Sk. Avants et al., When is less treatment better? The role of social anxiety in matching methadone patients to psychosocial treatments, J CONS CLIN, 66(6), 1998, pp. 924-931
In response to a need to match drug users to the most appropriate and cost-
effective level of care, it was hypothesized that socially anxious methadon
e-maintained patients would attain greater benefit from coping skills train
ing provided in the context of a low-intensity enhanced standard methadone
maintenance intervention (E-STD) than in the context of a high-intensity, s
ocially demanding day treatment program (DTP). Social anxiety was assessed
in 307 methadone-maintained patients using the Social Anxiety and Distress
Scale prior to randomization to either E-STD or DTP. The hypothesis was sup
ported: Socially anxious patients were drug free longer during treatment, w
ere more likely to be abstinent at treatment completion, and had greater re
ductions in HIV risk behaviors if assigned to the lower intensity intervent
ion, which was provided at 1/3 the cost of the DTP.