COURSES ARTICLE - THERAPYTOOLS. USCourse Description: Course meets the qualifications for 1. MFTs and/or LCSWs as required by the California Board of Behavioral Sciences. Course Objectives: Upon completion of this course the participant will be able to: 1) Describe the basic characteristics of Brief Interventions and Brief Therapies. Identify the components of a Brief Intervention. Discuss the basic elements of Brief Therapies. Gain an understanding of Brief Therapy techniques used in a clinical setting.
Psychological dependency. Psychological dependency is addressed in many drug rehabilitation programs by attempting to teach the patient new methods of interacting in a drug-free environment. In particular, patients are. H eritage Keepers, Abstinence Education I is a fear-based, abstinence-only-until-marriage curriculum produced by Heritage Community Services, a South Carolina-based organization that created and utilizes The Heritage Method, A. Brief Interventions and Brief Therapies for Substance Abuse. Chapter 1 - - Introduction to Brief Interventions and Therapies. The use of brief intervention and brief therapy techniques has become an increasingly important part of the continuum of care in the treatment of substance abuse problems. With the health care system changing to a managed model of care and with changes in reimbursement policies for substance abuse treatment, these short, problem- specific approaches can be valuable in the treatment of substance abuse problems. They provide the opportunity for clinicians to increase positive outcomes by using these modalities independently as stand- alone interventions or treatments and as additions to other forms of substance abuse and mental health treatment. They can be used in a variety of settings including opportunistic settings (e. Used for a variety of substance abuse problems from at- risk use to dependence, brief interventions can help clients reduce or stop abuse, act as a first step in the treatment process to determine if clients can stop or reduce on their own, and act as a method to change specific behaviors before or during treatment. For example, there are some issues associated with treatment compliance that benefit from a brief, systematic, well- planned intervention such as attending group sessions or doing homework. In other instances, brief interventions address specific family problems with a client and/or family members or deal with specific individual problems such as personal finances and work attendance. The basic goal for a client regardless of setting is to reduce the risk of harm that may result from continued use of substances. The reduction of harm, in its broadest sense, pertains to the clients themselves, their families, and the community. The brief therapies discussed in this TIP are brief cognitive- behavioral therapy, brief strategic and interactional therapies, brief humanistic and existential therapies, brief psychodynamic therapy, short- term family therapy, and time- limited group therapy. The choice to include these therapeutic modalities was based on a combination of relevant research and, in some instances where there is a smaller research base, the clinical knowledge and expertise of the Consensus Panel. All of these approaches are currently being used in the treatment of substance abuse disorders, and all of them can contribute something to the array of treatment techniques available to the eclectic practitioner. Brief interventions and brief therapies may be thought of as elements on a continuum of care, but they can be distinguished from each other according to differences in outcome goals. Interventions are generally aimed at motivating a client to perform a particular action (e. This TIP presents brief interventions as a way of improving client motivation for treatment. The brief therapies considered here are ways of changing client attitudes and behaviors. Other differences that help distinguish brief interventions from brief therapies include Length of the sessions (from 5 minutes for an intervention to more than six 1- hour therapy sessions) Extensiveness of assessment (which will be greater for therapies than for interventions) Setting (nontraditional treatment settings such as a social service or primary care setting, which will use interventions exclusively, versus traditional substance abuse treatment settings where therapy or counseling will be used in addition to interventions) Personnel delivering the treatment (brief interventions can be administered by a wide range of professionals, but therapy requires training in specific therapeutic modalities) Materials and media used (certain materials such as written booklets or computer programs may be used in the delivery of interventions but not therapies)Although the theoretical bases for brief therapy and brief intervention may be different, this distinction is less obvious in practice. These two approaches to substance abuse problems and behavior change reflect a continuum rather than a clear dichotomy. The distinction may be further blurred as the change process associated with the success of brief interventions is better understood or refined and as theories are developed to explain a brief intervention's mechanism of action. Already, some forms of brief intervention overlap with therapy, such as motivational enhancement therapy, which has a clearly articulated theoretical rationale (for more on this topic, see TIP 3. Enhancing Motivation for Change in Substance Abuse Treatment, which was conceived as a companion volume to this TIP . Therapy involves movement (or an attempt at movement) toward change. Brief therapy concentrates particularly on investigating a problem in order to develop a solution in consultation with the client; brief interventions generally involve a therapist giving advice to the client. The increasing emphasis on brief approaches is partly attributable to recent changes in the health care delivery system, in which clinicians are urged to reduce costs while maintaining treatment efficacy. Essentially, clinicians are constrained by time and diminishing resources yet are treating an increasing number of individuals with substance abuse problems. Fortunately, there is a body of literature on brief approaches in the treatment of substance abuse disorders. Brief interventions and brief therapies have the appeal not only of being brief but also of having research backing that supports their use. Brief interventions have been widely tested with both general clinical and substance- abusing populations and have shown great promise in changing client behavior. Brief therapies, however, have been unevenly researched. As indicated in the discussion of each type, in addition to the empirical results reported in scientific journals, clinical and anecdotal evidence supports the efficacy of brief therapies in the treatment of substance abuse. The brevity and lower delivery costs of these brief approaches make them ideal mechanisms for use in settings from primary care to substance abuse treatment where cost often plays as much of a role as efficacy in determining what treatments clients receive. Brief interventions and brief therapies are also well suited for clients who may not be willing or able to expend the significant personal and financial resources necessary to complete more intensive, longer term treatments. Although much research supports the theory that longer time in treatment is associated with better outcomes, research also suggests that for some clients, there is no loss in effectiveness when length and intensity of treatment are reduced. An Overview of Brief Interventions Definitions of brief interventions vary. In the recent literature, they have been referred to as . As one researcher notes,Brief interventions for excessive drinking should not be referred to as an homogenous entity, but as a family of interventions varying in length, structure, targets of intervention, personnel responsible for their delivery, media of communication and several other ways, including their underpinning theory and intervention philosophy (Heather, 1. Brief interventions, therefore, can be viewed as a set of principles regarding interventions which are different from, but not in conflict with, the principles underlying conventional treatment (Heather, 1. Brief interventions for alcohol problems, for example, have employed various approaches to change drinking behaviors. These approaches have ranged from relatively unstructured counseling and feedback to more formal structured therapy and have relied heavily on concepts and techniques from the behavioral self- control training (BSCT) literature (Miller and Hester, 1. Miller and Munoz, 1. Miller and Rollnick, 1. Miller and Taylor, 1. Chapter 4 for more information on BSCT). Usually, brief treatment interventions have flexible goals, allowing the individual to choose moderation or abstinence. The typical counseling goal is to motivate the client to change her behavior and not to assign self- blame. While much of the research to date has centered on clients with alcohol- related problems, similar approaches can be taken with users of other substances. Brief interventions are a useful component of a full spectrum of treatment options; they are particularly valuable when more extensive treatments are unavailable or a client is resistant to such treatment. Too few clinicians, however, are educated and skilled in the use of brief interventions and therapies to address the very large group of midrange substance users who have moderate and risky consumption patterns (see Figure 1- 1). Although this group may not need or accept traditional substance abuse treatment, these individuals are nonetheless responsible for a disproportionate share of substance- related morbidity, including lowered workforce performance, motor vehicle accidents and other injuries, marital discord, family dysfunction, and medical illness (Wilk et al., 1. These hazardous substance users are identified in employment assistance programs (EAPs), programs for people cited for driving while intoxicated (DWI), and urine testing programs, as well as in physicians' offices and other health screening efforts (Miller, 1.
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