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.

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.

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.

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 promote a healthier lifestyle. It is of proven effectiveness, and should be more widely used. This 2001 book presents 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 treatment approach to all involved with the support and treatment of those with alcohol and drug problems.

In May 1986, the Association for Behavior Analysis (ABA) established a task force on the right to effective behavioral treatment. The mandate of this task force was to identify and delineate specific rights as they apply to behavioral treatment. Impetus for this project came in part from the controversy over the use of aversive procedures, which some held had no place in treatment and, with evolution of the treatment process, were no longer necessary. In con trast, others cited evidence that programs based on positive reinforcement alone were sometimes not effective in treating severe problems. These re searchers and practitioners desired to ensure that clients and guardians be permitted to choose treatments that included punishment procedures when assessments warranted their use. The first editor approached Ogden Lindsley, president of ABA, about establishing a task force to examine this isuse. The ABA council decided to broaden the mandate to include an examination of clients' right to effective behavioral treatment in general. The first editor was asked to chair the task force and appointed Saul Axelrod, Jon S. Bailey, Judith E. Favell, Richard M. Foxx, and 0. Ivar Lovaas as members. Brian A. Iwata was appointed liaison by the ABA council.

The National Health System in the United Kingdom has supported the integration of CM because of its evidence basis. CM has recently been implemented in clinics in Spain, the Netherlands, and Israel, and the author has been asked to consult on its integration in treatment settings in Canada, South Africa, Turkey, China, and Australia. The completion of the National Institute on Drug Abuse Clinical Trials Network study of CM interventions has raised awareness and interest throughout the US and abroad, most notably in Canada and the UK.

The leading manual on group-based treatment of substance use disorders, this highly practical book is grounded in the transtheoretical model and emphasizes the experiential and behavioral processes of change. The program helps clients move through the stages of change by building skills for acknowledging a problem, deciding to act, developing and executing a plan, and accomplishing other critical tasks. The expert authors provide step-by-step guidelines for implementing the 35 structured sessions, along with strategies for enhancing motivation. In a large-size format with lay-flat binding for easy photocopying, the volume includes 58 reproducible handouts. Purchasers get access to a Web page where they can download and print the reproducible materials. New to This Edition *Reflects significant developments in research and clinical practice. *Eight new sessions focusing on the brain and substance use, gratitude, self-control, mindfulness, acceptance, and more. *Updated discussions of motivational interviewing and the use of cognitive-behavioral techniques with groups. *41 of the 58 handouts are new or revised; all are now downloadable. See also Substance Abuse Treatment and the Stages of Change, Second Edition, by Gerard J. Connors et al., which explores how the transtheoretical model can inform treatment planning and intervention in diverse clinical contexts.

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

Motivation is key to substance use behavior change. Counselors can support clients' movement toward positive changes in their substance use by identifying and enhancing motivation that already exists. Motivational approaches are based on the principles of person-centered counseling. Counselors' use of empathy, not authority and power, is key to enhancing clients' motivation to change. Clients are experts in their own recovery from SUDs. Counselors should engage them in collaborative partnerships. Ambivalence about change is normal. Resistance to change is an expression of ambivalence about change, not a client trait or characteristic. Confrontational approaches increase client resistance and discord in the counseling relationship. Motivational approaches explore ambivalence in a nonjudgmental and compassionate way.