Evidence-Based Addiction Treatment (eBook)

Front Cover 1
Evidence-Based Addiction Treatment 4
Copyright Page 5
Contents 6
Preface 12
Contributors 16
Part 1 Introduction to Evidence-Based Practices 20
CHAPTER 1 What Is Evidence-Based Treatment? 22
Summary points 22
What does "evidence based" mean? 24
Evaluating the evidence 25
Examples of key studies and findings 30
Examples of evidence-based treatments 33
Conclusions and future directions 36
References 37
CHAPTER 2 The Clinical Course of Addiction Treatment: The Role of Nonspecific Therapeutic Factors 40
Summary points 40
Introduction 41
Accessing treatment 44
Treatment engagement and outcomes 48
Conclusions 55
References 55
Part 2 Clinical Assessment and Treatment Monitoring 66
CHAPTER 3 History and Current Substance Use 68
Summary points 68
Self-report/interview methods of alcohol and other drug consumption 71
Biomarker measures of alcohol and illicit drug consumption 86
General summary and conclusions 91
References 92
CHAPTER 4 Dependence and Diagnosis 96
Summary points 96
Introduction 97
Defining substance use disorders 97
Screening methods 101
Diagnostic assessment 103
Summary 105
References 105
CHAPTER 5 Assessment of Co-occurring Addictive and Other Mental Disorders 108
Summary points 108
Definitions 109
Features of co-occurring disorders that inform assessment 109
Screening for AMDS 119
References 130
CHAPTER 6 Individualized Problem Assessment I: Assessing Cognitive and Behavioral Factors 138
Summary points 138
Antecedents to substance use and/or relapse 140
Self-efficacy 143
Expectancies 145
Motivation 146
Assessment of craving 150
Summary 152
References 152
CHAPTER 7 Individualized Problem Assessment II: Assessing Clients from a Broader Perspective 158
Summary points 158
Coping skills 159
Consequences 161
Social support 164
Treatment-related needs and preferences 166
Alcoholics anonymous involvement 166
Spirituality and religiosity 168
Multidimensional measures 169
Summary 170
References 171
Part 3 Treatment Methods 176
CHAPTER 8 Cognitive Behavioral Treatments for Substance Use Disorders 178
Summary points 178
Summary 179
Review of behavioral therapy and cognitive therapy 179
Cognitive behavioral therapy for substance use disorders 181
General format of CBT for substance use disorders 182
Evidence for efficacy of CBT for substance use disorders 190
Summary 192
References 192
CHAPTER 9 Motivational Interviewing for Addictions 194
Summary points 194
Introduction: The counselor's dilemma 194
What is motivational interviewing? 195
Four principles of motivational interviewing: "Common ingredients" 195
Client language: A unique ingredient in MI 196
The spirit of motivational interviewing 197
Revisiting the initial consultation 197
The transtheoretical model of change 198
Common misconceptions about motivational interviewing 199
Does motivational interviewing work? 200
Training and evaluating motivational interviewing 200
Conclusions 201
Motivational interviewing resources 205
Further reading 206
References 206
CHAPTER 10 Brief Intervention 208
Summary points 208
Introduction 209
Background 209
Origins and theory base 210
The evidence base 212
Delivering screening and brief intervention in primary care settings 216
Implementation issues 221
Conclusion 227
References 227
CHAPTER 11 Relapse Prevention: Evidence Base and Future Directions 234
Summary points 234
Background of relapse prevention 235
Theoretical models behind relapse prevention 237
Empirical evidence supporting relapse prevention 239
Therapeutic components of relapse prevention interventions 240
Specific intervention strategies 241
Global intervention strategies 245
Summary and conclusions 249
References 249
CHAPTER 12 Behavioral Couples Therapy in the Treatment of Alcohol Problems 252
Summary points 252
Introduction to alcohol behavioral couples therapy 253
How well does ABCT work? 259
Some criticisms of the ABCT approach 260
Expanding ABCT to fit innovations in EFT 262
Conclusions 264
Acknowledgment 264
References 264
CHAPTER 13 Contingency Management and the Community Reinforcement Approach 268
Summary points 268
Introduction 269
Conceptualizing treatment 270
Community reinforcement approach 271
Contingency management 272
Empirical support 273
Initial study 273
Extending CRA to treatment of patients with cocaine and opioid use disorders 274
Further extensions 275
Conclusions 281
Acknowledgment 282
References 282
CHAPTER 14 How Much Treatment Does a Person Need? Self-Change and the Treatment System 286
Summary points 286
Professional help and lay help—treatment systems in crisis 287
Self-organized quitting, self-change from addictive behaviors 289
Creating a societal climate friendly to individual change: Advice for policy makers 300
References 301
CHAPTER 15 Adjunctive Pharmacotherapy in the Treatment of Alcohol and Drug Dependence 306
Introduction 306
The neurobiology of addictions 307
Pharmacotherapy of addictions 310
Pharmacotherapy as an "adjunctive" therapy 321
Conclusions 323
References 323
Part 4 Special Populations and Applications 330
CHAPTER 16 Addiction Treatment Disparities: Ethnic and Sexual Minority Populations 332
Summary points 332
Addiction treatment disparities 334
Conditions that create disparities 335
Assessment issues 336
Treatment issues 336
Difference in cultural values may impact treatment outcomes 337
Prejudice, racism, and homophobia 337
Empirically based treatment and minority clients 338
Summary 339
References 339
CHAPTER 17 Treating the Patient with Comorbidity 346
Summary points 346
Empirically supported treatment and comorbidity 347
Is psychiatric comorbidity an indicator of poor prognosis? 347
What happens over time with comorbid symptoms? 349
Treatment of comorbid mental illness and substance abuse 350
References 358
CHAPTER 18 Evidence-Based Interventions for Adolescent Substance Users 364
Summary points 364
Introduction 365
Systematic reviews and meta-analyses 365
Interventions 367
Where do we go from here 373
References 375
CHAPTER 19 College Student Applications 380
Summary points 380
Prevention/brief intervention focus versus treatment 382
Delivery methods of intervention 384
Conclusions 392
References 393
CHAPTER 20 Internet Evidence-Based Treatments 398
Summary points 398
What do internet-based interventions look like? 400
Considerations for creating an evidence base 408
Looking to the future 412
References 413
Part 5 Evidence-Based Treatment in Action 418
CHAPTER 21 Evidence-Based Treatment Planning for Substance Abuse Therapy 420
Summary points 420
Overview of treatment planning 424
Steps in the individual treatment planning process 426
Advances toward the goal of evidence-based treatment planning 433
References 435
CHAPTER 22 Adoption and Implementation of Evidence-Based Treatment 438
Summary points 438
Background and introduction 439
Adoption and implementation 441
Leadership 441
Implementation science: A model for program change 442
Practical applications: Assessing the organization 447
Guidelines for administration 449
Interpretation 449
Reformative strategies 450
Conclusions and implications 452
Future directions 453
Acknowledgments 453
References 454
Part 6 A Look Toward the Future 458
CHAPTER 23 Challenges of an Evidence-Based Approach to Addiction Treatment 460
Summary points 460
Ongoing issues and challenges 462
Conclusions 466
References 467
Index 468
A 468
B 470
C 471
D 473
E 474
F 474
G 475
H 475
I 476
J 476
K 476
L 477
M 477
N 478
O 479
P 479
Q 480
R 480
S 481
T 483
U 483
V 484
W 484
X 484
Y 484