Early intervention strategies in substance abuse

Since the mid-eighties many efforts have been made to develop spezialized intervention strategies and interview techniques aiming at harm reduction and motivational enhancement in patients with substance related disorders. Firstly, the “Transtheoretical Model of Change” by Prochaska and DiClemente, which defines motivation as a dynamic process with several stage dependent intervention possibilities. Secondly, the “Motivational Interviewing” technique by Miller and Rollnick, who strongly suggest an empathic communication style deriving from humanistic psychology. It has been shown that especially persons in early stages of substance related disorders profited very well from such early interventions. Psychiatric institutions not involved in specialized addiction treatment have to face frequent comorbid substance abuse among their patients. Findings of the efficacy of early interventions in general psychiatry are encouraging. Despite there is strong evidence of efficacy of early and motivational intervention strategies in several medical fields, their implementation tends to be very difficult.