Verbesserung bei Patienten durch den Community Reinforcement Approach: Effekte auf Zufriedenheit und psychiatrische Symptome

Zusammenfassung

Patienten mit Suchterkrankungen weisen ein eingeschränktes Wohlbefinden auf. Eine Querschnittsstudie mit einem Prä-Post-Behandlungsdesign wurde durchgeführt, um Behandlungs­effekte des Community Reinforcement Approach (CRA) hinsichtlich Zufriedenheit und psychia­trischer Symptome zu erfassen. Die mehrdimen­sionale CRA-Zufriedenheitsskala (CRA-ZS) wurde eingesetzt, um Zufriedenheit mit verschiedenen Lebensbereichen zu erfassen. Zusätzlich wurden psychiatrische Symptome mit der Depression Anxiety Stress Skalen (DASS-21) und dem Brief Symp­tom Inventory (BSI) erfasst. Alle Erhebungsinstrumente erschienen sensitiv zur Identifikation von Veränderungen zwischen Baseline und Follow-up. Es ergaben sich keine alters-, geschlechts- oder Alkohol/Drogengruppenspezifischen Effekte auf die CRA-ZS-Outcomes und psychiatrischen Erhebungen. Es zeigte sich ein negativer Zusammenhang zwischen psychiatrischen Symptomen und Zufriedenheit in verschiedenen Lebensbereichen. Patienten mit ausgeprägten psychiatrischen Symptomen zur Baseline berichteten vergleichsweise niedrigere Baseline- und Follow-up-Werte auf der CRA-ZS gegenüber Patienten mit initial niedrigen psychiatrischen Symptomen. Neben Erhebungsinstrumenten zur Erfassung psychiatrischer Beschwerden erscheint die CRA-ZS eine interessante Möglichkeit zur Anwendung in Behandlungsevaluationen darzustellen.

Abstract

Patients with substance use disorders are associated with impaired well-being. A cross sectional study with a pre- post treatment design was carried out to examine the value of the Community Reinforcement Approach (CRA) in relation to treatment outcome in terms of satisfaction and psychiatric symptoms. The multidimensional CRA-Happiness Scale (CRA-HS) was employed to measure satisfaction on several life areas. Additionally, psychiatric symptoms, by means of the Depression Anxiety Stress Scales (DASS-21) and Brief Symptom Inventory (BSI), were measured. All instruments appeared to be “sensitive” to detect changes between baseline and follow-up measurement. There were no age, sex and alcohol/drug group effects on the CRA-HS outcomes and psychiatric measures. It was confirmed that psychiatric symptoms were inversely related with satisfaction on life areas. Patients with high baseline levels of psychiatric symptoms reported relatively lower baseline and follow-up scores on the CRA-HS than patients with low initial levels of psychiatric symptoms. Next to instruments that capture psychiatric complaints, the CRA-HS seems to be an interesting option to adopt in program evaluations.

Schlüsselwörter

CRA Zufriedenheitsskala - Alkoholabhängigkeit - Sucht - Community Reinforcement Approach - Erhebungsinstrument - Evaluation

Key words

CRA happiness scale - alcohol dependence - addiction - community reinforcement approach - assessment - evaluation

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