Reinforcement Based Treatment For Substance Use Disorders

Substance use disorders typically take years to develop and to become entrenched. Thus, for users, creating a new and sustainable drug-free life takes time, intensive effort, and extensive ongoing support. This book is a clinician-friendly manual for implementing Reinforcement-Based Treatment (RBT), an intensive, evidence-based model for treating substance use disorders in community settings. RBT integrates the most effective behavioral techniques with motivational interviewing, highly individualized treatment plans, and case management. The goal is to help clients avoid substance use triggers and develop recreational outlets and support systems that are incompatible with substance use. Additionally, the model emphasizes customer service-a concept underemphasized in most programs-to ensure that clients receive positive reinforcement for attending treatment. Using a step-by-step approach that takes the reader through each treatment component, the authors provide clear, detailed, and practical case illustrations and a variety of useful forms and therapist scripts. RBT is a comprehensive approach that can be used with various populations to help clients initiate abstinence, prevent relapses early in the recovery process, and maintain sobriety on an ongoing basis. It is therefore an ideal model for clinicians, administrators, case management professionals, and others who work with substance abusers.

This book is the first complete guide to implementing the Community Reinforcement Approach (CRA), an empirically based, highly effective cognitive-behavioral program for treating alcohol problems. CRA acknowledges the powerful role of environmental contingencies in encouraging or discouraging drinking, and attempts to rearrange these contingencies so that a non-drinking lifestyle is more rewarding than a drinking one. Unique in its breadth, the approach utilizes social, recreational, familial, and vocational strategies to aid clients in the recovery process. This authoritative manual is a hands-on guide to applying these therapeutic procedures. The authors present a step-by-step guide to each component of the treatment plan, many of which have been shown to be effective forms of treatment in themselves. Topics include behavioral skills training, social and recreational counseling, marital therapy, motivational enhancement, job counseling, and relapse prevention. Each chapter provides detailed instructions for conducting a procedure, describes what difficulties to expect, and presents strategies for overcoming them. Sample dialogues between clients and therapists, annotated by the authors, further illuminate the treatment process. The book concludes with a chapter that both addresses the common mistakes made when implementing CRA, and emphasizes the flexibility and benefits of this total treatment plan. This book is an invaluable resource for a wide range of practitioners including psychologists, psychiatrists, substance abuse counselors, and social workers.

The community reinforcement approach (CRA) to treating alcohol and other drug problems is designed to make changes in the client's daily environment, to reduce substance abuse, and to promote a healthier lifestyle. This is the first book to present research on the effectiveness of the CRA for a clinical readership. It includes the original study comparing CRA with traditional treatments of alcohol dependence, and summarizes other trials with alcohol, cocaine, and heroin users. The CRA program provides basic guidelines for clinicians, focusing on communication skills, problem solving and drink refusal strategies, and addresses the needs of the client as part of a social community. Combining practical advice on such matters with a scientific survey of CRA in use, this book offers a new treatment approach to all involved with the support and treatment of those with alcohol and drug problems.

Timely and authoritative, this volume brings together leading clinical researchers to describe contemporary applications of contingency management principles across a wide range of substance use disorders and patient populations. Contingency management uses a system of incentives and disincentives to motivate patients to meet their treatment goals, and has been implemented successfully in community treatment clinics, drug courts, and other settings. Featuring illustrative case material, the book presents a cogent empirical rationale and practical strategies for targeting major drugs of abuse and working with specific populations, including adolescents, pregnant women, and dually diagnosed and homeless individuals. Also addressed are the nuts and bolts of developing and funding contingency management programs.

Revised and updated to reflect the most recent developments in the field, the second edition of the Handbook of Motivational Counseling presents comprehensive coverage of the development and identification of motivational problems and the most effective treatment techniques. Equips clinicians with specific instructions for enhancing clients’ motivation for change by targeting their maladaptive motivational patterns Provides step-by-step instructions in the administration, scoring, and interpretation of the motivational assessments, along with details of how to implement the counseling procedures Updated to reflect the most current research and effective treatment techniques, along with all-new chapters on motive-based approaches, motivational counseling with the dually diagnosed, cognitive and motivational retraining, meaning-centered counseling, and motivation in sport Showcases various basic motivational techniques and their adaptations, such as bibliotherapy, individual therapy, and group counseling, while demonstrating specialized uses of the techniques, such as in work settings and rehabilitation medicine

The Adolescent Community Reinforcement Approach (A-CRA) is an evidence-based, developmentally-appropriate behavioral treatment for youth and young adults ages 12 to 25 years old with substance use disorders and related problems. Listed in several state and federal registries, including the National Registry of Evidence-Based Programs and Practices, A-CRA clinicians help youth and parents increase the family, social, and educational/vocational reinforcers to support recovery. Written by Drs. Susan H. Godley, Jane Ellen Smith, Robert J. Meyers, and Mark D. Godley, the principal researchers and experts in A-CRA, The Community Reinforcement Approach: A Clinical Guide for Treating Substance Use Disorders provides behavioral and mental health professionals with the detailed guidance needed to implement this evidence-based treatment.

Isn’t it unethical to pay people to do what they should be doing anyway? Won’t patients just sell the reinforcers and buy drugs? Others didn’t get prizes for not using. Why should they? The concerns surrounding Contingency Management (CM) are many and reflect how poorly understood and rarely utilized this evidence-based treatment model is in practice settings. Despite being identified as the most efficacious intervention for substance use disorders, a significant gap persists between research and practice, at the client’s expense. Nancy Petry, an experienced researcher and consultant for organizations such as the National Institute of Health, has begun to fill this gap by authoring the first clinician-oriented text that focuses on CM protocol development and implementation. In this well-organized and clear book she provides a foundation for understanding CM and details how to design and implement a program that can work for any clinician, whether he or she works for a well-funded program or not. She also addresses realistic concerns such as: How to describe CM to eligible and ineligible patients How to calculate the costs of CM interventions How to solicit donations and raise funds to support CM interventions How to stock a prize cabinet and keep track of prizes Over 50 charts, worksheets, and tables are provided to help the clinician pinpoint exactly which behaviors to target, brainstorm how to reinforce change, and develop a treatment plan that incorporates cost, length of treatment, and method for determining patient compliance. Included with the book is a CD-ROM of editable logs, forms, tables, and worksheets for personal use. More than just filling a void, Dr. Petry provides all of the tools clinicians require to successfully apply a novel treatment in practice.