1. Client characteristics and treatment needs (CARED-Project)*
Dilek Sonntag
1st REITOX Academy 2007
Berlin, March 29-30, 2007
*Funded by the Federal Ministry of Health and Social Security
Source: Simon, Sonntag, Bühringer & Kraus (2005). CARED-Project. BMGS. To be download.

2. Method 52 out-patient facilities all over Germany.
clients with a primary cannabis related problem (ICD-10; F12.1, F12.2)
Survey 1 (clients-questionnaire), retrospectively (N=223), response rate= 40%
Survey 2 (CIDI), clients currently undergoing therapy (N=51)
Survey 3 (staff-questionnaire) (N=183)

3. Socio-demographic characteristics
Typical client in out-patient centre:
Male (86%)
Between years (M=22, sd=5)
Lives with parents (40%)
Single with unsteady partners
55% in education (school/work)
23% unemployed
Onset of cannabis use with 15 years

4. Prevalence of use

5. Heterogeneity Low-risk Moderate-risk High-risk Days of use
No. in the last 30 days
1,0
14,1
28,7
Frequency /day
3,4
7,0
10,8
Heavy use (lifetime)
Yes
53,4
59,6
78,1
Number
1,17
5,0
7,33
Duration (months)
17,4
13,9
15,2
Diagnosis
Misuse
14,4
27,6
4,1
Dependence
56,7
63,8
87,7
Total
40,9
26,4
32,7

6. Comorbidity 64% single cannabis diagnosis 21% with alcohol
12% with amphetamines + ecstasy
11% with psychotic disorders
39% with affective disorders
15% with anxiety disorders

7. Self- and external motivation for counselling

8. Counselling and goals

9. Change motivation (in percent)
Low-risk
Moderate-risk
High-risk
Phases
Precontemplation 31 22 11
Contemplation 46 62 70
Action 16 19
Total 90 58 72

11. Summary 85% a ICD-10 diagnosis 15% sub-threshold problems
64% single cannabis diagnosis
Majority of clients has comorbid substance use and psychological disorders
3 client clusters: low (41%), moderate (26%) and high-risk (33%)
differ in problems, characteristics of use and treatment needed, but not socio-economic sit.
Voluntary help seeking and because of parents
Goals: reduction, abstinence and dealing with other problems
Satisfied with counselling, high-risk clients more critical
21/21

12. Conclusion
Improved diagnostic phase (development of screening instruments)
Tailored treatment approach
Low-risk: information, referral, in social or school system
Moderate-risk: motivation to change, controlled use, work with parents and peers
High-risk: training of staff to specialize to individual cannabis oriented problems, abstinence-oriented
Re-orientation of out-patient facilities
Younger clients
Parents‘ work
Peer access