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Biomedical subjects

Ray Hodgson

Publications and source records attributed to Ray Hodgson.

5 recordsLinked to original sources

The clients' perspective on change during treatment for an alcohol problem: qualitative analysis of follow-up interviews in the UK Alcohol Treatment Trial.

AIM: To develop a model of change during and following professional treatment for drinking problems, grounded in clients' accounts. PARTICIPANTS: Subsets of consecutively selected clients of the UK Alcohol Treatment Trial (UKATT), followed-up at 3 months (n = 211) and 12 months (n = 198) after randomization. Location Five statutory and non-statutory alcohol problems treatment agencies in three areas of England and Wales. Data Open-ended interviews conducted according to a brief interview guide, leading to 400-800-word post-interview reports used for analysis (tape-recordings used for auditing purposes). ANALYSIS: Reports analysed by a team according to grounded theory principles, involving an iterative process with successive refinement of interviewing and analysis with each successive batch of data. FINDINGS: A model of change from the clients' perspective was developed. Treatment was seen by clients as facilitating various changes in ways of thinking and/or increased support of various kinds from family and friends, along with new ways of acting in relation to drinking or more generally. For many those changes had led to an appreciation of the benefits accruing to them. Treatment was seen as part of a broader treatment system which included pretreatment assessment, forms of help additional to the trial treatment, plus an element of self-directed change during and following treatment. Taken with awareness of worsening alcohol-related harms, triggering events and external influence to seek treatment (the catalyst system), to which clients continued to refer following treatment, the change process is depicted as a complex, ongoing set of systems in which a trial treatment is embedded. CONCLUSIONS: Models of change should be broadened so that treatment is seen as a complex system of parts, facilitating a nexus of cognitive, social and behavioural changes, embedded within a broader system of events and processes catalysing change. Such a model helps explain the relative absence of between-treatments outcome differences in UKATT and in the alcohol problems treatment and more general psychotherapy research literatures.

Adaptation, Psychological↗

Social behaviour and network therapy basic principles and early experiences.

The present paper reports on the basic principles of a treatment approach currently being used in a National Multicentre Randomised Controlled Trial of Alcohol Treatments in the United Kingdom (UK Alcohol Treatment Trial). The treatment: Social Behaviour and Network Therapy (SBNT) is novel as a package but has been developed by integrating a number of strategies found to be effective in other treatment approaches. The intervention is based on the notion that to give the best chance of a good outcome people with serious drinking problems need to develop positive social network support for change. A brief review of the evidence supporting social treatments for alcohol problems is followed by an outline of the feasibility work and the basic principles that guided the development of SBNT. Process data from the first 33 trial cases and 2 case vignettes are described and discussed. It is concluded that SBNT is a feasible and coherent treatment approach that can be delivered by a range of therapists in the alcohol field.

Alcoholism↗

The FAST Alcohol Screening Test.

Using the Alcohol Use Disorders Identification Test (AUDIT) as the gold standard, the Fast Alcohol Screening Test (FAST) was developed for use in busy medical settings. AUDIT questionnaires were completed by 666 patients in two London accident & emergency (A&E) departments. Using a principal components analysis, as well as sensitivity and specificity indices, a two-stage screening test was developed, using four of the AUDIT items. The first stage involved one item that identified >50% of patients as either hazardous or non-hazardous drinkers. The second stage made use of the other three items to categorize the rest. The performance of this four-item questionnaire was then tested across a range of settings. Opportunistic samples of 100 patients completed AUDIT questionnaires in each of the following National Health Service settings: A&E department, fracture clinic, primary health centre and a dental hospital. It was concluded that the four-item FAST questionnaire had good sensitivity and specificity, across a range of settings, when the AUDIT score was used as the gold standard. The FAST questionnaire is quick to administer, since >50% of patients are categorized using just one question.

Adult↗

Family interventions for alcohol problems.

A growing body of evidence demonstrates that family interventions should be towards the top of the list of effective alcohol prevention and treatment approaches. A recent conference run by the UK Alcohol Education and Research Council presented some of this evidence (go to: aerc.org.uk then 'News' for a summary).

Alcoholism↗