Alcohol and Alcoholism Advance Access originally published online on April 24, 2008
Alcohol and Alcoholism 2008 43(4):451-455; doi:10.1093/alcalc/agn025
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Pilot Study of Assertive Community Treatment Methods to Engage Alcohol-Dependent Individuals
1 Division of Mental Health, Section of Addictive Behaviour, St George's, University of London, Cranmer Terrace, London SW17 0RE, UK and
2 South West London and St George's Mental Health NHS Trust, Springfield University Hospital, 61 Glenburnie Road, London SW17 7DJ, UK
* Corresponding author: Professor Colin Drummond, National Addiction Centre, PO48, Division of Psychological Medicine and Psychiatry, Institute of Psychiatry, King's College London, 4 Windsor Walk, London SE5 8BB; E-mail: Colin.Drummond{at}iop.kcl.ac.uk
Received 10 December 2007; in revised form 18 January 2008; in revised form 17 March 2008; accepted 20 March 2008
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Abstract |
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Aims: Assertive approaches to treatment, which are becoming established for individuals with severe and enduring mental illness, may also be beneficial for engaging alcohol-dependent individuals without severe psychiatric co-morbidity, but so far there has been little research on this. This pilot study looked at the feasibility and potential benefits of introducing assertive community methods into the treatment of alcohol-dependent individuals with a history of poor engagement. Methods: Non-randomized parallel cohort study comparing a Flexible Access Clinic employing assertive community treatment methods with the Usual Care Clinic. Participants were individuals re-referred to our service after they had previously disengaged from treatment. Results: Patients receiving assertive treatment attended assessment a mean of 14 days earlier than those receiving treatment as usual. Treatment at the Flexible Access Clinic was associated with significantly higher rates of completing assisted alcohol withdrawal (35% versus 26%) and entering an aftercare placement (23% versus 14%). Aftercare was entered significantly earlier in the Flexible Access Clinic group (93 days versus 125 days). Conclusions: These promising results point to the feasibility and potential efficacy of assertive community treatment methods for alcohol dependence, and the need for a randomized controlled trial of effectiveness and cost effectiveness.