From the Barlow chapter, during assessment what message is conveyed to clients initiating treatment?
Emphasis was placed on initiating and maintaining engagement in therapy with strategies such as brief initial visits for those reluctant to egnage; identifying lifestyle change as the key therapy target so as not to engender reistance in those with low motivation to reduce substance use in the initial stages of the intervention.
What domains of info are collected at intake
MAST Beck's Depression inventory SCL - 90 Drug history interview Addiction survey index
MAST
Michigan Alcohol Screening Test (MAST)
Relates to the patient’s self-appraisal of social, vocational, and family problems frequently associated with heavy drinking. Screens for alcohol problems in the general population
Beck’s depresion inventory
Measures characteristic attitudes and symptoms of depression
SCL - 90
Assesses nine symptoms of psychopathology and provides three global distress indicators
Addiction survey index
A semi-structured interview for substance abuse assessment and treatment planning. The ASI is designed to gather valuable information about areas of a client’s life that may contribute to their substance-abuse problems
Describe the behavioral conceptualization of substance abuse.
- Substance abuse is learned behavior that is reinforced by the physiological effects of the substance iteslf as well as social reinforcers
- Individuals may or may not have a genetic/biological predisposition underlying substance abuse problems
- Treatment must be based on empirically supported approaches, along with comprehensive, individually tailored strategies to address wide range of functional impairments
Explain what a functional analysis of substance abuse would include (using A-B-C, as we did in class)
- A= antecendent or the event or activity that immediately precedes a problem behavior
- B = observed behavior
- C= consequence the event that immediately follows a response
Comprehensive treatment of substance abuse “reorganizes the physical and social environments of the user” by using a number of treatment strategies. Be familiar with these strategies, be able to briefly describe them and differentiate them from one another. They include:
- Cognitive- Behavioral Treatment
- Relapse Prevention
- Contingency Management
- Motivational interviewing/ stages of change
- Behavioral couples therapy
- Refusal skills
- CRA + vouchers
Cognitive- Behavioral Treatment
CBT
- Decrease reinforcement from drug use
- Increase reinforcement from healthier activities
- Functional analysis: A-B-C
- Modify unrealistic expectations about drug use
- Cope with craving
- Change thoughts that increase likelihood of drug use
- Relapse prevention
Contingency management
- Arrange rewards- punishers for substance-related behaviors such as
- – abstinence
- – attendance at therapy session
Motivational interviewing/ stages of change
- Identify personal values/goals
- Identify how drug use is consistent/inconsistent with those goals
Behavioral couples therapy
- Communication skills
- Contract for behavioral changes that make relationship more reinforcing
CRA + Vouchers
Treatment package provided within the context of flexibility, empathy, compassion and activate problem solving
