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9781572306189

Combining Medication and Psychosocial Treatments for Addictions The BRENDA Approach

by ; ; ;
  • ISBN13:

    9781572306189

  • ISBN10:

    1572306181

  • Format: Hardcover
  • Copyright: 2001-03-07
  • Publisher: The Guilford Press
  • Purchase Benefits
List Price: $48.00

Summary

Recent studies have shown a combination of psychosocial support and medications to lead to better addiction treatment outcomes than talk therapy alone. This practical manual provides an empirically supported framework for managing biopsychosocial treatment of alcohol and drug dependence. Fully compatible with cognitive-behavioral and 12-step models, BRENDA is a collaborative, case-management approach to treatment. It incorporates the use of newly developed medications that target the biological underpinnings of addiction, and maximizes treatment compliance through working with patients in a nonjudgmental manner and enhancing their motivation to change. Illustrated with extended case examples, the book describes how to conduct a thorough assessment, make recommendations for a variety of individualized interventions, and coordinate service delivery with other providers as needed. The approach has been demonstrated effective in more than 80% of alcohol-dependent referrals to the authors' treatment program.

Author Biography

Joseph R. Volpicelli, MD, PhD, Associate Professor and Senior Scientist,University of Pennsylvania

Helen M. Pettinati, PhD, Associate Professor, Department of Psychiatry, Treatment Research Center, University of Pennsylvania

A. Thomas McLellan, PhD, Senior Scientist, Treatment Research Institute, Philadelphia, PA

Charles P. O'Brien, MD, PhD, Treatment Research Center, University of Pennsylvania

Table of Contents

PART I. THE BRENDA APPROACH AND HOW TO USE IT
The Biopsychosocial Understanding of Addiction
3(13)
A Review of Traditional Addiction Treatments
5(4)
The Biopsychosocial Approach
9(1)
A Comparison of the Typical Alcoholics Anomymous/Minnesota Model with the Biopsychosocial Model
10(6)
Managing Addiction Treatment Using the Brenda Approach
16(17)
Components of the Brenda Approach
17(6)
Integration of Stages of Change and Treatment Compliance
23(2)
Overview of the Course of Treatment: How the Components Work Together
25(8)
Biopsychosocial Assessment: How to Conduct It
33(14)
Crossing the Line: Screening for Addiction
33(2)
Approach to Assessment
35(4)
Conducting the Comprehensive Biopsychosocial Evaluation
39(8)
The Report: How to Prepare and Present the Assessment Results
47(8)
Formulating a Profile
48(2)
Reporting the Results
50(1)
Observing the Patient's Reaction to the Report (Assessing Stage of Change)
51(4)
Empathetic Understanding: Listening to the Patient
55(8)
Empathetic Listening Strategies
55(2)
Applying Empathy
57(6)
Needs: Identifying Patient Needs and Priorities
63(7)
Identifying Needs
64(1)
Basic Health and Safety Needs
65(1)
Patient Needs and Priorities
66(4)
Direct Advice: Matching Needs to Treatment Options
70(13)
Brenda Visits
71(1)
Meeting Safety Needs
71(1)
Meeting Patient Needs
72(6)
Giving Direct Advice
78(5)
Assessment of the Patient's Reaction to Advice: Adjusting Advice to Patient Response
83(9)
Response to Direct Advice: Feedback on Direct Advice
83(3)
How to Present the Assessment of Response to Direct Advice
86(6)
Dealing with Pharmacotherapy and Medication Compliance Issues
92(9)
Denial of Disorder
93(2)
Deficits in Knowledge
95(1)
Uncomfortable Side Effects
96(1)
A Desire to Get High
97(1)
Lack of Control over a Chaotic Life
97(1)
Forgetting to Take Medications
98(1)
Lost Medications/Failure to Renew Prescriptions
99(2)
Applying the Brenda Stages to Early Recovery Issues
101(13)
Protracted Withdrawal Symptoms
103(1)
The Relapse Process
103(9)
Employment
112(1)
Sexual Activity and Partner Issues
112(2)
Applying the Brenda Stages to Later Recovery Issues
114(13)
Triggers Revisited
115(2)
Childhood Issues
117(1)
Life Changes Revisited
117(2)
Relapse Prevention Revisited
119(2)
When to Stop Treatment
121(6)
PART II. THE BRENDA APPROACH IN ACTION
The Case of Bill: A Successful Businessman with Alcohol Addiction
127(17)
Initiating Treatment (Weeks 1-3)
128(4)
Early Recovery (Weeks 4-9)
132(5)
Later Recovery (Weeks 24-52)
137(5)
Follow-Up Visits
142(1)
Summary
142(2)
The Case of Alissa: Cocaine and Alcohol Addiction with Severe Psychosocial Complications
144(19)
Initiating Treatment (Weeks 1-4)
144(6)
Early Recovery (Weeks 5-24)
150(9)
Later Recovery (Weeks 28-52)
159(2)
Follow-Up Visits
161(1)
Summary
161(2)
The Case of Stephen: A Binge Drinker/Precontemplator
163(18)
Initiating Treatment (Weeks 1-4)
163(5)
Early Recovery (Weeks 5-24)
168(7)
Later Recovery (Weeks 25-52)
175(3)
Follow-Up Visits
178(1)
Summary
178(3)
Appendix A Instruments 181(10)
CAGE Questionnaire
183(1)
Alcohol Use Disorders Identification Test (Audit)
184(3)
Substance Use Disorders Screen
187(2)
Psychological Symptom Inventory---32 (PSI-32)
189(2)
Appendix B Naltrexone Pharmacotherapy for Alcohol Dependence 191(8)
Dosage and Administration
191(1)
Pharmacokinetics/Mechanism of Action
192(1)
Drug Interaction Precautions
192(1)
Side Effects
193(1)
Contraindications
193(1)
Patients' Frequently Asked Questions about Naltrexone
194(2)
Medication Tips for Patients
196(3)
References 199(4)
Index 203

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