What is the Community Reinforcement Approach (CRA) and CRAFT?
- The Community Reinforcement Approach (CRA) is a comprehensive, evidence-based behavioral treatment for substance use disorders that focuses on modifying a person’s environment to reward sobriety and discourage drug/alcohol use.
- Community Reinforcement and Family Training (CRAFT) is a related, specialized program designed for family members, designed to encourage treatment-resistant individuals to seek help.
Key idea: Lifestyle reinforcement and family involvement
What is Voucher-Based Reinforcement Therapy (VBRT) and how does it work?
- Voucher-Based Reinforcement Therapy (VBRT) is an evidence-based contingency management intervention used to treat substance use disorders (particularly cocaine and opioid dependence) by providing tangible rewards (i.e., vouchers) for verified drug-free urine samples. It operates on the behavioral principle that rewarding positive behavior (abstinence) with immediate, valuable incentives increases the likelihood of that behavior continuing.
What is Personalized Normative Feedback?
Personalized normative feedback (PNF) is a brief, often digital, intervention that reduces risky behaviors—like excessive drinking or gambling—by correcting an individual’s misperceived norms. It compares a person’s behavior to their peers’ actual behavior, typically showing the person that their peer group is more moderate than they thought.
How are text messages used in substance use treatment and is this technique more effective alone or with other interventions?
- Provide reminders, health info, support, self-monitoring
- Effective for smoking cessation alone or with other interventions
- Effect: Higher quit rates when combined with other interventions
What is Marlatt & Gordon’s Relapse Prevention Therapy?
Marlatt and Gordon’s Relapse Prevention Therapy (RPT) is a cognitive-behavioral approach designed to help individuals maintain behavioral changes, particularly in treating addiction. It identifies, avoids, or copes with high-risk triggers, managing lapses to prevent full relapse by enhancing self-efficacy and implementing lifestyle changes.
What is Project MATCH?
Multisite trial comparing:
1. CBT coping skills therapy
2. Motivational enhancement therapy (MET)
3. Twelve-step facilitation (TSF)
What is extinction in behavioral therapy?
The process of weakening or eliminating a learned response by removing reinforcement or stopping pairing of a conditioned stimulus with an unconditioned stimulus.
What is counterconditioning?
Replacing an unwanted response with a new, incompatible response using classical conditioning.
What is Cue Exposure Therapy?
A behavioral therapy that exposes clients to cues/triggers for substance use or cravings without allowing the behavior, aiming to reduce conditioned responses over time.
What is Systematic Desensitization?
A behavioral therapy technique that reduces anxiety or fear by gradually exposing the client to the feared stimulus while teaching relaxation skills.
What is aversion therapy?
A behavioral therapy that pairs an undesirable behavior with an unpleasant stimulus to reduce or eliminate the behavior.
What are the core symptoms, duration, and key feature of Pica?
Core: Eating non-nutritive substances
Duration: at least 1 month
Key feature: Can occur at any age but is most common among young children
What are the core symptoms, minimum duration, and key features of Anorexia Nervosa?
Core: restriction of food intake resulting in significant low body weight
Duration: None
Key features:
1) An intense fear of gaining weight or becoming fat
2) distorted body image
What are the core symptoms, duration, and key feature of Bulimia Nervosa?
Core: Binge eating + compensatory behaviors
Duration: Binges occur at least once a week for 3 months
Key: Weight usually normal
What are the core symptoms, duration, and key feature of Binge Eating Disorder?
Core: Binge eating WITHOUT compensatory behaviors
Duration: Binges occur at least once a week for 3 months
Key: Distress, no purging
What are key differences between Binge Eating Disorder (BED) and Bulimia Nervosa?
- No compensatory behaviors in BED (vs bulimia)
- Better treatment response in BED
- Dieting occurs AFTER onset (vs bulimia: dieting comes BEFORE)
What are the core symptoms, duration, and key feature of Insomnia Disorder?
Core: Dissatisfaction with sleep (quality or quantity) with at least 1 or more of the following:
* Difficulty falling asleep
* Difficulty staying asleep
* Early awakening (can’t return to sleep)
Duration: ≥ 3 nights/week for ≥ 3 months
Other key features: Occurs despite adequate opportunity and causes distress or impairment
What are the three types of insomnia?
- Sleep-onset (initial): trouble falling asleep
- Sleep maintenance (middle): waking during night (most common single type)
- Late insomnia: early morning awakening
How do subjective reports compare to objective measures in insomnia?
People with insomnia:
* Overestimate time to fall asleep
* Overestimate time awake
* Underestimate total sleep time
Client reports poor sleep 4 nights/week for 4 months despite adequate opportunity, with daytime fatigue.
Whats the diagnosis?
Insomnia disorder
Client is significantly underweight, restricts food intake, and fears gaining weight.
What is the diagnosis?
Anorexia
Client has weekly binge eating episodes followed by vomiting for 3 months; weight is normal.
What is the diagnosis?
Bulimia Nervosa
Client has weekly binge eating episodes for 3 months with no compensatory behaviors and feels distress.
What is the diagnosis?
Binge Eating Disorder
Client binges on large amounts of food, feels out of control, then uses laxatives to prevent weight gain.
What is the diagnosis?
Bulimia Nervosa
