Quality statement 8: Formal psychosocial interventions and psychological treatments

Quality statement

People in drug treatment are offered appropriate formal psychosocial interventions and/or psychological treatments.

Rationale

Evidence-based psychosocial interventions are effective in the treatment of people with drug use disorders. For the best chance of recovery a range of interventions should be provided to meet different needs.

Many people with drug use disorders have comorbid problems, particularly mental health problems that need concurrent or sequential interventions for treatment to be effective.

Quality measure

Structure: Evidence of local arrangements to ensure people in drug treatment are offered appropriate formal psychosocial interventions and/or psychological treatments.

Process:

a) Proportion of people in drug treatment who receive appropriate formal psychosocial interventions.

Numerator – the number of people in the denominator receiving appropriate formal psychosocial interventions.

Denominator – the number of people in drug treatment.

b) Proportion of people in drug treatment who have comorbid depression or anxiety disorders who receive psychological treatments for those disorders.

Numerator – the number of people in the denominator receiving psychological treatments for those disorders.

Denominator – the number of people in drug treatment who have comorbid depression or anxiety disorders.

What the quality statement means for each audience

Service providers ensure systems are in place for people in drug treatment to be offered appropriate formal psychosocial interventions and/or psychological treatments.

Healthcare professionals offer people in drug treatment appropriate formal psychosocial interventions and/or psychological treatments.

Commissioners ensure they commission services that offer people in drug treatment, appropriate formal psychosocial interventions and/or psychological treatments.

People in drug treatment are offered psychosocial treatments including contingency management, behavioural couples therapy and/or psychological treatments that are suitable for their needs.

Source guidance

NICE clinical guideline 51 recommendations 1.4.1.4 and 1.4.2.1 (key priorities for implementation), 1.4.1.3, 1.4.4.1 and 1.4.6.2.

NICE clinical guideline 52 recommendations 1.5.1.2 and 1.5.1.3.

Drug misuse and dependence: UK guidelines on clinical management section 4.2.3 and 4.3.3.

Data source

Structure: Local data collection

Process: a) and b) Local data collection. The National Drug Treatment Monitoring System collects data on all clients receiving specialist treatment for their problematic use of drugs. Data on a range of psychosocial interventions are collected.

Definitions

Formal psychosocial interventions

'Formal psychosocial interventions' have 3 aspects:

  • they need specific competencies to deliver them

  • they are supported by the relevant training and supervision

  • they are an enhanced level of intervention (above and beyond the standard keyworking platform).

Evidence based formal psychosocial interventions are listed in Drug misuse and dependence: UK guidelines on clinical management, NICE clinical guideline 51 and NICE clinical guideline 52. These should be appropriate to the needs and circumstances of the service user and include:

  • contingency management

  • behavioural couples therapy

  • community reinforcement approach

  • social behaviour network therapy

  • cognitive behavioural relapse prevention-based therapy

  • psychodynamic therapy.

Cognitive behavioural relapse prevention-based therapy and psychodynamic therapy should not be used as first-line psychosocial treatments. They may be reserved for individuals who have not benefited from first-line treatments such as brief interventions, contingency management and self-help groups, or in cases where clinical judgement suggests they may be appropriate in the particular circumstances of the case.

Psychological interventions

NICE clinical guideline 90, NICE clinical guideline 91 and NICE clinical guideline 113 recommend evidence-based psychological treatment, in particular cognitive behavioural therapy, for depression and anxiety.

The National Treatment Agency toolkits and resources for healthcare professionals and partners further outlines the effective delivery of psychosocial interventions for people with drug use disorders and with comorbid anxiety or depression