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Brief Therapy in Substance Abuse Treatment

Brief therapy is a systematic, focused process that relies on assessment, client engagement and rapid implementation of change strategies. Brief therapy differs from longer-term therapy in that it focuses on the present, emphasizes using therapeutic tools in a shorter time, and focuses on a specific behavioral change. There is promising evidence that brief therapies as a treatment for substance abuse disorders are often as effective as lengthier treatments. They are more effective than being on a waiting list. The suitability of brief therapy needs to be evaluated on a case-by-case basis. Brief therapy for substance abuse dx’s is often helpful, but should not be considered a standard for all persons or populations.

Components of Effective Brief Therapy

Screening/ Assessment: characteristics identified, determine if brief therapy approach suitable for client

Opening Session: identifying, focusing and prioritizing problems/goals, establish rapport/engagement

Establishing treatment goals: identify goals most important to client and work with client to achieve them

Subsequent sessions: help maintain motivation, reinforce, and maintain focus

Maintenance strategies: educating client, ongoing review, identify coping

Ending Treatment: review positive outcomes/pitfalls, relapse prevention

Follow up: reassures client

Before processing brief therapy for SA dx’s the following areas should be assessed:

- Current use patterns

- Hx of SA

- Consequences of SA

- Coexisting psychiatric dx’s

- Information about major medical problems & health status

- Information about education & employment

- Support mechanisms

- Client strengths & situational advantages

- Previous treatment

- Family hx of SA & psychological dx’s

Approaches to Brief Therapy

- Cognitive Therapy: helps clients examine their negative thoughts and replace them with more positive beliefs and actions.

- Behavioral Therapy: teaches clients skills to improve deficiencies in social functioning, selfcontrol or other behaviors contributing to SA.

- Cognitive behavioral therapy: learning and practicing various coping skills; changing what the client does and thinks rather than just focusing on changing how the client thinks.

- Strategic/interactional therapies: seek to understand a client’s viewpoint on a problem, what meaning is attributed to events, and what ineffective interpersonal interactions and coping strategies are being applied.

- Solution Focused Therapy: helps a client recognize the exceptions to use as a means to reinforce and change behavior. Find solutions to problem behaviors & focus on solutions that have already worked for the client in the past.

- Humanistic and Existential therapies: through unconditional acceptance, clients are encouraged to improve their self-respect, self-motivation, and growth. Seek alternatives to SA in order to fill the emptiness being experienced.

- Psychodynamic: helps the client gain insight into underlying causes of manifest problems, understand what function SA is serving and strengthen present defenses to work through the problem. Assist the client in making positive changes.

- Interpersonal: focuses on reducing the client’s dysfunctional systems and improving social functioning by concentrating on a client’s maladaptive pattern of behavior.

- Family therapy: helps family members discover how their own system operates, improve communication and problem-solving skills, and increase the exchange of positive reinforcement.

- Group therapy: the group itself & the processes that emerge are central to helping clients see themselves in the reactions of others.

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