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Tijdschrift voor Psychiatrie 55 (2013) 11, 907 - 913

Short report

Psychological treatment in substance use disorders: focus for the future

W.A.J.M. de Wildt, E. Vedel

background Cognitive behavioural therapy and motivational interviewing are evidence-based treatments for substance use disorders (suds). However, treatment for suds is still at an early stage and patients are being deprived of many new forms of treatment from which they could benefit. Low treatment compliance and limited treatment success are also problems that need attention.
aim To find out from the literature how these problems can be or are being tackled and to formulate suggestions for improvements.
method We reviewed the literature, collecting and formulating suggestions about possible improvements in the treatment of sud patients. We mention strategies to reduce the treatment gap, to improve treatment compliance and treatment results.
results According to the literature, clinics and hospital wards can introduce more structured screening for substance use disorders. Internet treatment has proven to lower the threshold for treatment. Patients reluctant to begin treatment can be motivated by their loved ones (via craft) to join treatment programmes. E-health is a promising technique for enhancing patients’ compliance with tasks that can be performed at home. The addition of contingency management can increase treatment compliance and encourage abstinence. Furthermore, the treatment of comorbid psychiatric disorders and the provision of continuing-care are strategies that are likely to optimise treatment results.
conclusion A number of viable strategies are available or are being developed for improving the treatment of sud patients. Dutch research has made an important contribution in this area.

keywords addiction, psychological treatment, substance use disorders, treatment