Chances of psychological rehabilitation

Last week, we cited three factors that can make drug rehabilitation a failure and perhaps explained the relapse rate of almost 3/4 among rehabilitated drug dependents in the country, as Philhealth president Alex Padilla disclosed in a news report last month.

I mentioned an updated report from The European Monitoring Centre for Drugs and Drug Addiction ( Perspectives on Drugs: The Role of Psychosocial Interventions in Drug Treatment) finding only one of the commonly used psychosocial interventions in drug rehabilitation showed positive results. I referred results in adult and youth populations.

The six psychosocial interventions are motivational interviewing, brief motivational interviewing, self-help groups, cognitive behavioral therapy, family therapy and contingency management. Only cognitive behavioral therapy appeared to show positive results in adult and youth patients.

Motivational interviewing is used to strengthen personal commitment to change and can be performed by psychotherapists, counsellors or other appropriately trained professionals. Brief motivational interviewing or intervention only takes at most 30 minutes, which involves advising, assessing, assisting and arranging the next consultation and involves non-mental health professionals (e.g. physicians, nurses and other trained professionals).

Self-help groups, like Narcotics Anonymous, have not been studied well due to the inherent confidentiality of their activities and their success rate cannot be established. Family therapy had often been used on youth patients with positive results but not among adult drug dependents. Meanwhile, contingency management, which uses rewards to motivate behavior, showed promise during pharmacological treatment but had not been applied after patient release.

Meanwhile, cognitive behavioral therapy are delivered by licensed psychotherapists. In the country, I have not heard that the Professional Regulations Commission already started licensure examinations for psychotherapists. In fact, in the Philippines, I only found the University of San Carlos offering clinical psychology.

With this lack of professionals wellsuited to provide psychotherapeutic services (psychiatrists are too clinical in training to deliver psychotherapy), psychological rehabilitation of drug dependents is still far from ready today. Thus, the Department of Health may have to find alternative ways of delivering effective psychotherapy using available resources of pharmacologically oriented psychiatrists and non-clinically oriented psychologists in the country. I hope a team of both professionals will work.