Think about it till it hurts: targeting intensive services to facilitate behaviour change - two examples from the field of substance misuse.
BACKGROUND
In traditional services for people in crisis there is an expectation that those people will come forward and seek help. At a time of crisis this may not be a reasonable expectation.


METHODS
Two proactive and engaging programmes have been developed for substance users in crisis. 'Option 2' is for families at risk of having their children removed. 'STIR' is for people leaving prison. In both cases, a brief but intensive person-focused intervention is offered during the critical period. While both interventions may incorporate standard clinical elements, the distinctive feature they have in common is that workers go to the prospective client and encourage him or her to shape the solution in terms of both defining the immediate practical support they need and beginning to set longer term goals.


RESULTS
In-service evaluations suggest that these services are valued by the clientele, produce measurable change in function for the majority and are likely to save public money.


CONCLUSIONS
Formal research evidence of effectiveness and efficiency might be accomplished by comparing outcomes for similar clients in areas with and without these service options.
Emlyn-Jones
Rhoda
R
Cardiff Alcohol and Drug Team, Cardiff, UK. r.emlyn-jones@cardiff.gov.uk
D000328:Adult; D000437:Alcoholism / Q000523:psychology / Q000534:rehabilitation*; D001521:Behavior Therapy / Q000379:methods*; D002648:Child; D002655:Child Custody; D003299:Cooperative Behavior; D003419:Crisis Intervention / Q000379:methods*; D005196:Family Therapy / Q000379:methods; D005260:Female; D006040:Goals; D006801:Humans; D008297:Male; D010348:Patient Care Team; D011329:Prisoners / Q000523:psychology; D011340:Problem Solving; D012017:Referral and Consultation; D012944:Social Support; D012947:Social Work / Q000379:methods; D019966:Substance-Related Disorders / Q000517:prevention & control / Q000523:psychology / Q000534:rehabilitation*; D016896:Treatment Outcome