Home > Effectiveness Bank Bulletin. [Cognitive-behavioral motivational intervention: group versus individual format]

Drug and Alcohol Findings. (2012) Effectiveness Bank Bulletin. [Cognitive-behavioral motivational intervention: group versus individual format]. Drug and Alcohol Findings, 25 Jan,

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External website: http://findings.org.uk/docs/bulletins/Bull_25_01_1...

Randomized controlled trial of a cognitive-behavioral motivational intervention in a group versus individual format for substance use disorders.
Sobell L.C., Sobell M.B., Agrawal S. Psychology of Addictive Behaviors: 2009, 23(4), p. 672–683.

For US problem drinkers and drug users not at the severest end of the spectrum, four sessions of group were as effective as four of individual therapy but took much fewer therapist hours per patient. The little research we have suggests this a common finding, commending group approaches on cost-effectiveness grounds.

Despite the popularity of group-based therapies for substance use problems, just four studies have directly compared outcomes from the same treatment delivered in a group versus an individual format. Each found substance use reductions which did not significantly differ between the formats.

The featured study aimed to add to this scarce literature by randomising problem drinkers and drug users who were not severely dependent to group versus individual formats of the Guided Self-Change Treatment Model. The approach combines motivational interviewing style and techniques with cognitive-behavioural elements, and was developed as a brief treatment for low severity alcohol problems. It features personalised feedback of assessment findings to clients (eg, extent of use, health risks), decisional balance exercises weighing the pros and cons of change, and advice for clients on selecting their treatment goal.

Patients were referred to a Guided Self-Change clinic in Toronto, Canada, or self-referred after seeing an advert aimed at people "Concerned about your drinking (drug use)". Very heavy or highly dependent drinkers or drug users, injectors, and primary heroin users were screened out of the study. The 231 problem drinkers and 56 problem drug (mainly cocaine or cannabis) users who qualified for and agreed to join the study were allocated as appropriate to alcohol or drug versions of the intervention, and then randomly to group or individual formats run by the same therapists. Group and individual formats were intended to run over four sessions of one and a half to two hours and one hour respectively.

264 clients attended at least the first treatment session, forming the cohort whose outcomes were analysed by the study. Of these, all but 23 completed follow-up assessments 12 months after treatment ended. The 264 patients were typically employed men in their thirties and forties and most had never before been in substance use treatment.

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