Most current psychotherapeutic approaches are self-focused in terms of focusing attention on how one thinks, feels, behaves or maintains, in one way or another, a pathological chain reactions. The aim of current is to challenge such focus by shifting the focus of attention to serving others rather than analyzing one's self.

Sixty patients were recruited after heroin detoxification, all have been subject to psycho-education about addictive behavior, craving process and risks of relapse. Half of them (group A; n = 30) were subject to weekly basis classical CBT group sessions while the other half (group B; n = 30) were subject to shifting focus approach where they were encouraged to serve on voluntary nonprofit basis at Alexandria university hospitals with weekly group support sessions to share experiences and encourage action. Patients in both arms were followed for 3 months and evaluated in terms of abstinence rate and quality of life.

Both groups were balanced in terms of age, marital status, age of onset of abuse, number of previous detoxification, criminal record and score of the Quality of Life Scale QLS at base line before psychotherapy. After 3 months, no difference as regards abstinence rate between both arms (X2 = 1.763; P = 0.288), also no difference between both groups as regards change in QLS score after 3 months (t = 0.039; P = 0.969).

Shifting focus approach shows no difference in terms of abstinence or quality of life improvement compared to classical CBT in non inferiority study.

The authors have not supplied their declaration of competing interest.