[PDF] Brief Intervention and Brief Therapies for Substance Abuse

View - Download Brief Intervention and Brief Therapies for Substance Abuse

Previous PDF

Next PDF

Center for Substance Abuse Treatment

T reatment Improvement Protocol (TIP) Series

Treatment mprovement Protocol TP Serie

Rockville, MD 20857

This publication was prepared under contract number 270-95-0013 for the Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and

Human Services (HHS). Sandra Clunies, M.S.,

I.C.A.D.C., served as the Contracting Officer"s

Representative

The opinions expressed herein are the views of

the consensus panel members and do not necessarily reflect the official position of

SAMHSA or HHS. No official support of or

endorsement by SAMHSA or HHS for these opinions or for the instruments or resources described are intended or should be inferred.

The guidelines presented should not be

considered substitutes for individualized client care and treatment decisions.

All materials appearing in this volume except

those taken directly from copyrighted sources are in the public domain and may be reproduced or copied without permission from

SAMHSA or the authors. Citation of the source

is appreciated. However, this publication may not be reproduced or distributed for a fee without the specific, written authorization of the

Office of Communications, SAMHSA, HHS. This publication may be ordered for free from SAMHSA"s Publications Ordering Web page at http://store.samhsa.gov. Or, please call

SAMHSA at 1-877-SAMHSA-7 (1-877-726-4727)

(English and Español). The document can be downloaded from the KAP Web site at http://kap.samhsa.gov.

Center for Substance Abuse Treatment. Brief

Interventions and Brief Therapies for Substance

Abuse. Treatment Improvement Protocol (TIP)

Series, No.

34. HHS P

ublication No. (SMA) 12- 3952
. Rockville, MD: Substance Abuse and

Mental Health Services Administration, 1999.

Quality Improvement and Workforce

Development Branch, Division of Services

Improvement, C

enter for Substance Abuse

Treatment, Substance Abuse and Mental Health

Services Administration, 1 Choke Cherry Road,

Rockville, MD 20857.

HHS Publicat

ion No. (SMA) 12-3952

First P

rinted 1999

Revised 2002, 2003, 2004, 2007, 2009, 2011, and

2012
ii

Contents

What Is a TIP?........................................................................ .................................................................................. vii

Editorial Advisory Board

................................................................ ix

Consensus Panel

.............................................................................. xi .......................................................................................... xiii

Executive Summary and Recommendations

............................. xv

Summary and Recommendations

................................................................................................................... xvi

Chapter 1—Introduction to Brief Interventions and Therapies ........................................................................

1

An Overview of Brief Interventions

An Overview of Brief Therapies

......................................................................................................................... 7

The Demand for Brief Interventions and Therapies

Barriers to Increasing the Use of Brief Treatments

Evaluating Brief Interventions and Therapies

Chapter 2—Brief Interventions in Substance Abuse Treatment

Stages-of-Change Model .................................................................................................................................... 14

Goals of Brief Intervention................................................................................................................................. 16

Components of Brief Interventions

Brief Intervention Workbooks

Essential Knowledge and Skills for Brief Interventions Brief Interventions in Substance Abuse Treatment Programs

Brief Interventions Outside Substance Abuse Treatment Settings ...............................................................28

Research Findings

............................................................................................................................................... 30

Chapter 3—Brief Therapy in Substance Abuse Treatment ......37

Research Findings

............................................................................................................................................... 38

When To Use Brief Therapy

Approaches to Brief Therapy

Components of Effective Brief Therapy ...........................................................................................................41

Therapist Characteristics

.................................................................................................................................... 49

Chapter 4—Brief Cognitive-Behavioral Therapy........................................................................

......................51

Behavioral Theory

............................................................................................................................................... 51

Behavioral Therapy Techniques Based on Classical Conditioning Models

Behavioral Therapy Techniques Based on Operant Learning Models ........................................................55

Cognitive Theory ................................................................................................................................................ 61

Cognitive Therapy

.............................................................................................................................................. 63

Cognitive-Behavioral Theory

Cognitive-Behavioral Therapy

Chapter 5—Brief Strategic/Interactional Therapies ..................87

Solution-Focused Therapy for Substance Abuse

............................................................................................ 88 Compatibility of Strategic/Interactional Therapies and 12-Step Programs

When To Use Strategic/Interactional Therapies

Case Study

........................................................................................................................................................... 92

Strategic/Interactional Therapies

Chapter 6—Brief Humanistic and Existential Therapies .......105

Using Humanistic and Existential Therapies

The Humanistic Approach to Therapy ..........................................................................................................109

The Existential Approach to Therapy

Chapter 7—Brief Psychodynamic Therapy

...............................121

Background

........................................................................................................................................................ 121

Introduction to Brief Psychodynamic Therapy

Psychodynamic Psychotherapy for Substance Abuse .................................................................................123

Psychodynamic Concepts Useful in Substance Abuse Treatment

Transference

....................................................................................................................................................... 131

Models of Brief Psychodynamic Therapy

Other Research

.................................................................................................................................................. 140

Chapter 8—Brief Family Therapy

Appropriateness of Brief Family Therapy

..................................................................................................... 144

Definitions of “Family"

.................................................................................................................................... 145

Theoretical Approaches

................................................................................................................................... 147

Using Brief Family Therapies

.......................................................................................................................... 152

Followup

............................................................................................................................................................ 154

Cultural Issues

................................................................................................................................................... 154

Chapter 9—Time-Limited Group Therapy

...............................157

Appropriateness of Group Therapy

Group Therapy Approaches

............................................................................................................................ 158

Theories of Group Therapy

Use o f Psychodrama Techniques in a Group Setting ................................................................................... 164

Therapeutic Factors

.......................................................................................................................................... 166

Using Time-Limited Group Therapy

Appendix A—Bibliography........................................................................ ......................................................... 173

Appendix B—Information and Training Resources

...............209

General Brief Therapy

...................................................................................................................................... 209

Cognitive-Behavioral Therapy

Strategic/Interactional Therapies

Humanistic and Existential Therapies

Psychodynamic Therapy.................................................................................................................................. 213

Family Therapy

................................................................................................................................................. 213

Group Therapy

.................................................................................................................................................. 214

Appendix C—Glossary

................................................................. 215

Appendix D—Health Promotion Workbook

............................221

Part 1: Summary of Health Habits..................................................................................................................221

Part 2: Types of Drinkers in the U.S. Population.......................................................................................... 222

Part 3: Consequences of Heavy Drinking

Part 4: Reasons To Quit or Cut Down on Your Drinking ............................................................................ 224

Part 5: Drinking Agreement

Part 6: Handling Risky Situations

Appendix E—Resource Panel ........................................................................

Appendix F—Field Reviewers

Figures

1-1 Substance Abuse Severity and Level of Care ........................................................................

...................4

1-2 Goal of Brief Interventions According to Setting..................................................................................... 6

2-1 The Stages of Change

................................................................................................................................. 15

2-2 Sample Objectives

...................................................................................................................................... 16

2-3 American Society of Addiction Medicine (ASAM) Patient Placement Criteria

.................................18

2-4 FRAMES

...................................................................................................................................................... 19

2-5 Scripts for Brief Intervention

2-6 Screening for Brief Interventions for Alcoholism

2-7 Client Feedback and Plan of Action

2-8 Talking About Change at Different Stages

2-9 Steps in Active Listening

2-10 Professionals Outside of Substance Abuse Treatment Who Can Administer

Brief Interventions

...................................................................................................................................... 28

3-1 Criteria for Longer Term Treatment

3-

2 Selected Criteria for Providing Brief Therapy

3-3 Approaches to Brief Therapy

3-4 Characteristics of All Brief Therapies

3-5 Sample Battery of Brief Assessment Instruments

4-1 Classical Conditioning and Operant Learning

4-2 Basic Assumptions of Behavioral Theories of Substance Abuse and Its Treatment ......................... 53

4-3 Advantages of Behavioral Theories in Treating Substance Abuse Disorders

....................................54

4-4 Functional Analysis

.................................................................................................................................... 56

4-5 Teaching Stress Management

................................................................................................................... 60

4-6 Programmed Therapy and Writing Therapy

4-7 The Relationship Among Factors Maintaining Behavior in Behavioral and

Cognitive Models

....................................................................................................................................... 62

4-8 Fifteen Common Cognitive Errors

4-9 Characteristic Thinking ofPeople With Substance Abuse Disorders .................................................64

4-10 Common Irrational Beliefs About Alcohol and Drugs With More Rational Alternatives

...............65

4-11 Thoughts, Feelings, and Behaviors

4-12 Introducing Cognitive Therapy: A Sample Script

................................................................................. 67

4-13 Common Elements of Brief CognitiveBehavioral Therapies ..............................................................69

704-14 Attributional Styles

4-15 Relapse Prevention Model Based on Self-Efficacy Theory

4-16 Taxonomy of High-Risk Situations Based on Marlatt"s Original

Categorization System

4-17 A CognitiveBehavioral Model of the Relapse Process ........................................................................

76

4-18 Essential and Unique Elements of CognitiveBehavioral Interventions ............................................78

4-19 Intrapersonal and Interpersonal Skills Training Elements

................................................................... 80

4-20 Assertiveness Training .............................................................................................................................. 80

4-21 Types of Clients for Whom Outpatient CBT Is Generally Not Appropriate

......................................85

5-1 Deliberate and Random Exceptions to Substance Abuse Behaviors

5-2 Strategic/Interactional Therapy in Practice: A Case Study

6-1 A Case Study

............................................................................................................................................. 111

7-1 Defense Mechanisms

................................................................................................................................ 132

7-2 Brief Psychodynamic Therapy ................................................................................................................136

What Is a TIP?

T reatment Improvement Protocols (TIPs) are developed by the Substance Abuse and Mental Health Services

Administration (SAMHSA) within the U.S.

Department of Health and Human Services

(HHS). Each TIP involves the development of topic-specific best-practice guidelines for the prevention and treatment of substance use and mental disorders. TIPs draw on the experience and knowledge of clinical, research, and administrative experts of various forms of treatment and prevention. TIPs are distribute d to facilities and individuals across the country.

Published TIPs can be accessed via the Internet

at http://kap.samhsa.gov.

Although each consensus-based TIP strives

to include an evidence base for the practices it recommends, SAMHSA recognizes that behavioral health is continually evolving, and research frequently lags behind the innovations pioneered in the field. A major goal of each TIP is to convey "front-line" information quickly but responsibly. If research supports a particular approach, citations are provided. vii

Editorial Advisory Board

Karen Allen, Ph.D., R.N., C.A.R.N.

Professor and Chair

Department of Nursing

Andrews University

Berrien Springs, Michigan

Richard L. Brown, M.D., M.P.H.

Associate Professor

Department of Family Medicine

University of Wisconsin School of Medicine

Madison, Wisconsin

Dorynne Czechowicz, M.D.

Associate Director

Medical/Professional Affairs

Treatment Research Branch

Division of Clinical and Services Research

National Institute on Drug Abuse

Rockville, Maryland

Linda S. Foley, M.A.

Former Director

Project for Addiction Co

unselor Training

National Association of State Alcohol and

Drug Abuse Directors

Washington, D.C.

Wayde A. Glover, M.I.S., N.C.A.C. II

Director

Commonwealth Addictions Consultants and

Trainers

Richmond, Virginia

Pedro J. Greer, M.

D.

Assistant Dean for Homeless Education

University of Miami School of Medicine

Miami, Florida Thomas W. Hester, M.D.

Former State Director

Substance Abuse Services

Division of Mental Health, Mental

Retardation and Substance Abuse

quotesdbs_dbs25.pdfusesText_31

[PDF] Le crédit immédiat image-chèque - Bred

[PDF] MOELLER - Guide de sélection : Systèmes d 'automatisme - AUDIN

[PDF] Automate programmable S7-300 Fonctions intégrées CPU 312 IFM

[PDF] SIMATIC Système d 'automatisation S7-300,installation et

[PDF] ( ))(3 ( ) AUTOMATIQUE CONTINUE exercices - Site des SII du lycée

[PDF] Automatique Linéaire 1

[PDF] Automatique Linéaire 1

[PDF] Automatique Linéaire 1

[PDF] Automatique - Systèmes linéaires, non linéaires, temps continu

[PDF] calendrier universitaire trimestre d 'automne 2017 - UQAC

[PDF] sa batterie solaire

[PDF] Bac S 2015 Liban Correction © http://labolyceeorg Spécialité

[PDF] Bac S 2015 Liban http://labolyceeorg Spécialité EXERCICE III

[PDF] Autonomie dans les pratiques infirmières hospitalières, contribution

[PDF] L 'autonomisation économique des femmes dans l 'espace