The International Treatment Effectiveness Project. Implementing psychosocial interventions for adult drug misusers

Introduction: The International Treatment Effectiveness Project (ITEP) is part of the National Treatment Agencys Treatment Effectiveness strategy, which identified areas for enhancing the quality of treatment interventions. The project was a collaboration between the NTA, the Institute of Behavioural Research (IBR) in Texas and several service providers in the north-west England and London. ITEP utilised a care planning approach (referred to as mapping) in the form of a manual, which was used by trained keyworkers with their clients. Previous research had shown that these psychosocial interventions had a number of positive outcomes in terms of clients treatment experiences and reductions in illicit drug use.
Method: Four services, comprising 24 sites, in Greater Manchester took part in the project. Two services from London were also involved, but due to differences in training schedules the results from London services are not yet available. The psychosocial interventions were developed into a manual by the NTA clinical team and contain two approaches node link mapping and a brief intervention aimed at changing thinking patterns. A number of questionnaires were completed by service staff and clients, which assessed the organisational climate and clients opinions of their treatment. Data was collected in two waves: one before the implementation of the psychosocial interventions and the other three months after implementation. Additionally, two questionnaires were completed by keyworkers trained in implementing the manual, which measured views on training and, at a later period, their views on how useful the manual was.
Findings: Staff were extremely positive about the training and psychosocial interventions. The majority agreed that they were relevant to their needs and found them useful. Lack of time was cited as the main barrier to use. Services that implemented mapping found that clients had better rapport with their keyworkers, there were improved levels of client participation in treatment and clients benefited from better peer support, compared to clients in those services that did not receive mapping, or received very little.
Conclusion: The implementation of the interventions was found to have had a positive effect in several areas. Clients engagement with treatment was found to be higher in those services where mapping was used, compared to services where mapping was either not implemented, or was to a very small degree.