1. Foundations of Addictions Counseling, 3/E David Capuzzi & Mark D. Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved Chapter 8 Psychotherapeutic Approaches Updated by Melinda Haley, Walden University

2. Counselor Beliefs and Behaviors Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved Addiction ideology (e.g., medical, humanitarian or empathic, moralistic) affects the selection of specific treatment strategies. No one tried and true approach Views influence acceptance and use of new therapeutic approaches

3. Informed Eclecticism Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved No single best approach for everyone Treatment systems should include a variety of effective approaches Different individuals respond to different approaches

4. Empirically Supported Treatment Approaches (NIDA) Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved 96 interventions Relapse prevention Family behavior therapy Motivational Interviewing Motivational enhancement therapy Multisystemic therapy Contingency management Seeking Safety Various brief interventions (i.e. BASICS)

5. Cognitive-Behavioral Practices Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved Effective for alcohol and other drug dependencies behavioral self-control training community reinforcement contingency management and behavior contracting social skills training behavioral couples / family counseling

6. Cognitive-Behavioral Assumptions Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved Substance abuse Involves complex cognitive and behavioral processes Is largely learned Can be modified A major goal is to teach coping skills to resist substance use and to reduce problems

7. CBT Assumptions, (continued) Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved CB counseling requires comprehensive case conceptualization warm, supportive, collaborative counseling relationship

8. Cognitive-Behavioral Interventions that Target “Triggers” Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved Social interventions Environmental interventions Emotional interventions Cognitive interventions Physical interventions Useful Techniques ride the craving wave, surf the urge

9. Contingency Management and Behavior Contracting Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved Counselor and client contract External incentives or tangible reinforcers Vouchers, groceries, movie theater tickets

10. Community Reinforcement Approach (CRA) Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved Rearrange environmental stimuli to support sobriety Procedures according to client’s needs Goals for gaining/maintaining something positive

11. Community Reinforcement and Family Training (CRAFT) Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved Work with concerned others More constructive ways of interacting Natural consequences

12. Mindfulness-based Relapse Prevention Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved Several evidence-based approaches consider mindfulness a core skill and practice. MBRP is intended to promote increased awareness of triggers for substance use, habitual patterns of using, and “automatic” reactions that seem to control a person’s daily living.

13. Brief Interventions Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved All should include FRAMES Feedback Responsibility Advice Menu of alternatives Empathy Self-efficacy Often delivered by other professionals Target to those in early stage of change

14. Solution-Focused Counseling Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved Focus on the successes, achievements, strengths, resources, and abilities of the client “Counseling of hope” Research is positive Treatment plan-based reinforcement (TP) Strengths based/Non-punitive form of treatment

15. Solution-Focused Counseling Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved Pragmatism and parsimony Client-counselor collaboration Visitor-type, Complainant-type, Customer-type Language of hope Exceptions facilitate change Past exceptions Recent and recurrent exceptions Future exceptions (Miracle Question) Notice the difference Commendations

16. Harm Reduction Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved Based on client advocacy Compassionate pragmatism (vs. moralistic idealism) Effort to reduce harm to individuals and/or society Meets individuals where they are Low threshold for services Goals of staying alive, maintaining health, and/or getting better

17. Harm Reduction (continued) Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved Routes to abstinence “Warm Turkey” approach Sobriety sampling Tapering down Trial moderation Limiting intake Deemed inappropriate by some practitioners

18. Useful Web Sites Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved The Brief Family Therapy Center (SFC) www.brief-therapy.org The Harm Reduction Coalition www.harmreduction.com