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Evidence summaries

Family Therapy for Drug Abuse

Family therapy appears to be more effective than individual counselling, peer group therapy or family psychoeducation in treatment of drug abuse. Day programmes may be effective in adolescents with substance abuse. Level of evidence: "B"

A meta-analysis of drug abuse outcome studies 1 involving 1 571 cases and an estimated 3500 patients and family members that family therapy was more effective than individual counselling, peer group therapy or family psychoeducation. Family therapy was as effective for adults as for adolescents and appeared to be a cost-effective adjunct to methadone maintenance.

A technology assessment report 2 assessing the effectiveness of programmes for serious adolescent mental and substance abuse problems was abstracted in the Health Technology Assessment Database. The review was based on profound literature searches. The authors conclude that present evidence favours the use of family therapy over individual therapy in adolescents with mental illness. This evidence is stronger for adolescents with anorexia nervosa than those with other diagnoses. There was no sufficient evidence on the effectiveness of day-care programmes for adolescents with mental illness. Day programmes appeared to be effective in reducing substance abuse and improving educational outcome.

Comment: The quality of evidence is downgraded by heterogeneity of interventions and outcomes.

    References

    • Stanton MD, Shadish WR. Outcome, attrition, and family-couples treatment for drug abuse: a meta-analysis and review of the controlled, comparative studies. Psychol Bull 1997 Sep;122(2):170-91. [PubMed]
    • Adolescent therapeutic day programmes and community-based programmes for seious mental illness and serious drug and alcohol problems: a critical appraisal of the literature. Christchurch: NewZealand Health Technology Assessment (NZHTA). NZHTA Report 5. 1998. [DARE]

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