Table 10Characteristics of studies evaluating assertive methods

StudyStudy designComparisonsOutcomesBaseline severityTreatment characteristicsResults
Non-randomised parallel cohort pilot studyFlexible access clinic (ACT methods)

Usual care clinic
Percentage completed assessment

Percentage completed aftercare

Percentage completed medically assisted withdrawal
Alcohol units per week (mean [SD]):

Flexible access: 143(111)

Usual care: 177 (120)
Flexible access clinic (n = 188): two walk-in weekly slots, each of 3 hours; two full-time CPNs, social workers, clinical psychologists and medical cover provided by staff of community alcohol team. Offered community-based assessments whenever patients had failed to attend. Modelled on ACT in the sense that it targeted patients with a history of disengagement; maintained a small case load; operated proactively and engaged assertively; it offered flexible access including assessment and treatment in the community where required; run by a CPN care coordinator working within a multidisciplinary team that met frequently, typically after each assessment or review.

Usual care clinic (n = 223): two full-time specialist CPNs and two social workers. Full time medical staff; large caseload (25 to 30), multidisciplinary case discussion took place once weekly or less, community-based assessments were not offered and limited integration of health and social care staff work.
No significant differences between the two groups on percentage completing assessment.

Significant differences found between two groups on percentage completed withdrawal programmes, p <0.05 (in favour of flexible access clinic) and percentage entered aftercare, p <0.02


Cover of Alcohol-Use Disorders
Alcohol-Use Disorders: Diagnosis, Assessment and Management of Harmful Drinking and Alcohol Dependence.
NICE Clinical Guidelines, No. 115.
National Collaborating Centre for Mental Health (UK).
Leicester (UK): British Psychological Society; 2011.
Copyright © 2011, The British Psychological Society & The Royal College of Psychiatrists.

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