[Investigating actual conditions to clarify issues accompanying SMARPP]

Serigaya Methamphetamine Relapse Prevention Program (SMARPP) is an effective treatment program for drug-dependent patients that has been introduced by many psychiatric institutions. To conduct SMARPP effectively, the issues accompanying this program need to be clarified. Recently, an investigation was conducted on the healthcare/medical institutions that introduced this program and the results are reported in this study.

Of healthcare/medical institutions that have introduced SMARPP as of June 2012, 35 were selected as subjects.

Responses were collected from 26 institutions. Responses were also collected from 165 healthcare professionals who have conducted SMARPP at the 26 institutions. About 35% of the institutions were not medical institutions specializing in treatment of drug dependence. Of the healthcare professionals who have conducted the program, 26.7% (n = 44) completed a SMARPP training course; with most of them having no opportunity to participate in a training course before conducting it. Forty-three percent of them (n = 71) conducted the program once a week. The staff in charge of SMARPP reported participants' troublesome words and actions that they confronted. There were 60 cases in which the staff found it difficult to answer the participant's question, 91 cases in which they found it difficult to respond to the participant's behavior, and 98 cases in which they found it difficult to lead the meeting. Most of these words and actions seemed to reflect .'resistance' that was recognized in the course of treatment of drug dependence/alcoholism. The 'resistance' can be categorized into the following two types: 'resistance' to staying away from drug/alcohol which is also called 'suction talk' and 'resistance' reflecting 'discord' in the treatment relationship. Because physicians and psychologists were generally in charge of meetings, they frequently found it difficult to cope with troublesome situations. More healthcare professionals with the experience of treatment of drug dependence/alcoholism recognized difficulty in coping with them. This is probably because, unlike the conventional treatment for dependence emphasizing guiding or educational aspect, SMARPP is an intervention focusing on raising awareness. As a method of intervention for the participants in SMARPP, the intervention that does not control patients' 'resistance,' characteristic of motivational interviewing, seems to be effective.