title: The use of psychotherapeutic interventions by primary care GPs in Ireland in the treatment of their methadone patients: a grounded theory study.
abstract: BACKGROUND
  The methadone protocol placed responsibility on general practitioners (GPs) for the methadone treatment of stabilised drug-addicted patients. The protocol emphasised a medico-pharmacological model with minor reference to psychotherapeutic treatment.
  
  
  OBJECTIVE
  This qualitative study investigated how primary care GPs in Ireland use psychotherapeutic interventions in the treatment of methadone patients.
  
  
  METHODS
  A grounded theory methodology was used.
  
  
  RESULTS
  There is a wide variation in the beliefs and knowledge of methadone-prescribing GPs regarding the efficacy of psychotherapeutic interventions for patients on methadone maintenance. GPs do not formally integrate psychotherapeutic interventions into methadone patient treatment. Accessing psychotherapeutic services raises concerns for GPs in terms of availability, location and quality. Primary care GPs who offer methadone maintenance view opiate abuse as a health issue similar to other such issues within their community. They take a holistic view of their methadone patient and, without formal guidelines, develop individual approaches to the use of psychotherapeutic interventions. The absence of a framework for the use of psychotherapeutic interventions in primary care methadone treatment in Ireland militates against the development of a basis for improving practice.
authors.affiliation: Mountjoy Street Medical Practice, 53 Mountjoy Street, Dublin 7, Ireland. kennykevin@gmail.com
authors.forename: K
authors.initials: K
authors.lastname: Kenny
authors.forename: A
authors.initials: A
authors.lastname: O'Carroll
mesh_terms: D001291:Attitude of Health Personnel; D037001:Directive Counseling; D058006:General Practice; D006801:Humans; D007494:Ireland; D008691:Methadone / Q000627:therapeutic use; D009294:Narcotics / Q000627:therapeutic use; D058850:Opiate Substitution Treatment; D009293:Opioid-Related Disorders / Q000628:therapy*; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care; D011613:Psychotherapy; D012017:Referral and Consultation
chemical_list: D009294:Narcotics; D008691:Methadone