Forschung zur drogenfreien Behandlung in den USA

  • G. De Leon
Part of the Suchtproblematik book series (SUCHT)

Zusammenfassung

Dieser Beitrag gibt einen kurzen Überblick über die Therapie und deren Effektivität für die vier wichtigsten Behandlungsmodalitäten bei Drogenmißbrauch: alleinige Entgiftung, Methadon-Erhaltungsbehandlung (“methadone maintenance”), drogenfreie ambulante Behandlung und stationäre therapeutische Gemeinschaften. Es werden die wichtigsten Erkenntnisse und Schlüsse aus Studien berichtet, die sich mit Klientenmerkmalen als Prädiktoren für Behandlungsergebnis und für den Verbleib in der Behandlung befassen.

Es werden die Forschungsergebnisse über therapeutische Gemeinschaften zum Therapieprozeß und zur Verweildauer dargestellt; im Vordergrund stehen psychische Veränderungen, die Wahrnehmung der Therapie durch die Klienten sowie deren Attribuierung von Therapieeinflüssen. Erste Ergebnisse einer laufenden Untersuchung am Phoenix House an 1055 Patienten über den vorzeitigen Therapieabbruch zeigen, daß zusätzliche therapeutische Interventionen den Verbleib in der Therapie während der ersten 30 Tage geringfügig verbessern. Untersucht wurden drei verschiedene Interventionen: Seminare, die von erfahrenen Mitarbeitern geleitet werden, um die Rolleninduktion in der therapeutischen Gemeinschaft zu erleichtern; Orientierungssitzungen für Gruppen von Familienmitgliedern oder anderen Bezugspersonen, um die Verbindung zwischen diesen und der Behandlungseinrichtung zu stärken; zusätzliche individuelle Beratung, um die Angst vor der Therapie zu reduzieren.

Research on Drug Free Treatment in the United States of America

Summary

This paper is a brief overview of the four major treatment modalities for substance abuse —detoxification, methadone maintenance, drug-free out-patient settings, and drug-free residential therapeutic communities — and an assessment of their relative effectiveness. The key findings and conclusions in studies of client predictors of retention in treatment and of treatment outcome are reviewed.

A review is also given of research at drug-free therapeutic communities on treatment process and retention, with emphasis on psychological changes, client perception of such changes and attribution to treatment influences. First results are presented of a study in progress on 1055 subjects at Phoenix House aimed at reducing the number of early dropouts. Three therapeutic interventions: seminars provided by various senior staff members to facilitate role induction to the therapeutic community, orientation sessions for groups of family members or significant others aimed at strengthening the alliance between family and treatment program, and additional individual counseling to reduce anxiety about treatment, appear to have increased 30-day retention.

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Copyright information

© Springer-Verlag Berlin Heidelberg 1989

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  • G. De Leon

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