Addressing Addictive Disorders that Induce Recidivism

Carry each other’s burdens, and in this way you will fulfill the law of Christ

(Galatians 6:2).

Evidence-based guidelines are the newest panacea in health care, which involves empirically supported treatments and accountability systems to enhance the process and outcome of care. According to Moss, although substantial progress has been made, several questions remain to be resolved regarding addictive disorders.[1] Moss focuses on three puzzles about the structure and process of treatment.[2] Moss then consider two puzzles about the content of treatment and one about treatment outcome. The final puzzle addresses the context of addictive disorders.

Researchers should explore how effective best practices are disseminated in quality-improvement programs and applied to a diverse patient population under normal treatment conditions.[3] If the prevailing paradigm of evidence-based practices (EBPs) is valid, efforts should lead to better quality care and improved client outcomes. An epic discovery in the foci of research would enable researchers to understand the full implication of the essential role of the social context in the ebb and flow of addictive disorders.[4]

A continuing battle over implementing evidence-based practices is the therapist's lack of basic knowledge and skills to disseminate effective practices. The execution of evidence-based practices extends beyond the therapist but requires a team of service providers. Organizational barriers, such as poor leadership, insufficient collegial support, and bureaucratic constraints hinder the team’s effort to execute and maintain evidence-based practices.[5] A therapist who desires to implement evidence-based programs into their practice should have mastered a basic set of competencies.

According to Moos, evidence-based practices promote supporting the client; alternative goals, new activities, self-efficacy, and coping skills are common to this approach.[6] Evidence-based practices in substance use abusers have shown to be better than treatment as usual in community treatment programs and have exhibited better outcomes than some comparison conditions.[7]

To understand the essence of recovery, ongoing life context factors, formal treatment, and self-help groups they need to be placed in ongoing life context factors.[8] Moos suggest dividing this process into three categories: quality of interpersonal relationships, personal growth goals, and level of structure. Because the influence of any one of these categories depends on the context in which it is embedded, recognizing their interconnections is relevant to effective evidence-based practices.[9]

[1] Rudolf H. Moos, “Addictive Disorders in Context: Principles and Puzzles of Effective Treatment and Recovery.,” Psychology of Addictive Behaviors 17, no. 1 (2003): 4. [2] ibid., 4. [3] ibid., 6. [4] ibid., 6. [5] Patrick W. Corrigan, Leigh Steiner, Stanley G. Mccracken, Barbara Blaser, and Michael Barr, “Strategies for Disseminating Evidence-Based Practices to Staff Who Treat People With Serious Mental Illness,” Psychiatric Services 52, no. 12 (2001): 1603. [6] Rudolf H. Moos, “Addictive Disorders in Context: Principles and Puzzles of Effective Treatment and Recovery.,” Psychology of Addictive Behaviors 17, no. 1 (2003): 6. [7] Patrick W. Corrigan, Leigh Steiner, Stanley G. Mccracken, Barbara Blaser, and Michael Barr, “Strategies for Disseminating Evidence-Based Practices to Staff Who Treat People With Serious Mental Illness,” Psychiatric Services 52, no. 12 (2001): 1603. [8] Rudolf H. Moos, “Addictive Disorders in Context: Principles and Puzzles of Effective Treatment and Recovery.,” Psychology of Addictive Behaviors 17, no. 1 (2003): 7. [9] ibid., 7.