacy and dependency, independent of group allocation. CONCLUSIONS: The tendency toward increased attendance rates should be confirmed in a larger sample. Findings have potential implications for the usage of treatment preparatory material.

Treatment outcome following day care for alcohol dependency: the effects of reducing programme length.

Because of the need to maximise treatment adherence and minimise costs, the duration of treatment for alcohol problems should not be longer than is necessary to achieve clinical benefit. The present authors have previously demonstrated the effectiveness of a 10-week outpatient treatment programme. In this paper, they evaluate the effects of reducing the length of the programme to 6 weeks by comparing the outcomes to those of the original programme. One hundred and twenty-four patients were followed up 11 months after choosing the revised 6-week programme. Eighty-eight patients (71%) were successfully contacted. Data collected included alcohol-related problems, use of other services, drinking patterns throughout the follow-up period and details of alcohol intake for the week prior to interview. Reducing the programme length significantly increased the number of patients completing the programme at no cost to clinical effectiveness.

Treatment setting and treatment outcome in alcohol dependency: residential and day-care options compared.

When empowered to select either a residential or a day care treatment programme for problem drinking, more patients favour the latter option. Those completing the full programme, which was similar in content in both settings, were followed up at approximately 9 months after initial engagement in treatment. Attrition was a major problem, particularly in the day-patient sample. Of the 103 patients who began each programme, 91 completed the residential option but only 23 completed all sessions in the day-patient course. Day-care completers tended to have less severe alcohol-related problems than in-patient completers. They were also older, had experienced fewer episodes of alcohol-related admissions in the past and were less likely to show biochemical evidence of alcohol-related physical damage. Both groups showed positive changes in drinking intake, drink-related problems, the use of adjunct services and the self-ratings of improvement throughout the follow-up period. Outcome in the day programme completers group was, however, generally better than that shown by the in-patients. The results should be interpreted with caution owing to the significant inter-group differences at the start of treatment and the considerably higher non-attendance and attrition rates for the day-care programme. A cognitive-behavioural in-patient programme for alcohol dependent patients can be provided in a day-care setting. For some patients, this option is both attractive and effective.