...the most reliable recipe for a successful therapy experience is that strong therapeutic alliance plus a therapist able to explain the problem and the process skillfully, along with a treatment approach that the patient finds believable.
One program complained that the incentive program seemed to work best with people who were already more motivated, and not as well with more resistant clients.
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If you’d paid thousands of dollars in order to travel to a foreign country for a last-ditch, Hail Mary-type grab at lasting relief, wouldn’t you really want it to work?
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I get frequent questions from providers unsure how well their telehealth clients are actually doing, in terms of common measures like, say, substance use. Are they drinking, still using drugs?
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Of the patients I met, all decided on aversion therapy for essentially the same reason: they’d tried other things, experienced relapse, and lost patience.
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Of more than 9000 Veterans Administration patients, only one-quarter rated their pain control with opioids as excellent or very good.
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Research admittedly takes a long time, including the need for replication, and patients in clinical programs aren’t necessarily willing to wait.
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Perhaps more important, the patient could begin to resume a normal life.
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“It’s too much like doing your taxes,” was her verdict. That’s probably the worst thing I’ve heard anyone say about psychotherapy.
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Some approaches are better than others at helping an individual identify what works for them in understanding their disease and establishing a stable recovery.
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A new study may be exciting to read, but its credibility will ultimately depend on the accumulation of a body of evidence that confirms it.
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We may be stuck relying on the soft stuff– therapy, support, behavior change, even spiritual growth– all those icky-squicky things that neuroscientists struggle to quantify.
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Not surprisingly, the vast majority of patients who drop out or otherwise leave maintenance programs return to heroin at rates of 80% or higher.
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