What is Usual About "treatment-as-usual"? Data from Two Multisite Effectiveness Trials

Overview

Journal J Subst Abuse Treat

Specialty Psychiatry

Date 2008 Mar 14

PMID 18337053

Citations 45

Authors

Elizabeth J Santa Ana

Steve Martino

Samuel A Ball

Charla Nich

Tami L Frankforter

Kathleen M Carroll

Affiliations

Soon will be listed here.

Abstract

Despite increased emphasis on broadening the implementation of empirically supported therapies (ESTs) to improve standard clinical practice and patient outcomes, objective descriptions of what actually constitutes standard practice in community-based drug abuse treatment do not exist. We present data from independent ratings of 379 audiotapes drawn from the "treatment-as-usual" arm of two multisite randomized effectiveness trials in the National Institute on Drug Abuse Clinical Trials Network. As expected, the most frequently occurring strategies involved assessing the participant's substance use and social functioning, asking open-ended questions, discussing problems and feedback, and giving advice and direction. However, a number of interventions associated with ESTs were very rarely implemented in these early sessions. These data suggest missed opportunities for optimally engaging patients in the early stages of treatment and enhancing substance use outcomes and only moderate success to date of efforts to bridge the gap between research and practice.

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