Quality standard

Quality statement 8: Formal psychosocial interventions and psychological treatments

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.

Data source: Local data collection.

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.

Data source: 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.

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.

Data source: 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.

What the quality statement means for different audiences

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

Drug misuse in over 16s: psychosocial interventions. NICE guideline CG51 (2007), 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

Drug misuse in over 16s: opioid detoxification. NICE guideline CG52 (2007), recommendations 1.5.1.2 and 1.5.1.3

Drug misuse and dependence: UK guidelines on clinical management. Department of Health and Social Care (2007), section 4.2.3 and 4.3.3

Definitions of terms used in this quality statement

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's guidelines on drug misuse in over 16s: psychosocial interventions and drug misuse in over 16s: opioid detoxification. 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's guidelines on depression in adults and generalised anxiety disorder and panic disorder in adults recommend evidence-based psychological treatments for depression and anxiety.