The Efficacy of Stepped Care Models Involving Psychosocial Treatment of Alcohol Use Disorders and Nicotine Dependence: A Systematic Review of the Literature

摘要: Of particular interest in the psychosocial treatment of addictions is determining how much therapy required to bring about behaviour change. Stepped care approaches, where non-responders a less intensive receive more intervention, aim only provide assistance those who need it, thereby allocating therapeutic resources efficiently. This paper provides systematic review stepped models involving different levels intervention for alcohol use disorders and smoking cessation. Five publications on three were included review. Due heterogeneity outcome measures, participant characteristics interventions, narrative format was employed. Overall, little evidence found suggest that stepping up improved outcomes, finding could partially be attributed lack power find significant effects. In one study, application approach reduce costs compared with usual care. There some greater differentiation between intensity interventions offered at each step, better outcome. Further research needed evaluate efficacy approaches providing treatment, employing larger samples and/or consistent definitions nature assessing response timely manner.