Abstract
This study evaluated an outpatient treatment programme for stimulant drug misusers based in a Central London outpatient NHS setting. The design of the programme was broadly cognitive-behavioural, specifically using motivational, educational, lifestyle and relapse prevention components and was conducted over a six-month period in a step-wise, structured manner. Qualitative and quantitative measures were taken in order to evaluate outcome and the general issue of the treatment efficacy of this model for such a population. Given the small initial sample size (n=5) and subsequent drop-out’s from treatment, the quantitative data was presented in single case study form. The qualitative data was provided by a pretreatment focus group attended by all of the initial sample. Although there are limitations to the generalisability of the data to treatment populations, the results are promising and provide preliminary support for the use of cognitive behavioural interventions for the treatment of stimulant misusers on an outpatient basis. Such support is shown on a number of dimensions provided by the data. The single case study outcome not only indicates marked changes in drug using and related behaviours from baseline to end of treatment but also that there are specific changes on particular dimensions relating to the treatment focus of the time ie. relapse prevention or motivational work, therefore also supporting the efficacy of the psychological construct underpinning each phase of treatment. The focus group highlighted a number of interesting issues which also provide support for the treatment intervention in a non-empirical way. The results are discussed in terms of future service development and the implications for the outpatient treatment of stimulant misusers. Issues of access and retention in treatment and patient - treatment matching within a heterogenous population are highlighted and discussed in the context of resource implications and future programme development and evaluation.