|
Evidence-Based
Treatment Interventions
|
|
Protocol
|
Studied
Populations
|
Description
|
| Behavioral
Couples Therapy |
Methadone-maintained
opioid-addicted men; drug-abusing women. |
BCT
is a couples' therapy that utilizes a sobriety/abstinence contract
and behavioral principles to reinforce abstinence from drugs and
alcohol. |
| Brief
Intervention |
It
is most often used with adult and adolescent patients who are
not alcohol dependent, and its goal may be moderate drinking1
rather than abstinence. |
Brief
intervention is designed to be conducted by health professionals
who do not specialize in addictions treatment. To identify the
key ingredients of brief intervention, Miller and Sanchez (20)
proposed six elements summarized by the acronym FRAMES: feedback,
responsibility, advice, menu of strategies, empathy, and self-efficacy.
Brief intervention is generally restricted to four or fewer sessions,
each session lasting from a few minutes to 1 hour. |
| Brief
Strategic Family Therapy |
Hispanic
adolescent polydrug-abusers, with and without conduct problems,
and their families, in Southern Florida |
Because
of concerns with the sustainability of existing contingency management
programs, this approach (based on one developed for alcohol abuse)
takes advantage of the fact that people will work for the chance
to win a tangible prize intermittently. |
| Cognitive
Behavioral Interventions |
Cocaine-dependent
adults |
Adapted
from Marlatt and Gordon's Relapse Prevention treatment for problem
drinking, CBT strategies are based on the theory that learning
processes play a role in the development of maladaptive behavioral
patterns. Individuals learn to identify and correct problematic
behaviors. |
| Community
Reinforcement Approach |
Mainly
Caucasian intranasal and IV cocaine-dependent individuals (many
of whom also use alcohol). |
CRA
is an individual counseling approach originally developed for
alcoholism that includes a Job Club, Marital Counseling, Social
Skills/Relapse Prevention training and Disulfiram (Antabuse).
|
| Contingency
Management |
varied |
Contingency
Management involves systematically reinforcing a client with a
tangible good or service in exchange for a target behavior, usually
abstinence from an illicit drug confirmed by a drug-negative urine
specimen. |
| The
Matrix Model |
cocaine
addicts and methamphetamine users |
The
Matrix Model of outpatient treatment was developed during the
1980s in response to an overwhelming demand for stimulant abuse
treatment services. Treatment materials draw heavily upon published
literature pertaining to the areas of relapse prevention (Marlatt
and Gordon,1985), family and group therapies, drug education,
self help participation and drug abuse monitoring. |
| Motivational
Interviewing/ Enhancement |
|
Motivational
Enhancement Therapy (MET) seeks to evoke from clients their own
motivation for change and to consolidate a personal decision and
plan for change. The approach is largely client centered, although
planned and directed. MET is based on principles of cognitive
and social psychology. The counselor seeks to develop a discrepancy
in the client's perceptions between current behavior and significant
personal goal; emphasis is placed on eliciting from clients self-motivational
statements of desire for and commitment to change. The working
assumption is that intrinsic motivation is a necessary and often
sufficient factor in instigating change. |
| Multidimensional
Family Therapy |
Multidimensional Family Therapy (MDFT) studies have been conducted among diverse samples of adolescents including, African-American, Hispanic/Latino, and White males and females between the ages of 11 and 18 in urban, suburban and rural settings with various socioeconomic backgrounds. |
MDFT
is used to treat polydrug-abusing adolescents by targeting the
individual adolescent, the parent(s), the relationship between
children and parents, and other systems (school, peers, juvenile
justice, etc.). |
| Pharmacological
Interventions: Naltrexone |
Adult
heroin users |
Using
naltrexone for opiate addicts usually is conducted in outpatient
settings, although initiation of the medication often begins after
medical detoxification in a residential setting. Naltrexone is
a long-acting synthetic opiate antagonist with few side effects
that is taken orally either daily or three times a week for a
sustained period. Individuals must be medically detoxified and
opiate-free for several days before naltrexone can be taken to
prevent precipitating an opiate abstinence syndrome. When used
this way, all the effects of self-administered opiates, including
euphoria, are completely blocked. |
| Pharmacological
Interventions: Buprenorphine |
Adult
heroin users |
Buprenorphine
is related to morphine but is a partial agonist (possesses both
agonist and antagonist properties). Partial agonists exhibit ceiling
effects (i.e., increasing the dose only has effects to a certain
level) and thus have greater safety profiles than full agonists,
like heroin. Buprenorphine tablets (either buprenorphine alone
or the combination with nalaxone) were shown in a large clinical
trial to be superior to placebo treatment in reducing opiate use.
The treatment of patients by physicians or group practice would
allow office-based treatment to augment the current system, while
placing an adequate level of control on the dispensing of these
medications. |
| Pharmacological
Interventions: Methadone |
Adult
heroin users |
Methadone
is a long-acting synthetic opiate medication administered orally
for a sustained period at a dosage sufficient to prevent opiate
withdrawal, block the effects of illicit opiate use, and decrease
opiate craving. Patients stabilized on methadone can engage more
readily in counseling and other behavioral interventions essential
to recovery and rehabilitation. The best, most effective methadone
maintenance programs include individual and/or group counseling,
as well as provision of, or referral to, other needed medical,
psychological, and social services. |
| Solution-Focused
Brief Therapy |
The
approach was developed for low-income clients with serious alcohol
or other drug problems. Many were African-American. The majority
of clients were unemployed and may be homeless at the time treatment
is initiated. The approach has also been used with clients who
use a variety of drugs. Because the model stresses that the problem
and solution are not necessarily related, the type of drug is
not seen as a critical factor in determining differential treatment.
|
The
Solution-Focused Model is a brief therapy approach developed over
the past 20 years at the Brief Family Therapy Center in Milwaukee,
WI. Primarily, the model is designed to help clients engage their
own unique resources and strengths in solving the problems that
bring them into treatment. Goals are the entire focus of the solution-focused
brief therapy approach. The model uses a specialized interviewing
procedure to negotiate treatment goals whose qualities facilitate
efficient and effective treatment. |
| Supportive-Expressive
Therapy |
Supportive-Expressive
therapy (SE) has been manualized for a variety of disorders including
depression, generalized anxiety disorder, opiate drug dependence,
and cocaine dependence. |
Supportive-Expressive
therapy (SE) is a short-term psychodynamic treatment. Its goal
is to help patients gain understanding of conflictual relationship
patterns. The main techniques include supportive techniques to
bolster the therapeutic alliance and interpretations to help patients
gain self-understanding. |
| Twelve-Step
Faciliation |
TSF
has been utilized in controlled outcome studies with alcohol abusers
and alcoholics and with persons who have concurrent alcohol-cocaine
abuse and dependency. It has been used with clients of diverse
socioeconomic, educational, and cultural backgrounds and a range
of maladjustment |
Twelve-Step
Facilitation (TSF) consists of a brief, structured, and manual-driven
approach to facilitating early recovery from alcohol abuse/alcoholism
and other drug abuse/addiction. It is intended to be implemented
on an individual basis in 12 to 15 sessions and is based in behavioral,
spiritual, and cognitive principles that form the core of 12-step
fellowships such as Alcoholics Anonymous (AA) and Narcotics Anonymous
(NA). It is suitable for problem drinkers and other drug users
and for those who are alcohol or other drug dependent. |