Group Intervention Using Solution Focused Approach for Patients with Substance Abuse Issues

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Authors (including presenting author) :
Lee, TK (1), Yip WK (1), Ip CK (2), Lee SCA (1), Choi KW (1), Lam YL (1)
Affiliation :
(1) Department of Psychiatry, Tai Po Hospital, (2) Department of Psychiatry, North District Hospital
Introduction :
Substance abuse (SA) is associated with a range of mental health problems and could lead to repeated psychiatric admissions. It is also challenging for mental health professionals to engage patients with history of SA and to enhance their motivation to be in abstinence. Solution focused brief therapy (SFBT) is a patient-centred intervention approach which emphasizes clients’ strengths/resources, which could bring positive therapeutic outcome within 3 to 4 sessions and is effective for the SA patients as reported by evidence. A systematic group intervention (4 sessions, 1.5 hours each) had been carried out for patients with SA issues under SFBT’s conceptual framework.
Objectives :
(1) To improve motivation to quit substance usage; (2) To minimize symptoms distress; (3) To enhance self-efficacy for stress coping; (4) To enhance utilization of community resources.
Methodology :
A “Pre-test” vs. “Post-test’ design was employed. Subjects recruited were those having history of SA or ongoing SA problem. Outcome measures were (1) Contemplation Ladder (Ladder) – motivation for quitting SA; (2) Brief Psychiatric Rating Scale (BPRS) & Hamilton Depression Rating Scale (HAMD) – symptom distress; (3) Generalized Self-efficacy Scale (GSES) – stress coping; (4) participant satisfaction survey. Data was analysed using SPSS 23 with Descriptive statistics and Mann-Whitney U test.
Result & Outcome :
Total of 31 patients (Male = 20, Female = 11, Age = 19 - 62) completed the program. Mann-Whitney U test result showed significant result in the comparison between pre-test and post-test median total scores of Ladder, BPRS, HAMD and GSES. Ladder median score was improved from 8 to 9 (U = 240.5, Z = -3.469, p < 0.001); BPRS median score was reduced from 6 to 2 (U = 97.0, Z = -5.437, p < 0.000); HAMD median score was reduced from 5 to 2 (U = 127.5, Z = -5.004, p < 0.000); GSES median score was improved from 28 to 33 (U = 256.0, Z = -3.166, p < 0.002). In the satisfaction survey, most of the participants (n = 29, 93.5%) agreed that they were satisfied with the program. Besides, majority of them (n = 30, 96.8) indicated that the program increased their self-efficacy in utilization of community resources. The captioned program is effective and time-efficient for patients with SA history to enhance motivation for quitting SA, reduce symptom distress, enhance stress coping and utilization of community resources.

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