Group-Based Strategies for Stress Reduction in Methadone Maintenance Treatment: What Do Patients Want?

Abstract

Objectives-To assess methadone maintenance treatment (MMT) patients' willingness to use, and perceived efficacy of, conventional and unconventional group stress reduction treatments Methods-A survey, developed by the authors, was administered to 150 MMT patients.Results-Levels of treatment willingness and perceived efficacy for both conventional and unconventional treatments were relatively high; however, ratings for conventional interventions were, on average, significantly higher than those for unconventional ones. The highest rated conventional and unconventional treatments in terms of willingness and perceived efficacy were nutrition and spiritual counseling, respectively, while the lowest rated conventional and unconventional group treatments were anger management and visualization training, respectively. White race was a significant predictor of lower willingness to try conventional and unconventional group therapies and lower perceived efficacy of unconventional group treatment, while female sex and older age were significant predictors of higher levels of willingness to try unconventional group treatment. Higher levels of substance use problems were associated with increased willingness to try conventional group treatment. Higher levels of anxiety emerged as a significant independent predictor of treatment willingness and perceived efficacy for both conventional and unconventional group treatments.Conclusions-The relatively high levels of treatment willingness and perceived efficacy of conventional and unconventional group stress reduction treatments point to the feasibility of offering these interventions in MMT and suggest that in particular high levels of anxiety are associated with greater treatment willingness and perceived treatment efficacy.

Management of mood and anxiety disorders in patients receiving opioid agonist therapy: Review and meta-analysis

“…The effectiveness of these therapies could also have derived from decreasing the stress of the individual's negative environment, such as legal issues and/or coping with certain problematic personality features. This decrease in stress could facilitate effective treatment, as reported by Raby et al This is supported by another report that indicated patients on methadone are highly willing to participate in any stress‐reduction group treatment . High levels of anxiety were associated with greater willingness to participate in treatment .…”

“…This decrease in stress could facilitate effective treatment, as reported by Raby et al This is supported by another report that indicated patients on methadone are highly willing to participate in any stress‐reduction group treatment . High levels of anxiety were associated with greater willingness to participate in treatment . In addition, targeting early maladaptive schemas might be beneficial to assist with symptoms of depression and anxiety in patients with OUD …”

“…The presence of symptoms of depression and anxiety in patients with OUD are common, debilitating, and associated with poor outcomes . Patients perceive these symptoms as highly stressful and are willing to engage in treatment to reduce their symptoms …”

A Pilot Investigation of Nonpharmacological Pain Management Intervention Groups in Methadone Maintenance Treatment

“…Studies conducted in MMT settings have found that: (1) counselors are interested in learning NPMIs, especially CBT 14 ; (2) it is feasible to deliver psychoeducation and relaxation training, core components of CBT for chronic pain, in groups 16 ; and (3) patients are interested in receiving groups for stress reduction. 17 In this pilot study, we explored the feasibility of implementing 3 low-cost and easy-to-disseminate NPMI groups in a busy MMT clinic where patients were free to choose which groups to attend: Coping with Pain (CBT-informed), Wii-Covery (an exergame to facilitate exercise), and Juggling Group (an intervention to promote social inclusion and reduce stress). We examined whether (1) patients receiving MMT would attend specific NPMI groups when offered an array of group options (ie, feasibility), and (2) exposure to a single NPMI group session would produce acute improvements in current pain intensity and mood states, important domains related to management of chronic pain.…”

“…Since counseling groups are common in MMT, it may be particularly beneficial to explore the feasibility of NPMI groups. Studies conducted in MMT settings have found that: (1) counselors are interested in learning NPMIs, especially CBT 14 ; (2) it is feasible to deliver psychoeducation and relaxation training, core components of CBT for chronic pain, in groups 16 ; and (3) patients are interested in receiving groups for stress reduction 17 …”