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Combining Medication and Psychosocial Treatments for Addictions : The BRENDA Approach - A. Thomas McLellan

Combining Medication and Psychosocial Treatments for Addictions

The BRENDA Approach

Hardcover Published: 7th March 2001
ISBN: 9781572306189
Number Of Pages: 208

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Recent studies have shown combined addiction treatments to be more effective than either medication or talk therapy alone. This practical manual presents an empirically supported 6-stage framework for managing biopsychosocial treatment of alcohol and drug dependence. The BRENDA approach helps practitioners integrate emerging and established psychosocial and medical intervention approaches into a comprehensive treatment program that is tailored to the needs of the individual patient. Fully compatible with cognitive-behavioral and 12-step treatment models, BRENDA incorporates the use of newly developed medications, such as naltrexone, that target the biological underpinnings of addiction. The approach has been demonstrated effective in more than 80% of alcohol dependent referrals to the authors' treatment program. Illustrated with extended case examples, the manual describes how to conduct a thorough evaluation and assessment, select appropriate interventions, enhance the patient's motivation to change, coordinate service delivery with other providers as needed, and maximize treatment compliance.

Industry Reviews

"'A groundbreaking book--the first in the field to provide a clear, clinically useful, and practical explication of how to enhance patient compliance with medication and addictions treatment. While there have been other publications that have addressed this important issue in the age of increasing attention to neurobiological treatments for addiction, none has been as comprehensive or as solidly grounded in research findings. It is a 'must read' for all clinicians working with addicted patients in settings where medications are a part of treatment, or where other treatment compliance issues are important to address. It will also be useful in professional training for physicians, psychologists, social workers, and addiction counselors.' - Frederick Rotgers, PsyD, Smithers Addiction Treatment and Research Center, New York, NY 'This book describes treatment principles that are helpful to 80per cent of drug and alcohol patients! Within the BRENDA approach, psychosocial and pharmacological treatment choices are individualized, with emphasis on naltrexone for alcohol addiction. These talented researcher-practitioners have produced a much-needed guide that will be readily understood and used in practice and teaching by psychologists, counselors, social workers, nurse practitioners, and others.' - Lester Luborsky, PhD, School of Medicine, University of Pennsylvania"

The Brenda Approach and How to Use it
The Biopsychosocial Understanding of Addictionp. 3
A Review of Traditional Addiction Treatmentsp. 5
The Biopsychosocial Approachp. 9
A Comparison of the Typical Alcoholics Anonymous/Minnesota Model with the Biopsychosocial Modelp. 10
Managing Addiction Treatment Using the BRENDA Approachp. 16
Components of the BRENDA Approachp. 17
Integration of Stages of Change and Treatment Compliancep. 23
Overview of the Course of Treatment: How the Components Work Togetherp. 25
Biopsychosocial Assessment: How to Conduct Itp. 33
Crossing the Line: Screening for Addictionp. 33
Approach to Assessmentp. 35
Conducting the Comprehensive Biopsychosocial Evaluationp. 39
The Report: How to Prepare and Present the Assessment Resultsp. 47
Formulating a Profilep. 48
Reporting the Resultsp. 50
Observing the Patient's Reaction to the Report (Assessing Stage of Change)p. 51
Empathetic Understanding: Listening to the Patientp. 55
Empathetic Listening Strategiesp. 55
Applying Empathyp. 57
Needs: Identifying Patient Needs and Prioritiesp. 63
Identifying Needsp. 64
Basic Health and Safety Needsp. 65
Patient Needs and Prioritiesp. 66
Direct Advice: Matching Needs to Treatment Optionsp. 70
BRENDA Visitsp. 71
Meeting Safety Needsp. 71
Meeting Patient Needsp. 72
Giving Direct Advicep. 78
Assessment of the Patient's Reaction to Advice: Adjusting Advice to Patient Responsep. 83
Response to Direct Advice: Feedback on Direct Advicep. 83
How to Present the Assessment of Response to Direct Advicep. 86
Dealing with Pharmacotherapy and Medication Compliance Issuesp. 92
Denial of Disorderp. 93
Deficits in Knowledgep. 95
Uncomfortable Side Effectsp. 96
A Desire to Get Highp. 97
Lack of Control over a Chaotic Lifep. 97
Forgetting to Take Medicationsp. 98
Lost Medications/Failure to Renew Prescriptionsp. 99
Applying the BRENDA Stages to Early Recovery Issuesp. 101
Protracted Withdrawal Symptomsp. 103
The Relapse Processp. 103
Employmentp. 112
Sexual Activity and Partner Issuesp. 112
Applying the BRENDA Stages to Later Recovery Issuesp. 114
Triggers Revisitedp. 115
Childhood Issuesp. 117
Life Changes Revisitedp. 117
Relapse Prevention Revisitedp. 119
When to Stop Treatmentp. 121
The Brenda Approach in Action
The Case of Bill: A Successful Businessman with Alcohol Addictionp. 127
Initiating Treatment (Weeks 1-3)p. 128
Early Recovery (Weeks 4-9)p. 132
Later Recovery (Weeks 24-52)p. 137
Follow-Up Visitsp. 142
Summaryp. 142
The Case of Alissa: Cocaine and Alcohol Addiction with Severe Psychosocial Complicationsp. 144
Initiating Treatment (Weeks 1-4)p. 144
Early Recovery (Weeks 5-24)p. 150
Later Recovery (Weeks 28-52)p. 159
Follow-Up Visitsp. 161
Summaryp. 161
The Case of Stephen: A Binge Drinker/Precontemplatorp. 163
Initiating Treatment (Weeks 1-4)p. 163
Early Recovery (Weeks 5-24)p. 168
Later Recovery (Weeks 25-52)p. 175
Follow-Up Visitsp. 178
Summaryp. 178
Instrumentsp. 181
CAGE Questionnairep. 183
Alcohol Use Disorders Identification Test (AUDIT)p. 184
Substance Use Disorders Screenp. 187
Psychological Symptom Inventory--32 (PSI-32)p. 189
Naltrexone Pharmacotherapy for Alcohol Dependencep. 191
Dosage and Administrationp. 191
Pharmacokinetics/Mechanism of Actionp. 192
Drug Interaction Precautionsp. 192
Side Effectsp. 193
Contraindicationsp. 193
Patients' Frequently Asked Questions about Naltrexonep. 194
Medication Tips for Patientsp. 196
Referencesp. 199
Indexp. 203
Table of Contents provided by Syndetics. All Rights Reserved.

ISBN: 9781572306189
ISBN-10: 1572306181
Audience: Tertiary; University or College
Format: Hardcover
Language: English
Number Of Pages: 208
Published: 7th March 2001
Publisher: Guilford Publications
Country of Publication: US
Dimensions (cm): 22.9 x 15.2  x 1.9
Weight (kg): 0.5
Edition Number: 1