Psychosoziale Behandlungen bei Suchterkrankungen – Suchtspezifische Psychotherapieformen und ihre Wirksamkeit

Zusammenfassung

Suchterkrankungen sind chronisch rezidivierende Erkrankungen mit zwanghaftem und häufig unkontrolliertem Konsum psychotroper Substanzen oder Reize. In der Übersicht werden die aktuellen suchtspezifischen psychotherapeutischen Interventionen und ihre Wirksamkeit zusammengestellt und diskutiert. Als wirksam gelten neben der Kognitiv-Behavioralen Therapie die Motivierende Gesprächsführung, die Rückfallprävention, der Community Reinforcement Approach und das Kontingenzmanagement. Für diese Psychotherapieformen sind mehrheitlich moderate Effektstärken erzielt worden. Am besten scheint die Cannabisabhängigkeit auf die Interventionen anzusprechen. Derzeit gibt es bei der Drogenabhängigkeit für das Kontingenzmanagement, bei der Alkoholabhängigkeit für die Motivierende Gesprächsführung und den Community Reinforcement Approach die umfangreichste empirische Evidenz. In Zukunft werden Kombinationsbehandlungen und auch Online-Interventionen weitere Fortschritte in der psychosozialen Behandlung der Suchterkrankungen bringen.

Abstract

Addictive disorders are chronic relapsing conditions marked by compulsive and often uncontrolled use of psychotropic substances or stimuli. In this review, we present and discuss the current specific psychosocial interventions for addictive disorders and their effectiveness. In particular cognitive behavioral therapy, motivational interviewing, relapse prevention, the community reinforcement approach, and contingency management were found to be effective. For these psychotherapeutic treatments, mostly moderate effect sizes have been found. Their effectiveness seems to be highest in cannabis dependence. Empirical evidence for dependence on “hard” drugs is largest for contingency management, while for alcohol dependence motivational interviewing and the community reinforcement approach show the largest effect sizes. Presumably, combinations of different approaches as well as online interventions will bring further progress in the psychosocial treatment of addictive disorders in the future.

Schlüsselwörter

Sucht - Psychosoziale Behandlungen - Psychotherapie - Alkohol - Drogen

Key words

addiction - psychosocial interventions - psychotherapy - alcohol - drugs

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