EVIDENCE-BASED ADDICTION TREATMENT
CONTENTS PART 1 INTRODUCTION TO EVIDENCE BASED PRACTICES 1 CHAPTER 1 WHAT IS EVIDENCE BASED TREATMENT 3 SUMMARY POINTS 3 WHAT DOES EVIDENCE BASED MEAN 5 EVALUATING THE EVIDENCE 6 EXAMPLES OF KEY STUDIES AND NDINGS 11 EXAMPLES OF EVIDENCE BASED TREATMENTS 14 CONCLUSIONS AND FUTURE DIRECTIONS 17 REFERENCES 18 CHAPTER 2 THE CLINICAL COURSE OF ADDICTION TREATMENT THE ROLE OF NONSPECI C THERAPEUTIC FACTORS 21 SUMMARY POINTS 21 INTRODUCTION 22 ACCESSING TREATMENT 25 TREATMENT ENGAGEMENT AND OUTCOMES 29 CONCLUSIONS 36 REFERENCES 36 PART 2 CLINICAL ASSESSMENT AND TREATMENT MONITORING 47 CHAPTER 3 HISTORY AND CURRENT SUBSTANCE USE 49 SUMMARY POINTS 49 SELF REPORT INTERVIEW METHODS OF ALCOHOL AND OTHER DRUG CONSUMPTION 52 BIOMARKER MEASURES OF ALCOHOL AND ILLICIT DRUG CONSUMPTION 67 GENERAL SUMMARY AND CONCLUSIONS 72 REFERENCES 73 CHAPTER 4 DEPENDENCE AND DIAGNOSIS 77 SUMMARY POINTS 77 INTRODUCTION 78 DE NING SUBSTANCE USE DISORDERS 78 SCREENING METHODS 82 DIAGNOSTIC ASSESSMENT 84 SUMMARY 86 REFERENCES 86 CHAPTER 5 ASSESSMENT OF CO OCCURRING ADDICTIVE AND OTHER MENTAL DISORDERS 89 SUMMARY POINTS 89 DE NITIONS 90 FEATURES OF CO OCCURRING DISORDERS THAT INFORM ASSESSMENT 90 SCREENING FOR AMDS 100 REFERENCES 111 CHAPTER 6 INDIVIDUALIZED PROBLEM ASSESSMENT I ASSESSING COGNITIVE AND BEHAVIORAL FACTORS 119 SUMMARY POINTS 119 ANTECEDENTS TO SUBSTANCE USE AND OR RELAPSE 121 SELF EF CACY 124 EXPECTANCIES 126 MOTIVATION 127 ASSESSMENT OF CRAVING 131 SUMMARY 133 REFERENCES 133 CHAPTER 7 INDIVIDUALIZED PROBLEM ASSESSMENT II ASSESSING CLIENTS FROM A BROADER PERSPECTIVE 139 SUMMARY POINTS 139 COPING SKILLS 140 CONSEQUENCES 142 SOCIAL SUPPORT 145 TREATMENT RELATED NEEDS AND PREFERENCES 147 ALCOHOLICS ANONYMOUS INVOLVEMENT 147 SPIRITUALITY AND RELIGIOSITY 149 MULTIDIMENSIONAL MEASURES 150 SUMMARY 151 REFERENCES 152 PART 3 TREATMENT METHODS 157 CHAPTER 8 COGNITIVE BEHAVIORAL TREATMENTS FOR SUBSTANCE USE DISORDERS 159 SUMMARY POINTS 159 SUMMARY 160 REVIEW OF BEHAVIORAL THERAPY AND COGNITIVE THERAPY 160 COGNITIVE BEHAVIORAL THERAPY FOR SUBSTANCE USE DISORDERS 162 GENERAL FORMAT OF CBT FOR SUBSTANCE USE DISORDERS 163 EVIDENCE FOR EF CACY OF CBT FOR SUBSTANCE USE DISORDERS 171 SUMMARY 173 REFERENCES 173 CHAPTER 9 MOTIVATIONAL INTERVIEWING FOR ADDICTIONS 175 SUMMARY POINTS 175 INTRODUCTION THE COUNSELOR S DILEMMA 175 WHAT IS MOTIVATIONAL INTERVIEWING 176 FOUR PRINCIPLES OF MOTIVATIONAL INTERVIEWING COMMON INGREDIENTS 176 CLIENT LANGUAGE A UNIQUE INGREDIENT IN MI 177 THE SPIRIT OF MOTIVATIONAL INTERVIEWING 178 REVISITING THE INITIAL CONSULTATION 178 THE TRANSTHEORETICAL MODEL OF CHANGE 179 COMMON MISCONCEPTIONS ABOUT MOTIVATIONAL INTERVIEWING 180 DOES MOTIVATIONAL INTERVIEWING WORK 181 TRAINING AND EVALUATING MOTIVATIONAL INTERVIEWING 181 CONCLUSIONS 182 MOTIVATIONAL INTERVIEWING RESOURCES 186 FURTHER READING 187 REFERENCES 187 CHAPTER 10 BRIEF INTERVENTION 189 SUMMARY POINTS 189 INTRODUCTION 190 BACKGROUND 190 ORIGINS AND THEORY BASE 191 THE EVIDENCE BASE 193 DELIVERING SCREENING AND BRIEF INTERVENTION IN PRIMARY CARE SETTINGS 197 IMPLEMENTATION ISSUES 202 CONCLUSION 208 REFERENCES 208 CHAPTER 11 RELAPSE PREVENTION EVIDENCE BASE AND FUTURE DIRECTIONS 215 SUMMARY POINTS 215 BACKGROUND OF RELAPSE PREVENTION 216 THEORETICAL MODELS BEHIND RELAPSE PREVENTION 218 EMPIRICAL EVIDENCE SUPPORTING RELAPSE PREVENTION 220 THERAPEUTIC COMPONENTS OF RELAPSE PREVENTION INTERVENTIONS 221 SPECI C INTERVENTION STRATEGIES 222 GLOBAL INTERVENTION STRATEGIES 226 SUMMARY AND CONCLUSIONS 230 REFERENCES 230 CHAPTER 12 BEHAVIORAL COUPLES THERAPY IN THE TREATMENT OF ALCOHOL PROBLEMS 233 SUMMARY POINTS 233 INTRODUCTION TO ALCOHOL BEHAVIORAL COUPLES THERAPY 234 HOW WELL DOES ABCT WORK 240 SOME CRITICISMS OF THE ABCT APPROACH 241 EXPANDING ABCT TO T INNOVATIONS IN EFT 243 CONCLUSIONS 245 ACKNOWLEDGMENT 245 REFERENCES 245 CHAPTER 13 CONTINGENCY MANAGEMENT AND THE COMMUNITY REINFORCEMENT APPROACH 249 SUMMARY POINTS 249 INTRODUCTION 250 CONCEPTUALIZING TREATMENT 251 COMMUNITY REINFORCEMENT APPROACH 252 CONTINGENCY MANAGEMENT 253 EMPIRICAL SUPPORT 254 INITIAL STUDY 254 EXTENDING CRA TO TREATMENT OF PATIENTS WITH COCAINE AND OPIOID USE DISORDERS 255 FURTHER EXTENSIONS 256 CONCLUSIONS 262 ACKNOWLEDGMENT 263 REFERENCES 263 CHAPTER 14 HOW MUCH TREATMENT DOES A PERSON NEED SELF CHANGE AND THE TREATMENT SYSTEM 267 SUMMARY POINTS 267 PROFESSIONAL HELP AND LAY HELP TREATMENT SYSTEMS IN CRISIS 268 SELF ORGANIZED QUITTING SELF CHANGE FROM ADDICTIVE BEHAVIORS 270 CREATING A SOCIETAL CLIMATE FRIENDLY TO INDIVIDUAL CHANGE ADVICE FOR POLICY MAKERS 281 REFERENCES 282 CHAPTER 15 ADJUNCTIVE PHARMACOTHERAPY IN THE TREATMENT OF ALCOHOL AND DRUG DEPENDENCE 287 INTRODUCTION 287 THE NEUROBIOLOGY OF ADDICTIONS 288 PHARMACOTHERAPY OF ADDICTIONS 291 PHARMACOTHERAPY AS AN ADJUNCTIVE THERAPY 302 CONCLUSIONS 304 REFERENCES 304 PART 4 SPECIAL POPULATIONS AND APPLICATIONS 311 CHAPTER 16 ADDICTION TREATMENT DISPARITIES ETHNIC AND SEXUAL MINORITY POPULATIONS 313 SUMMARY POINTS 313 ADDICTION TREATMENT DISPARITIES 315 CONDITIONS THAT CREATE DISPARITIES 316 ASSESSMENT ISSUES 317 TREATMENT ISSUES 317 DIFFERENCE IN CULTURAL VALUES MAY IMPACT TREATMENT OUTCOMES 318 PREJUDICE RACISM AND HOMOPHOBIA 318 EMPIRICALLY BASED TREATMENT AND MINORITY CLIENTS 319 SUMMARY 320 REFERENCES 320 CHAPTER 17 TREATING THE PATIENT WITH COMORBIDITY 327 SUMMARY POINTS 327 EMPIRICALLY SUPPORTED TREATMENT AND COMORBIDITY 328 IS PSYCHIATRIC COMORBIDITY AN INDICATOR OF POOR PROGNOSIS 328 WHAT HAPPENS OVER TIME WITH COMORBID SYMPTOMS 330 TREATMENT OF COMORBID MENTAL ILLNESS AND SUBSTANCE ABUSE 331 REFERENCES 339 CHAPTER 18 EVIDENCE BASED INTERVENTIONS FOR ADOLESCENT SUBSTANCE USERS 345 SUMMARY POINTS 345 INTRODUCTION 346 SYSTEMATIC REVIEWS AND META ANALYSES 346 INTERVENTIONS 348 WHERE DO WE GO FROM HERE 354 REFERENCES 356 CHAPTER 19 COLLEGE STUDENT APPLICATIONS 361 SUMMARY POINTS 361 PREVENTION BRIEF INTERVENTION FOCUS VERSUS TREATMENT 363 DELIVERY METHODS OF INTERVENTION 365 CONCLUSIONS 373 REFERENCES 374 CHAPTER 20 INTERNET EVIDENCE BASED TREATMENTS 379 SUMMARY POINTS 379 WHAT DO INTERNET BASED INTERVENTIONS LOOK LIKE 381 CONSIDERATIONS FOR CREATING AN EVIDENCE BASE 389 LOOKING TO THE FUTURE 393 REFERENCES 394 PART 5 EVIDENCE BASED TREATMENT IN ACTION 399 CHAPTER 21 EVIDENCE BASED TREATMENT PLANNING FOR SUBSTANCE ABUSE THERAPY 401 SUMMARY POINTS 401 OVERVIEW OF TREATMENT PLANNING 405 STEPS IN THE INDIVIDUAL TREATMENT PLANNING PROCESS 407 ADVANCES TOWARD THE GOAL OF EVIDENCE BASED TREATMENT PLANNING 414 REFERENCES 416 CHAPTER 22 ADOPTION AND IMPLEMENTATION OF EVIDENCE BASED TREATMENT 419 SUMMARY POINTS 419 BACKGROUND AND INTRODUCTION 420 ADOPTION AND IMPLEMENTATION 422 LEADERSHIP 422 IMPLEMENTATION SCIENCE A MODEL FOR PROGRAM CHANGE 423 PRACTICAL APPLICATIONS ASSESSING THE ORGANIZATION 428 GUIDELINES FOR ADMINISTRATION 430 INTERPRETATION 430 REFORMATIVE STRATEGIES 431 CONCLUSIONS AND IMPLICATIONS 433 FUTURE DIRECTIONS 434 ACKNOWLEDGMENTS 434 REFERENCES 435 PART 6 A LOOK TOWARD THE FUTURE 439 CHAPTER 23 CHALLENGES OF AN EVIDENCE BASED APPROACH TO ADDICTION TREATMENT 441 SUMMARY POINTS 441 ONGOING ISSUES AND CHALLENGES 443 CONCLUSIONS 447 REFERENCES 448