Brief Interventions and Brief Therapies for Substance Abuse

Brief Interventions and Brief Therapies for Substance Abuse

Treatment Improvement Protocol (TIP) Series

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What is a TIP?

Treatment Improvement Protocols (TIPs) are developed by the Substance Abuse and Mental Health Services Administration (SAMHSA) within the U.S. Department of Health and Human Services (HHS). Each TIP involves the development of topic-specific best-practice guidelines for the prevention and treatment of substance use and mental disorders. TIPs draw on the experience

and knowledge of clinical, research, and administrative experts of various forms of treatment and prevention. TIPs are distributed to facilities and individuals across the country.

Published TIPs can be accessed via the Internet at http://kap.samhsa.gov. Although each consensus-based TIP strives to include an evidence base for the practices it recommends, SAMHSA recognizes that behavioral health is continually evolving, and research frequently lags behind the innovations pioneered in the field. A major goal of each TIP is to convey "front-line" information quickly but responsibly. If research supports a particular approach, citations are provided.

Forward

The Treatment Improvement Protocol (TIP) series fulfills the Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) mission to improve prevention and treatment of substance use and mental disorders by providing best practices guidance to clinicians, program administrators, and payers. TIPs are the result of careful consideration of all relevant clinical and health services research findings, demonstration experience, and implementation requirements. A panel of non-Federal clinical researchers, clinicians, program administrators, and patient advocates debates and discusses their particular area of expertise until they reach a consensus on best practices. This panel’s work is then reviewed and critiqued by field reviewers. This TIP is one in a series of Evidenced Based Programs that is designed to fulfill the above mentioned mission.

Acknowledgments

This publication was prepared under subcontracted curriculum consultant Debra Orrick with editing and technical revision by Philip Orrick, Co-director of the South Southwest Addiction Technology Transfer Center (SSWATTC), Jim Bradley and Stephanie Askins, consultants.

Disclaimer

The opinions expressed herein are the views of the consensus panel members and do not necessarily reflect the official position of SAMHSA or HHS. No official support of or endorsement by SAMHSA or HHS for these opinions or for the instruments or resources described are intended or should be inferred. The guidelines presented should not be considered substitutes for individualized client care and treatment decisions.

Public Domain Notice

All materials appearing in this volume except those taken directly from copyrighted sources are in the public domain and may be reproduced or copied without permission from SAMHSA, the authors of SSWATTC. Citation of the source is appreciated. However, this publication may not be reproduced or distributed for a fee without the specific, written authorization of the Office of Communications, SAMHSA, HHS, or SSWATTC.

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Electronic Access and Printed Copies

The document can be downloaded from the SSWATTC Web site at www.attcnetwork.org/regcenters/index_gulfcoast.asp

Recommended Citation

Center for Substance Abuse Treatment. Brief Interventions and Brief Therapies for Substance Abuse. Treatment Improvement Protocol (TIP) Series, No. 34. HHS Publication No. (SMA) 12-

3952. Rockville, MD: Substance Abuse and Mental Health Services Administration, 1999.

Contents

Executive Summary and Recommendations……………………………………………...... vii

Summary and Recommendations……………………………………………………………...... viii

Introduction……………………………………………………………………………………….xxi

Trainer Guide Organization………………………………………………………………………xxv

Notes for Trainers………………………………………………………………………………xxviii

Module 1: Introduction to the TIP 34 Training Program…...... 31

TIP References, Training Emphasis, Learning Objectives, Agenda, Common Characteristics of

Brief Interventions and Brief Therapies, Training Equipment and Supplies, Definition of Terms,

and Participant Materials………………………………………………………………………….31

Section 1 – Welcome and Introduction……………………………………………………………33

Section 2 - Reasons for Using Brief Interventions and Brief Therapies………………………….35

Section 3 - Common Characteristics of Brief Interventions and Brief Therapies………………..37

Section 4 – Training Overview………………………………………………………………...... 39

Section 5 – Quality Assurance and Improvement……………………………………………...... 42

Section 6 - Strategy Identification Exercise Overview………………………………………...... 43

Section 7 – Strategy Integration Mind-Map Exercise Overview…………………………………44

Section 8 – Training Follow-up and Feedback………………………………………………...... 46

Section 9 – Assignments and Closing…………………………………………………………….47

Participant Workbook - (Identical titles to each section in Sections 1-9 above)…...... 48

Sample Strategy Integration Mind-Map (Blank)………………………………………………….56

Sample Strategy Integration Mind-Map (Instructions)…………………………………………...57

Module 2: Brief Interventions………………………………………………………………….58

TIP Reference, Training Emphasis, Learning Objectives, Agenda, Training Equipment and

Supplies, Definition of Terms, and Participant Materials…………………………………………58

Section 1 – Welcome and Introduction……………………………………………………………60

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Section 2 – Brief Interventions Summary Grid…………………………………………………60

Section 3 – Strategy Identification Exercise……………………………………………………67

Section 4 – Strategy Identification Mind-Map Exercise………………………………………..68

Section 5 – Assignments and Closing…………………………………………………………..70

Participant Workbook - (Identical titles to each section in Sections 1-5 above)…...... 72

Sample Strategy Integration Mind-Map (Blank)…………………………………………….....83

Module 3: Brief Therapy……………………………………………………………………...84

TIP Reference, Training Emphasis, Learning Objectives, Agenda, Training Equipment and

Supplies, Definition of Terms, and Participant Materials……………………………………….84

Section 1 – Welcome and Introduction………………………………………………………….86

Section 2 – Brief Therapy Summary Grid……………………………………………………….86

Section 3 – Strategy Identification Exercise…………………………………………………….97

Section 4 – Strategy Identification Mind-Map Exercise………………………………………...98

Section 5 – Assignments and Closing………………………………………………………….100

Participant Workbook - (Identical titles to each section in Sections 1-5 above)…...... 101

Sample Strategy Integration Mind-Map (Blank)……………………………………………….112

Module 4: Brief Behavioral Therapy Based on Classical Conditioning…………………..113

TIP Reference, Training Emphasis, Learning Objectives, Agenda, Training Equipment and

Supplies, Definition of Terms, and Participant Materials………………………………………113

Section 1 – Welcome and Introduction…………………………………………………………115

Section 2 – Brief Behavioral Therapy Based on Classical Conditioning Summary Grid……..116

Section 3 – Strategy Identification Exercise……………………………………………………120

Section 4 – Strategy Identification Mind-Map Exercise………………………………………..122

Section 5 – Assignments and Closing…………………………………………………………..123

Participant Workbook - (Identical titles to each section in Sections 1-5 above)…...... 125

Sample Strategy Integration Mind-Map (Blank)………………………………………………..131

Module 5: Brief Behavioral Therapy Based on Operant Learning………………………..132

TIP Reference, Training Emphasis, Learning Objectives, Agenda, Training Equipment and

Supplies, Definition of Terms, and Participant Materials………………………………………132

Section 1 – Welcome and Introduction…………………………………………………………134

Section 2 – Brief Behavioral Therapy Based on Operant Learning Summary Grid…………...143

Section 4 – Strategy Identification Mind-Map Exercise………………………………………..144

Section 5 – Assignments and Closing…………………………………………………………..146

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Participant Workbook - (Identical titles to each section in Sections 1-5 above)…...... 148

Sample Strategy Integration Mind-Map (Blank)……………………………………………….157

Module 6: Brief Cognitive Therapy………………………………………………………....158

TIP Reference, Training Emphasis, Learning Objectives, Agenda, Training Equipment and

Supplies, Definition of Terms, and Participant Materials……………………………………...158

Section 1 – Welcome and Introduction………………………………………………………...160

Section 2 – Brief Cognitive Therapy Summary Grid…………………………………………..161

Section 3 – Strategy Identification Exercise…………………………………………………...166

Section 4 – Strategy Identification Mind-Map Exercise……………………………………….168

Section 5 – Assignments and Closing………………………………………………………….169

Participant Workbook - (Identical titles to each section in Sections 1-5 above)…...... 171

Sample Strategy Integration Mind-Map (Blank)……………………………………………….178

Module 7: Brief Cognitive-Behavioral Therapy…………………………………………....179

TIP Reference, Training Emphasis, Learning Objectives, Agenda, Training Equipment and

Supplies, Definition of Terms, and Participant Materials……………………………………..179

Section 1 – Welcome and Introduction………………………………………………………..182

Section 2 – Brief Cognitive-Behavioral Therapy Summary Grid……………………………..182

Section 3 – Strategy Identification Exercise…………………………………………………...196

Section 4 – Strategy Identification Mind-Map Exercise……………………………………….199

Section 5 – Assignments and Closing………………………………………………………….201

Participant Workbook - (Identical titles to each section in Sections 1-5 above)…...... 202

Sample Strategy Integration Mind-Map (Blank)……………………………………………….216

Module 8: Brief Strategic/Interactional Therapies………………………………………...218

TIP Reference, Training Emphasis, Learning Objectives, Agenda, Training Equipment and

Supplies, Definition of Terms, and Participant Materials……………………………………..218

Section 1 – Welcome and Introduction………………………………………………………..219

Section 2 – Brief Strategic/Interactional Therapies Summary Grid…………………………..220

Section 3 – Strategy Identification Exercise…………………………………………………..229

Section 4 – Strategy Identification Mind-Map Exercise……………………………………....231

Section 5 – Assignments and Closing………………………………………………………....232

Participant Workbook - (Identical titles to each section in Sections 1-5 above)…...... 234

Sample Strategy Integration Mind-Map (Blank)……………………………………………...247

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Module 9: Brief Humanistic and Existential Therapies…………………………………..248

TIP Reference, Training Emphasis, Learning Objectives, Agenda, Training Equipment and

Supplies, Definition of Terms, and Participant Materials……………………………………248

Section 1 – Welcome and Introduction………………………………………………………250

Section 2 – Brief Humanistic and Existential Therapies Summary Grid…………………....251

Section 3 – Strategy Identification Exercise………………………………………………....264

Section 4 – Strategy Identification Mind-Map Exercise……………………………………..266

Section 5 – Assignments and Closing………………………………………………………..268

Participant Workbook - (Identical titles to each section in Sections 1-5 above)…...... 269

Sample Strategy Integration Mind-Map (Blank)…………………………………………….283

Module 10: Brief Psychodynamic Therapies…………………………………………….284

TIP Reference, Training Emphasis, Learning Objectives, Agenda, Training Equipment and

Supplies, Definition of Terms, and Participant Materials…………………………………..284

Section 1 – Welcome and Introduction……………………………………………………..287

Section 2 – Brief I Brief Psychodynamic Therapies Summary Grid……………………….288

Section 3 – Strategy Identification Exercise………………………………………………..306

Section 4 – Strategy Identification Mind-Map Exercise……………………………………308

Section 5 – Assignments and Closing………………………………………………………310

Participant Workbook - (Identical titles to each section in Sections 1-5 above)…...... 311

Sample Strategy Integration Mind-Map (Blank)……………………………………………329

Module 11: Brief Family Therapy……………………………………………………….330

TIP Reference, Training Emphasis, Learning Objectives, Agenda, Training Equipment and

Supplies, Definition of Terms, and Participant Materials…………………………………..330

Section 1 – Welcome and Introduction……………………………………………………..332

Section 2 – Brief Family Therapy Summary Grid…………………………………………..333

Section 3 – Strategy Identification Exercise………………………………………………...348

Section 4 – Strategy Identification Mind-Map Exercise…………………………………….348

Section 5 – Assignments and Closing……………………………………………………….350

Participant Workbook - (Identical titles to each section in Sections 1-5 above)…...... 351

Sample Strategy Integration Mind-Map (Blank)…………………………………………….368

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Module 12: Time-Limited Group Therapy

TIP Reference, Training Emphasis, Learning Objectives, Agenda, Training Equipment and

Supplies, Definition of Terms, and Participant Materials………………………………….369

Section 1 – Welcome and Introduction…………………………………………………….371

Section 2 – Time-Limited Group Therapy Summary Grid………………………………...372

Section 3 – Strategy Identification Exercise……………………………………………….388

Section 4 – Strategy Identification Mind-Map Exercise…………………………………...390

Section 5 – Assignments and Closing……………………………………………………...392

Participant Workbook - (Identical titles to each section in Sections 1-5 above)…...... 393

Sample Strategy Integration Mind-Map (Blank)…………………………………………...411

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