Finding the ideal place for a psychotherapeutic intervention in a stepped care approach – a brief overview of the literature and preliminary results from the Project PREDICT

✍ Scribed by M. Berner; C. Günzler; K. Frick; L. Kriston; B. Loessl; R. Brück; H. Gann; A. Batra; K. Mann

• Publisher: John Wiley and Sons
• Year: 2008
• Tongue: English
• Weight: 88 KB
• Volume: 17
• Category: Article
• ISSN: 1049-8931
• DOI: 10.1002/mpr.250

✦ Synopsis

Aims: To provide an overview over empirical evidence regarding stepped care approaches that include psychotherapies. To present own preliminary study results in alcohol dependent patients. Methods: Publications were searched in the databases Medline, PsycINFO and the internet search engine Google Scholar.

Inclusion criteria were psychosocial treatment and psychiatric disorders. Our own study consists of two steps. In step 1 patients receive anti-craving medication or placebo and Medical Management (MM). After a relapse to heavy drinking patients can step up and after randomization they either continue with the same treatment or they receive additional alcoholism specifi c psychotherapy (ASP).

Results: Evidence suggests that stepped care might be effi cacious in patients with obsessive-compulsive behavior and depression. There is no evidence for effi cacy in problem drinkers. Results of our own study show that the completer rate in MM alone is higher than in ASP with MM, but there are no signifi cant differences concerning age, sex and disease severity between completer and non-completer in both study arms. Conclusions: Further research with regard to stepped care in alcohol dependent patients is needed. An introduction of the psychotherapy at earlier stages might be sensible.