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The Healthy Liver Program, established at the Minneapolis Veterans Affairs Medical Center Substance Use Disorder Clinic, provides screening for exposure to hepatitis infections, a group education class, and an individual nursing appointment to review screening results, give vaccinations for hepatitis A and hepatitis B, and make referrals to the hepatitis clinic as appropriate. A patient chart audit was completed 11 months after the establishment of the Healthy Liver Program. The attendance rate for the educational group and individual feedback sessions was 66.9%, with 94.1% of attendees accepting recommended hepatitis A and/or hepatitis B vaccinations. All patients with chronic hepatitis C who attended the Healthy Liver Program received a referral for evaluation in the hepatitis clinic, as compared with only 50% of patients with chronic hepatitis C who were identified before the establishment of the program. The importance of providing comprehensive educational sessions and recommendations for how patients with substance use disorders can access hepatitis screening, vaccination, and treatment resources are stressed. Keywords: Substance abuse treatment programs; Hepatitis C infections; Hepatitis services; Implementation; Vaccinations

Objective: The objective of this study was to test a model using pretreatment readiness for change scores (Contemplation, Determination and Action) to predict 1-year alcohol use and recovery activities (AA affiliation and having a sponsor). Method: Subjects were 125 middle-aged, mostly white, high school educated, mostly unemployed, male patients who met DSM-III-R criteria for alcohol dependence. The patients participated in a 21-day, Minnesota model, inpatient treatment program. Pretreatment readiness for change was assessed using a modified version of the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES). The prediction model also included four pretreatment variables: DSM-III-R criteria, alcohol consumption, AA affiliation and presence of a sponsor. Logistic regression procedures were used to test the model. Results: High Action scores (and not having a sponsor at pretreatment) were predictive of no reported alcohol use at any time during the 1-year posttreatment period. High Determination scores (and low DSM-III-R criteria scores) were predictive of reported affiliation with AA. Having a sponsor at pretreatment and low Contemplation scores were predictive of reports of having a sponsor at follow-up. There were no relationships between the pretreatment readiness for change measures and the actual quantity and frequency of alcohol consumed. There were indications that at follow-up those patients who affiliated with AA or had a sponsor consumed less alcohol than those patients who did not affiliate with AA or have a sponsor. Conclusions: These results demonstrated a relationship between pretreatment readiness for change and both the decision to drink and to engage in recovery activities; however, it appeared that, once drinking begins, variables other than pretreatment readiness for change influence frequency and quantity of alcohol consumption, Screening tools designed to evaluate whether alcoholics are ready to change seem able to predict patients' future participation in recovery programs but not future drinking patterns. Drinking patterns and participation in recovery programs were evaluated one year after pre-treatment screening tests were performed on 125 patients at an alcohol treatment center. Patients who acknowledged their addiction problems before treatment were more likely to affiliate with recovery programs., (J. Stud. Alcohol 58: 351-357, 1997) A major challenge for substance abuse treatment providers is to better understand who will benefit from what type of treatment and when treatment will [...]

Factor and cluster analysis of the altered stages of Change Readiness and Treatment Eagerness Scales from 165 inpatient substance abusers involved an examination of three dimensions, determination, action and contemplation, and identified three motivational subgroups, uninvolved, ambivalent and active, to facilitate future treatment measures to improve compliance and involvement. The uninvolved group scored lower than the other two groups in alcohol abuse measures while the ambivalent and active groups had similar scores on alcohol use and abuse. The ambivalent group scored high in conflict and inaction while the active group were ready for a behavioral change.

The short form of the Inventory of Drinking Situations (IDS42), which assesses the likelihood of alcoholism relapse in high-risk situations, was evaluated psychometrically. Results showed that negative affect, social pressure, testing personal control,positive affect and physical discomfort may predict future heavy alcohol use insimilar circumstances. The instrument's psychometric stability suggests that generalization may be made using the IDS42 in similar populations. However, IDS42 has to be tested among women and across a variety of demographic characteristics since results apply only to male veterans.

Motivational interviewing (MI) is an evidence-based practice that is being implemented in a wide range of settings. Research supports the importance of ongoing coaching and feedback sessions following initial training in MI to implement and sustain MI-adherent competencies. This article describes the development and preliminary testing of a group feedback and consultation process where clinicians code each others' clinical samples of MI sessions and provide feedback to each other regarding the level of adherence to MI fidelity measures. Preliminary results suggest that group feedback may help clinicians develop and sustain MI skills. [ABSTRACT FROM AUTHOR]