Evidenzbasierte Therapieverfahren in der stationären Rehabilitation alkoholabhängiger Patienten

Abstract

Evidence-based treatment description is used for knowledge aggregation and knowledge evaluation, for definition of recommendations and encouraging process quality in medicine. Starting with a detailed assessment of therapy studies, the following treatments were specified as effective treatments according to their evidence basing: "training of soft skills", "motivational enhancement therapy", "couple/family therapy", "cognitive behavioural treatment" and "relapse prevention". We examined the analogy of both treatment elements used in inpatient rehabilitation of alcohol dependents and the published knowledge concerning the effectiveness of therapy elements. The examination based on a representative sample of 5540 alcohol dependent patients completed inpatient alcohol rehabilitation in a clinic for drug addiction in 2004. The analyses based on the realized treatment units. The highest utilisation rate resulted for the treatments "information/schooling" with 93.3 %. The utilisation rate of "cognitive behavioural treatment" was 85.4 %, and of "soft skill training" 79.1 %. Low utilisation rates resulted for "relapse prevention" with 29.6 %, "nutrient schooling" (28.9 %), "non-smoker training" (17.3 %), "motivational enhancement therapy" (14.8 %), and the therapy element "groups of mental comorbidity" (11.2 %). 39.5 % of the patients received services from the therapy element "psychoanalytic therapy". On the average, patients took part in 18 treatment offers (SD = 6.8). This were treatment offers of 9 (SD = 2.1) from a total of 14 evidence based treatment categories, on the average. While the scientifically based therapy realization of some treatments, e. g. "soft skill training" and "cognitive behavioural treatment", was at a high level, the low level of utilisation for "relapse prevention" and "motivational enhancement therapy" is surprising on account of their proven effectiveness. Further calculations are to analyze combinations of treatments, the inclusion of demographic variance and to analyse the variance due to different treatment providers.