%0 Generic %C London %D 2017 %F ndc:27633 %I Drug and Alcohol Findings %N 21 July 2017 %T Intervene beyond the family to help young problem substance users. %U http://www.drugsandalcohol.ie/27633/ %X Review finds multidimensional family therapy more effective than group therapies and other psychosocial therapies, particularly among adolescents with severe substance use and other behavioural problems. Key points from summary and commentary • A review of the effectiveness of multidimensional family therapy versus cognitive-behavioural therapy, group therapy, or treatments which combined cognitive-behavioural therapy with other approaches. • Compared with other therapies, multidimensional family therapy was more effective overall, particularly among young people with severe substance use and other behavioural problems. • This makes it a valuable therapy, especially for young people with more challenging treatment and support needs. %0 Journal Article %@ 1469-1833 %A Van Hout, Marie Claire %A Norman, Ian %A Rich, Eileen %A Bergin, Michael %D 2017 %F ndc:26839 %I Cambridge University Press %J Behavioural and Cognitive Psychotherapy %N 3 %P 238-252 %T Experiences of codeine use, misuse and dependence: application of Liese and Franz's cognitive developmental model of substance abuse. %U http://www.drugsandalcohol.ie/26839/ %V 45 %X BACKGROUND Misuse of codeine-containing medicines is an emerging public health issue. AIMS We present the application of Liese and Franz's (1996) cognitive developmental model of substance abuse to the trajectory from legitimate codeine use for pain, towards that of therapeutic and other forms of misuse, and physical and psychological dependence. It illustrates a cognitive behavioural analysis of the experiences of codeine misusers - which 'surfaces' the specific beliefs, thoughts, emotions and behaviours of this group of hidden codeine dependent individuals, who are distinct and unique from other opioid-dependent cohorts. METHOD In-depth one-to-one interviews with codeine misusers and dependent individuals in Ireland (n = 21) and South Africa (n = 25) are analysed and applied to Liese and Franz's (1996) cognitive developmental model of substance abuse. RESULTS Misuse and dependence pathways are maintained by the interplay between physiological determinants relating to pain, withdrawal and tolerance, and psychological influences such as therapeutic need, pre-empting of anticipated physical pain, pleasure from the dreamy sedative opiate effect of codeine and relief of emotional distress. Progression towards habitual use and misuse for therapeutic and intoxication purposes appears to be mediated by external environmental triggers pertaining to availability, internal meta-cognitions around physical pain and emotional distress, and increasing importance of codeine in the life of the user. CONCLUSION The concept mapping of codeine misuse and dependence presented here could provide psychological therapists working with individuals experiencing problems with codeine, misusing codeine and those with iatrogenic dependence, with an enhanced understanding of the key concepts involved in misuse and recovery pathways. %0 Generic %C London %D 2016 %F ndc:26017 %I Drug and Alcohol Findings %T The shared essence of effective therapies. %U http://www.drugsandalcohol.ie/26017/ %0 Generic %A European Monitoring Centre for Drugs and Drug Addiction, %C Lisbon %D 2015 %F ndc:24051 %I European Monitoring Centre for Drugs and Drug Addiction %T Perspectives on drugs: The role of psychosocial interventions in drug treatment. %U http://www.drugsandalcohol.ie/24051/ %X Psychosocial interventions are structured psychological or social interventions used to address substance-related problems. They can be used at different stages of drug treatment to identify the problem, treat it and assist with social reintegration. Psychosocial interventions are used to treat many different types of drug problems and behavioural addictions. This analysis explains what the main psychosocial interventions are and to whom they are provided. Part of the Perspectives on Drugs (PODs) series, launched as part of the European Drug Report package, these designed-for-the-web interactive analyses provide deeper insights into a selection of important issues. %0 Generic %A Darker, Catherine D %A Sweeney, Brion %A Barry, Joseph %A Farrell, Michael %A Donnelly-Swift, Erica %C London %D 2015 %F ndc:18864 %I John Wiley & Sons, Ltd %T Psychosocial interventions for benzodiazepine harmful use, abuse or dependence. %U http://www.drugsandalcohol.ie/18864/ %V 5 %X Conclusion: Cognitive behavioural therapy (CBT) plus taper is effective in the short term (three month time period) in reducing benzodiazepine (BZD) use. However, this is not maintained at six months and subsequently. The possibility of including a 'top-up' of CBT to sustain long term effects should be investigated. Currently there is insufficient evidence to support the use of Motivational Interviewing (MI) to reduce BZD use. There is some evidence to suggest that a tailored GP letter versus a general GP letter, standardised interview versus treatment as usual (TAU) and relaxation versus TAU could be effective for BZD reduction. There is currently insufficient evidence for other psychosocial approaches to reduce BZD use. %0 Generic %A Filges, Trine %A Knudsen, Anne-Sofie Due %A Svendsen, Majken Mosegaard %A Kowalski, Krystyna %A Benjaminsen, Lars %A Jørgensen, Anne-Marie Klint %D 2015 %F ndc:26161 %I The Campbell Collaboration %N 2015:3 %T Cognitive-behavioural therapies for young people in outpatient treatment for non-opioid drug use: a systematic review. %U http://www.drugsandalcohol.ie/26161/ %X Youth drug use is a severe problem worldwide. This review focuses on Cognitive-Behavioural Therapy (CBT) as a treatment for young people who misuse non-opioid drugs, such as cannabis, amphetamines, ecstasy and cocaine, which are strongly associated with a range of health and social problems. CBT is an individualized and multicomponent intervention that combines behavioural and cognitive therapy. While behavioural therapy mainly focuses on external settings and observable behaviour, cognitive therapy is concerned with internal cognitive processes. The primary focus of CBT is to reduce users’ positive expectations about drug use, to enhance their self-confidence to resist drugs, and to improve their skills for problem-solving and for coping with daily life stressors. The objective of this review is to assess the effectiveness of CBT for young people (aged 13-21) in outpatient treatment for non-opioid drug use and to explore any factors that may moderate outcomes. The literature search yielded a total of 18,514 references, of which 394 were deemed potentially relevant and retrieved for eligibility determination. Of these, 360 did not fulfil the screening criteria and were excluded. Four records were unobtainable. A total of seven unique studies, reported in 17 papers, were included in the review. Meta-analysis was used to examine the effects of CBT on drug use reduction, social and family functioning, school problems, treatment retention and criminal activity compared to a group of other interventions (Adolescent Community Reinforcement Approach (ACRA), Chestnut Bloomington Outpatient (CBOP) (+Assertive Continuing Care (ACC)), Drugs Harm Psychoeducation curriculum (DHPE), Functional Family Therapy (FFT), Interactional Therapy (IT), Multidimensional Family Therapy (MDFT), and Psychoeducational Therapy (PET)). Our main objective was to evaluate the current evidence on the effect of CBT on abstinence and drug use reduction for young people in outpatient treatment for non-opioid drug use. Seven randomised trials, involving 953 participants, were included in this review. Each of the seven included studies compared CBT to another intervention. We analysed the effects in the short term (from the start of treatment to up to 6 months thereafter), medium term (from 6 months to less than 12 months after the start of treatment), and long term (12 months or more after the start of treatment). We analysed CBT that was delivered with an add-on component such as motivational interviewing (four studies) separately from CBT that was delivered without an add-on component (three studies). Based on meta-analysis of data from the four included studies analysing CBT with an add-on component, there was no evidence of a relative effect of CBT for the reduction of youth drug use frequency compared to other interventions (ACRA, CBOP (+ACC), DHPE, FFT and MDFT). The random effects standardized mean difference was -0.14 (95% CI -0.64, 0.36) for the short term based on four studies, -0.06 (95% CI -0.44, 0.32) for the medium term based on four studies and -0.15 (95% CI -0.36, 0.06) for the long term based on two studies. Based on meta-analysis of data from the four included studies analysing CBT without an add-on component, there was no evidence of a relative effect of CBT for the reduction of youth drug use frequency compared to other interventions (IT, MDFT, and PET ). The random effects standardized mean difference was -0.13 (95% CI -0.68, 0.42) for the short term based on two studies, -0.08 (95% CI -0.48, 0.31) for the medium term based on three studies and 0.02 (95% CI -0.48, 0.52) for the long term based on two studies. Thus, the available data does not support the hypothesis that there is a drug use reduction effect from using CBT with young drug users compared to other interventions (ACRA, CBOP (+ACC), DHPE, FFT, IT, MDFT, and PET ). Statistically significant heterogeneity was present in the short term. In the medium term statistically significant heterogeneity was present between studies analysing CBT with an add-on component. In the analysis of studies without an add-on component there was no statistically significant heterogeneity in the medium term. Due to the low power of detecting heterogeneity with only two studies included in the analysis, this result should be interpreted with caution. There was no heterogeneity between studies in the long term; however, with only two studies included in the analyses the power to detect heterogeneity was low. The primary outcome measured as recovery could only be analysed in the long term. The meta-analysis of CBT with an add-on component was inconclusive as the eight different comparison combinations analysed showed different results. Only one study analysing CBT without an add-on component provided data on recovery status. The reported effect was not statistically significant. %0 Journal Article %@ 0790-9667 %A Farren, Conor Kevin %A Milnes, Jennie %A Lambe, K %A Ahern, Sinead %D 2015 %F ndc:23100 %I Medmedia Group %J Irish Journal of Psychological Medicine %N 3 %P 237-246 %T Computerised cognitive behavioural therapy for alcohol use disorder: a pilot randomised control trial. %U http://www.drugsandalcohol.ie/23100/ %V 32 %0 Journal Article %@ 1878-1888 %A Thekiso, Thekiso B %A Murphy, Philip %A Milnes, Jennie %A Lambe, Kathryn %A Curtin, Aisling %A Farren, Conor K %D 2015 %F ndc:25668 %I n/a %J Behavior Therapy %N 6 %P 717-728 %T Acceptance and commitment therapy in the treatment of alcohol use disorder and comorbid affective disorder: a pilot matched control trial. %U http://www.drugsandalcohol.ie/25668/ %V 46 %X This study examined whether acceptance and commitment therapy (ACT) enhances treatment as usual (TAU) in improving treatment outcomes in patients with alcohol use disorder (AUD) and comorbid affective disorder. Fifty-two participants were included in the study, of whom 26 were patients with AUD and either depression or bipolar disorder treated with ACT group therapy in parallel with TAU (inpatient integrated treatment) and 26 were matched controls who had received TAU alone. Drinking and craving outcomes were total alcohol abstinence, cumulative abstinence duration (CAD) and Obsessive Compulsive Drinking Scale (OCDS) scores at 3 and 6 months postintervention. Affective and anxiety outcomes were Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Young Mania Rating Scale (YMRS) scores at these follow-ups. Baseline demographic and clinical characteristics were similar in both groups. Retention rates were high: 100% of the ACT group were followed up at 3 and 6 months; 92.3% and 84.6% of the TAU alone group were followed up at 3 and 6 months, respectively. Patients in the ACT group reported significantly higher CAD at 3 and 6 months, significantly lower BDI and BAI scores at 3 and 6 months, and significantly lower OCDS scores at 3 months, than those who received only TAU. No other significant differences in treatment outcomes were found between the groups. ACT provides added benefit to TAU in improving drinking, craving, depression and anxiety outcomes in patients with AUD and comorbid affective disorder. Most treatment improvements were sustained over a 6-month follow-up period. %0 Report %9 Other %A Dermody, Aoife %A Gardner, Caroline %B %C Dublin %D 2014 %F ndc:22231 %I Dublin 12 Local Drugs Task Force and Addiction Response Crumlin %T Dublin 12 alcohol programme evaluation. %U http://www.drugsandalcohol.ie/22231/ %X The Addiction Response Crumlin alcohol programme is a ten-week programme to support those who want to reduce or abstain from alcohol use. It is based on the Reduce the Use model. The evaluation took place in 2014 using interviews, focus groups, surveys and case studies. Over 30 people took part. %0 Report %9 Other %A SAOL Project, %B %C Dublin %D 2014 %F ndc:22052 %I SAOL Project %T RecoverMe. %U http://www.drugsandalcohol.ie/22052/ %0 Generic %A Drug and Alcohol Findings, %A Substance Misuse Skills Consortium, %C London %D 2014 %F ndc:22524 %I Drug and Alcohol Findings and the Substance Misuse Skills Consortium %T Alcohol Matrix cell A4: Interventions - psychosocial therapies. %U http://www.drugsandalcohol.ie/22524/ %0 Generic %A Drug and Alcohol Findings, %C London %D 2013 %F ndc:20052 %I Drug and Alcohol Findings %T Effectiveness Bank Bulletin. [Prison health care]. %U http://www.drugsandalcohol.ie/20052/ %V 11 Jun %X 1. The effectiveness of Prisoners Addressing Substance Related Offending (P-ASRO) programme: evaluating the pre and post treatment psychometric outcomes in an adult male category C prison. Crane M.A.J., Blud L. British Journal of Forensic Practice: 2012, 14(1), p.49–59. From the early 2000s cognitive-behavioural group therapy programmes have been relied on to improve the anti-offending record of UK prisons and probation services, but evidence has been scarce and generally negative. This prison study at least suggests that one such programme does promote the intended psychological changes. 2. Comparison of methadone and buprenorphine for opiate detoxification (LEEDS trial): a randomised controlled trial. Wright N.M.J., Sheard L., Adams C.E. et al. British Journal of General Practice: December 2011. Three English prisons hosted the first randomised trial of tapering doses of buprenorphine versus methadone to ease the withdrawal of opiate users entering prison. As outside prison, there was little difference in their effectiveness, and three months later just a fifth of the (former) prisoners were assessed as no longer using illegal opiates. 3. The effectiveness of opioid maintenance treatment in prison settings: a systematic review. Hedrich D., Alves P., Farrell M. et al. Addiction: 2012, 107(3), p. 501–517. Largely due to the treatment's health benefits, this review argues that failure to implement effective opioid maintenance programmes in prison represents an important missed opportunity to engage high-risk drug users in treatment, at possibly substantial costs both to individuals and to the community. %0 Generic %C London %D 2013 %F ndc:19894 %I Drug and Alcohol Findings %T Effectiveness Bank Bulletin [Continuing care enhancements for cocaine-dependent patients]. %U http://www.drugsandalcohol.ie/19894/ %V 8 May %X Randomized trial of continuing care enhancements for cocaine-dependent patients following initial engagement. McKay J.R., Lynch K.G., Coviello D. et al. Journal of Consulting and Clinical Psychology: 2010, 78(1), p. 111–120. Unusually this US study took a set of patients who had generally already initiated abstinence from cocaine use and then used abstinence incentives and/or cognitive-behavioural therapy to extend and consolidate these gains. There was some evidence that offering the therapy and improving attendance via incentives prolonged the impact of those incentives. Summary This US study of treatment for cocaine dependence aimed to test whether the remission of patients who had initially done well in intensive outpatient treatment could be preserved and extended by financially rewarding cocaine non-use ('contingency management') and/or by extra individual counselling sessions based on cognitive-behavioural principles intended to help the patients avoid relapse. Unusually it tested contingency management not as way to initiate abstinence, but to sustain it. Essentially the study found that the combination of both approaches helped the greatest proportions of patients to remain free of cocaine use, most notably in the middle of the 18-month follow-up. The study recruited 100 adult patients who had attended regularly during their initial fortnight at one of two 12-step group-based programmes. For up to four months, these programmes scheduled sessions three days a week totalling nine to 10 hours per week, before stepping down to a session a week. Of the 573 patients approached to see if they were suitable for and wanted to join the study, 200 did not join because they did not complete the initial fortnight or the following baseline research assessments. Among other criteria, the patients had to have not injected heroin for at least a year. Typically participants were unmarried black women (nearly 6 in 10 were female) and were in the their late 30s and early 40s. By the time they entered the study, 70% had not used cocaine for at least a month. They were randomly allocated to carry on with treatment as usual or to one of three additional therapies. For 12 weeks one set (the contingency management set) were rewarded with shopping vouchers if urine tests taken three days a week were clear of indications of cocaine use, a regimen implemented by non-clinical study staff. Another set (relapse-prevention patients) were instead offered 20 weekly individual relapse-prevention counselling sessions aimed at identifying situations which for them had precipitated substance use and learning to anticipate and cope with these in future. The final set (combination patients) were offered both types of additional intervention, with the rider that the voucher incentives required not just cocaine-free urine tests, but also attendance at the relapse-prevention sessions. This seems to have had the desired impact, as on average they attended 13 sessions compared to just three for the relapse-prevention patients who had been offered the same sessions but with no inducements to attend. By the final follow-up 18 months after the study started, three quarters of the patients could be reassessed by being interviewed and the same proportion by urine tests. %0 Generic %A Blenheim CDP, %C London %D 2012 %F ndc:19025 %I Blenheim %T Making research work: How Blenheim hosted a successful contingency management research project. %U http://www.drugsandalcohol.ie/19025/ %X There is consensus in the substance misuse field that all interventions delivered must be developed from a robust evidence base that is supported by rigorous research. Creating optimum conditions for a research project to flourish is a challenge, especially if the aim is to carry out the research in an authentic environment. The London & Maudsley NHS Foundation Trust (SLAM) has been able to complete the first ever contingency management (CM) research project in the UK by entering into a two year research partnership with Blenheim. This research, once published, will be the largest piece of CM research analysing the relationship between CM and cognitive behavioural therapy (CBT) in the UK. Summary of key learning points: • Embed the programme • Development of the therapy manual • Lead in period • Identify lead staff member for the research project • Staff training and supervision • Pilot phase Summary of recommendations: • Develop a reciprocal relationship with the researchers • Invest • Get the programme right • Demonstrate leadership • Involve the whole organisation • Work with resistance • Be realistic It is evident from the experience of Blenheim that while hosting a research project is not easy and requires commitment and investment, there are many benefits and rewards to be gained. %0 Generic %D 2012 %F ndc:16848 %I Drug and Alcohol Findings %T Effectiveness Bank Bulletin. [Cognitive-behavioral motivational intervention: group versus individual format] %U http://www.drugsandalcohol.ie/16848/ %V 25 Jan %X Randomized controlled trial of a cognitive-behavioral motivational intervention in a group versus individual format for substance use disorders. Sobell L.C., Sobell M.B., Agrawal S. Psychology of Addictive Behaviors: 2009, 23(4), p. 672–683. For US problem drinkers and drug users not at the severest end of the spectrum, four sessions of group were as effective as four of individual therapy but took much fewer therapist hours per patient. The little research we have suggests this a common finding, commending group approaches on cost-effectiveness grounds. Summary Despite the popularity of group-based therapies for substance use problems, just four studies have directly compared outcomes from the same treatment delivered in a group versus an individual format. Each found substance use reductions which did not significantly differ between the formats. The featured study aimed to add to this scarce literature by randomising problem drinkers and drug users who were not severely dependent to group versus individual formats of the Guided Self-Change Treatment Model. The approach combines motivational interviewing style and techniques with cognitive-behavioural elements, and was developed as a brief treatment for low severity alcohol problems. It features personalised feedback of assessment findings to clients (eg, extent of use, health risks), decisional balance exercises weighing the pros and cons of change, and advice for clients on selecting their treatment goal. Patients were referred to a Guided Self-Change clinic in Toronto, Canada, or self-referred after seeing an advert aimed at people "Concerned about your drinking (drug use)". Very heavy or highly dependent drinkers or drug users, injectors, and primary heroin users were screened out of the study. The 231 problem drinkers and 56 problem drug (mainly cocaine or cannabis) users who qualified for and agreed to join the study were allocated as appropriate to alcohol or drug versions of the intervention, and then randomly to group or individual formats run by the same therapists. Group and individual formats were intended to run over four sessions of one and a half to two hours and one hour respectively. 264 clients attended at least the first treatment session, forming the cohort whose outcomes were analysed by the study. Of these, all but 23 completed follow-up assessments 12 months after treatment ended. The 264 patients were typically employed men in their thirties and forties and most had never before been in substance use treatment. %0 Generic %A Furlong, Mairead %A McGilloway, Sinead %A Bywater, T %A Hutchings, J %A Smith, SM %A Donnelly, M %D 2012 %F ndc:17209 %I John Wiley & Sons, Ltd %N 2 %T Behavioural and cognitive-behavioural group-based parenting programmes for early-onset conduct problems in children aged 3 to 12 years. %U http://www.drugsandalcohol.ie/17209/ %X To assess the effectiveness and cost-effectiveness of behavioural and cognitive-behavioural group-based parenting programmes for improving child conduct problems, parental mental health and parenting skills. Parenting programmes that are delivered in group settings have the potential to help parents develop parenting skills that improve the behaviour of their young children. This review provides evidence that group-based parenting programmes improve childhood behaviour problems and the development of positive parenting skills in the short-term, whilst also reducing parental anxiety, stress and depression. Evidence for the longer-term effects of these programmes is unavailable. These group-based parenting programmes achieve good results at a cost of approximately $2500 (£1712 or €2217) per family. These costs are modest when compared with the long-term social, educational and legal costs associated with childhood conduct problems. %0 Generic %9 Other %A SAOL Project, %C Dublin %D 2011 %F ndc:16230 %I SAOL Project %T Reduce the use 2. %U http://www.drugsandalcohol.ie/16230/ %X A cognitive behavioural type manual for professionals working with poly drug users who want to reduce or stop their drug or alcohol use. %0 Journal Article %A Barrowclough, Christine %A Haddock, Gillian %A Wykes, Til %A Beardmore, Ruth %A Conrod, Patricia %A Craig, Tom %A Davies, Linda %A Dunn, Graham %A Eisner, Emily %A Lewis, Shon %A Moring, Jan %A Steel, Craig %A Tarrier, Nicholas %D 2010 %F ndc:14349 %I BMJ Publishing %J British Medical Journal %N c6325 %T Integrated motivational interviewing and cognitive behavioural therapy for people with psychosis and comorbid substance misuse: randomised controlled trial. %U http://www.drugsandalcohol.ie/14349/ %V 341 %X Objectives: To evaluate the effectiveness of integrated motivational interviewing and cognitive behavioural therapy in addition to standard care for patients with psychosis and a comorbid substance use problem. Design: Two centre, open, rater blind randomised controlled trial. Setting: Secondary care in the United Kingdom. Participants: 327 patients with a clinical diagnosis of schizophrenia, schizophreniform disorder, or schizoaffective disorder and a diagnosis of dependence on or misuse of drugs, alcohol, or both according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition. Intervention: The intervention was integrated motivational interviewing and cognitive behavioural therapy plus standard care, which was compared with standard care alone. Phase one of therapy—“motivation building”—concerns engaging the patient, then exploring and resolving ambivalence for change in substance use. Phase two—“action”—supports and facilitates change using cognitive behavioural approaches. Up to 26 therapy sessions were delivered over one year. Main outcome measures: The primary outcome was death from any cause or admission to hospital in the 12 months after completion of therapy. Secondary outcomes were frequency and amount of substance use (assessed using the timeline followback method), readiness to change, perceived negative consequences of use, psychotic symptom ratings, number and duration of relapses, and global assessment of functioning and deliberate self harm at 12 and 24 months, with additional timeline followback assessments at 6 and 18 months. Analysis was by intention to treat and robust treatment effect estimates were produced. Results: 327 participants were randomly allocated to either the intervention (n=164) or treatment as usual (n=163). At 24 months, 326 (99.7%) were assessed on the primary outcome and 246 (75.2%) on the main secondary outcomes. Treatment had no beneficial effect on hospital admissions or death during follow-up, with 23.3% (38/163) of the therapy group and 20.2% (33/163) of controls deceased or admitted (adjusted odds ratio 1.16, 95% confidence interval 0.68 to 1.99; P=0.579). Therapy had no effect on the frequency of substance use or the perceived negative consequences of misuse, but did have a statistically significant effect on amount used per substance using day (adjusted ORs for main substance 1.50, 95% CI 1.08 to 2.09; P=0.016; and all substances 1.48, 95% CI 1.07 to 2.05; P=0.017). Treatment had a statistically significant effect on readiness to change use at 12 months (adjusted OR 2.05, 95% CI 1.26 to 3.31; P=0.004) that was not maintained at 24 months (0.78, 95% CI 0.48 to 1.28; P=0.320). There were no effects of treatment on clinical outcomes such as relapses, psychotic symptoms, functioning, and self harm. Conclusions: Integrated motivational interviewing and cognitive behavioural therapy for people with psychosis and substance misuse do not improve outcome in terms of hospitalisation, symptom outcomes, or functioning. This approach does reduce the amount of substance used for at least one year after completion of therapy. %0 Journal Article %A Keane, Martin %D 2010 %F ndc:12809 %I Health Research Board %J Drugnet Ireland %P 22 %T Mental health and young people: a review of CBT-based interventions. %U http://www.drugsandalcohol.ie/12809/ %V Issue 32, Winter 2009 %0 Generic %A O'Shea, James %A Goff, Paul %A Gillespie, Kate %C Kilkenny %D 2010 %F ndc:15782 %I Centre of Nurse Education and the Nursing and Midwifery Planning and Development Unit, HSE South (Carlow, Kilkenny, South Tipperary, Waterford, Wexford) %T Cognitive behavioural skills for practice a model for delivery in the Irish mental health service. %U http://www.drugsandalcohol.ie/15782/ %X This publication outlines a model of delivery for introductory level Cognitive Behavioural Therapy (CBT) training in the Mental Health Service, HSE South (Carlow, Kilkenny, South Tipperary, Waterford, Wexford). This model has proved useful in guiding the development of four introductory programmes during 2009 and 2010. As a result of this experience, we have amended and updated our programme delivery strategies. We see this process as organic and ever changing, thus these reflections are a snap shot of our current thinking which we have no doubt will evolve as we proceed with future programmes. This booklet will act as a guide for our upcoming programmes in 2010 and 2011 and we believe it may also offer guidance to others who will be involved in the delivery of CBT training within the Irish Mental Health Service. %0 Journal Article %@ ISSN 1354 - 9960 %A James, Philip %D 2010 %F ndc:19990 %I Association for Rational Emotive Behaviour Therapy %J The Rational Emotive Behaviour Therapist %N 1 %P 5-11 %T Rational Emotive Behaviour Therapy with substance abusing adolescents. %U http://www.drugsandalcohol.ie/19990/ %V 13 %X Substance abuse among adolescents is a growing concern in both the UK and Ireland. Both countries consistently report high rates of substance misuse among their teenagers when compared to their European neighbours. As a result many adolescents presenting for therapy may have substance abuse problems making it vital that REBT therapists working with this age group are able to provide appropriate interventions. This article examines adolescent substance misuse and covers many areas including rates of substance abuse, the REBT perspective and research on substance abuse as well as many practical considerations. Finally it makes some suggestions for the development of REBT in this area. %0 Journal Article %@ 0026-4075 %A McCarthy, Paul M %A O'Sullivan, David %D 2010 %F ndc:14342 %I AMSUS - Association of Military Surgeons of the U.S. %J Military Medicine %N 11 %P 841-846 %T Efficacy of a brief cognitive behavioral therapy program to reduce excessive drinking behavior among new recruits entering the Irish Navy: a pilot evaluation. %U http://www.drugsandalcohol.ie/14342/ %V 175 %X This pilot study evaluated the efficacy of a brief cognitive behavioral therapy (CBT) intervention program designed to reduce excessive pre-enlistment drinking behaviors in a sample of Irish Navy recruits undergoing a 16-week basic training course. Participants were randomly allocated to either a treatment or control group ( N = 13 each). The program was conducted over four consecutive 1.5-hour weekly sessions. Data were collected at pre and post intervention as well as at a 2-month follow-up. In comparison to those in the control group, participants who received the intervention reported increased scores ( p 0.05) in readiness to change drinking at time 2 and reduced scores in binge drinking ( p 0.05) at time 3. There were also marginal changes in self-efficacy and risky drinking behavior. This work adds to the evidence of the emerging efficacy of a workplace CBT intervention for unhealthy drinking. %0 Generic %A Pilling, Stephen %A Hesketh, Kathryn %A Mitcheson, Luke %A British Psychological Society, %C London %D 2010 %F ndc:13622 %I National Treatment Agency for Substance Misuse %T Psychosocial interventions in drug misuse: a framework and toolkit for implementing NICE-recommended treatment interventions. %U http://www.drugsandalcohol.ie/13622/ %X Psychosocial Interventions for Drug Misuse was commissioned by the National Treatment Agency for Substance Misuse (NTA) from the British Psychological Society (BPS) to provide support for drug treatment providers and commissioners wishing to develop or to introduce a range of evidence-based psychosocial interventions for those with drug misuse problems. The document is designed to support drug treatment services in the effective delivery of evidence-based psychosocial interventions both for drug misuse and for common co-morbid mental health problems. It focuses on evidence-based treatment interventions recommended by the National Institute for Health and Clinical Excellence (NICE) and provides a range of tools to support effective implementation. The document is primarily relevant to practitioners, service managers and commissioners, but may also be of interest to service users and carers as a guide to a number of NICE-recommended treatment options. The framework used in the document for describing the specific psychosocial interventions adopts a systematic, competence-based approach. The majority of the interventions described are likely to be delivered as adjuncts to standard care (including keyworking and pharmacological interventions) and it is important that staff delivering them are competent in these core interventions. Hence, this can usefully be read in conjunction with established guidance on keyworking and keyworker competences. In addition to the information and tools presented in the appendices of this document, a range of other resources for the delivery of psychosocial interventions is accessible at the NTA’s Psychosocial Interventions Resource Library (PIRL) at www.nta.nhs.uk/PIRL.The key evidence-based psychosocial interventions (categorised as either low- or high-intensity) that that are discussed in detail in the document are: For the management of drug misuse: • Motivational interventions (low-intensity) • Contingency management (low-intensity) • Behavioural couples therapy (high-intensity). For the management of common mental health problems: • Cognitive behavioural therapy by guided self help (low-intensity) • Behavioural activation (low-intensity) • Cognitive behavioural therapy for depression and anxiety (high-intensity). %0 Generic %A Haber, Paul %A Lintzeris, Nicholas %A Proude, Elizabeth %A Lopatko, Olga %C Sydney %D 2009 %F ndc:20201 %I Commonwealth of Australia %T Guidelines for the treatment of alcohol problems. %U http://www.drugsandalcohol.ie/20201/ %X Summary of recommendations vii 1. Introduction 1 • Purpose of the guidelines 1 • Structure of the guidelines 1 • Evidence-based health care 3 • Community and population approaches to alcohol problems 4 • A note on terminology 4 2. Prevalence of alcohol consumption and related harms in Australia 7 • Prevalence of alcohol use 7 • Alcohol-related harm 8 3. Screening, assessment and treatment planning 13 • Screening 13 • Comprehensive clinical assessment 21 • Treatment planning 32 4. Brief interventions 41 • Who to target for brief interventions 41 • How to deliver brief interventions 42 • Who can deliver brief interventions? 43 • Where should brief interventions be delivered? 43 • Limitations of brief intervention 45 5. Alcohol withdrawal management 49 • Alcohol withdrawal syndrome: Clinical presentation 49 • Assessment and treatment matching 51 • Supportive care 57 • Medications for managing alcohol withdrawal 61 • Treating severe withdrawal complications 68 • Wernicke–Korsakoff’s syndrome 76 6. Psychosocial interventions for alcohol use disorders 81 • Overview of psychosocial interventions 81 • When to use psychosocial interventions 82 • Choosing psychosocial interventions: a stepped care approach 82 • Motivational interviewing 85 • Cognitive behavioural interventions 86 • Relapse prevention strategies 89 • Residential rehabilitation programs 89 7. Pharmacotherapies for alcohol dependence 93 • Naltrexone 93 • Acamprosate 96 • Combined acamprosate and naltrexone 98 • Disulfiram 98 • Other medications 101 • Integration with psychosocial treatments 102 • Increasing medication adherence 102 • Selecting medications for individual patients 103 8. Self-help programs 107 • Alcoholics Anonymous 107 • SMART RecoveryR 110 • Self-help for families 111 9. Specific populations 115 • Adolescents and young people 115 • Pregnant and breastfeeding women 121 • Indigenous Australians and people from other cultures 130 • Older people 135 • Cognitively impaired patients 138 10. Comorbidities 145 • Physical comorbidity 145 • Co-occurring mental and alcohol-use disorders 147 • Polydrug use and dependence 153 11. Aftercare and long-term follow-up 161 • Aftercare 161 • Working with the persistent problem drinker 161 Appendixes 165 • Appendix 1 Screening and diagnostic instruments 167 • Appendix 2 Diagnostic criteria for alcohol use disorders 195 • Appendix 3 Withdrawal scales 197 • Appendix 4 Alcohol and drug interactions 202 • Appendix 5 Getting through alcohol withdrawal: A guide for patients and carers 205 • Appendix 6 A guide for people with alcohol-related problems 208 • Appendix 7 Disulfiram Agreement 213 • Appendix 8 Treatment guidelines for mental disorders 214 • Appendix 9 Standard drinks 215 Glossary 221 Acronyms 225 References 229 %0 Generic %A NSW Department of Health, %C Sydney %D 2008 %F ndc:18987 %I NSW Department of Health %T NSW Health drug and alcohol psychosocial interventions. Professional practice guidelines. %U http://www.drugsandalcohol.ie/18987/ %X The Drug and Alcohol (D&A) Psychosocial Interventions Professional Practice Guidelines are the first generic professional guidelines for psychosocial interventions to be developed in NSW for drug and alcohol practice. The Guidelines take a stepped care approach to drug and alcohol treatment, which focuses on the adoption of best practice models for people with drug and alcohol issues, and reflects current best evidence and practice in the drug and alcohol counselling field. Responsibility for implementation of the Guidelines is shared across all levels of drug and alcohol clinical practice, and the Guidelines aim to increase the effectiveness of staff as psychosocial clinicians and systematise the use of psychosocial interventions for problematic drug and alcohol use across NSW. The Guidelines are intended to be applicable across the various allied health disciplines within drug and alcohol specialist services that are providing clinical psychosocial interventions. This includes Specialist and Generalist D&A professionals across public and private sectors. These Guidelines are not intended to provide detailed information relating to the implementation of all psychosocial therapies relevant to problematic drug and alcohol use. Rather, a range of psychosocial models are described with reference to the available evidence base for treating problematic drug and alcohol use, with readers referred to a range of additional resources, texts, and training courses that can provide advice and skills in the use of these psychosocial models. A range of treatment processes are described in Section 3 of these Guidelines, which are considered fundamental to any psychosocial intervention, regardless of the theoretical model on which the intervention is based. %0 Report %9 Other %A Cafferty, Siobhan %A Gardner, Caroline %A O’Connell, Ann %B %C Dublin %D 2007 %F ndc:13493 %I SAOL Project %T Reduce the use: An 8 session course on reducing cocaine use. %U http://www.drugsandalcohol.ie/13493/ %X Overview of course content: This course has been developed by the SAOL project in consultation with local drugs services to respond to the need for tools which can assist participants with problematic cocaine use. While the course is specifically targeted at cocaine users, it could be used effectively with other addictive behaviours by adapting the examples. %0 Journal Article %A Loughran, Hilda %D 2003 %F ndc:6904 %I Haworth Press %J Journal of Teaching in the Addictions %K AODU treatment method, behavior therapy, brief psychosocial therapy, Ireland, North America, treatment outcome, twelve-step model %N 1 %P 1-15 %T Teaching evidence-based addiction practice: project MATCH comes to the classroom. %U http://www.drugsandalcohol.ie/6904/ %V 2 %X This article describes a teaching model used in two sites (Dublin, Ireland, and San Diego) to train students in different methods of substance abuse treatment. Addiction Studies students and graduate social work students received treatment manuals that were used in Project MATCH study, three methods of treatment were used: Cognitive-Behavioral, Motivational Enhancement, and Twelve-Step Facilitation. The manuals describe each intervention, which the students adapted to a group setting. Students presented and then role-played each method, demonstrating the various elements of each model. Results of Project MATCH were then discussed. Students reported surprise at the level of sophistication in substance abuse treatment, and a recognition of the connection between research and practice. %0 Generic %A Shand, Fiona %A Gates, Jennifer %A Fawcett, Julia %A Mattick, Richard P %C Syndey %D 2003 %F ndc:20200 %I National Drug and Alcohol Research Centre %T Guidelines for the treatment of alcohol problems. %U http://www.drugsandalcohol.ie/20200/ %X Contents: Chapter 1: Introductory comments 13 • Purpose of the Guidelines 13 • Audience for the Guidelines 14 • Levels of Evidence 14 Chapter 2: Access to treatment: overcoming barriers 21 Chapter 3: Screening and assessment 25 • The need for screening 25 • In-depth assessment before more intensive treatment 33 Chapter 4: Patient-treatment matching 55 Chapter 5: Alcohol withdrawal management 59 • Alcohol withdrawal syndrome 59 • Medical care for alcohol withdrawal complications 61 • Home-based, outpatient and inpatient withdrawal management 69 • Supervised medicated and non-medicated withdrawal management 73 Chapter 6: Post-withdrawal treatment setting 83 • Who should receive residential treatment? 84 • Potential improvements to residential/therapeutic community care 86 Chapter 7: Brief interventions 91 Chapter 8: Psychosocial interventions 99 • Characteristics of effective clinicians 99 • Counselling 100 • Motivational interviewing 103 • Cognitive-behavioural interventions 107 • Skills training 108 • Behavioural self-management 112 • Cognitive restructuring 114 • Cue exposure 116 • Couples and family therapy 117 • Self-guided materials 120 • Standardised versus tailored treatment 121 Chapter 9: Relapse prevention 127 • Identifying factors associated with relapse 127 • Strategies for assessing relapse risk 128 • Reducing the risk of relapse 129 • Pharmacotherapies for relapse prevention 130 Chapter 10: Extended care 145 • Treatment retention 145 • Alcoholics Anonymous 145 • Assertive outreach and structured aftercare 147 Chapter 11: Interventions for specific client groups 151 • Adolescents and young adults 151 • Cognitive impairment 155 • Comorbid disorders 158 • Gender 161 • Indigenous clients 164 Chapter 12: How to put it together 169 • When there is no time available 172 • Brief, one session, face-to-face interventions 172 • Brief outpatient interventions 173 • Longer multi-session outpatient interventions 174 • Brief inpatient/residential withdrawal management 175 • Day patient and inpatient/residential interventions 175 References 179 Appendices 197 %0 Generic %A Kadden, Ronald M %A Kathleen, Carroll %A Donovan, Dennis M %A Cooney, Ned L. %A Monti, Peter M %A Abrams, David B %A Litt, Mark %A Hester, Reid K %C Maryland %D 2003 %F ndc:13606 %I National Institute on Alcohol Abuse and Alcoholism %T Cognitive behavioural coping skills therapy manual: a clinical research guide for therapists treating individuals with alcohol abuse and dependence, %U http://www.drugsandalcohol.ie/13606/ %X Describes cognitive behavioral coping skills therapy, which is based on the principles of social learning theory and views drinking behaviour as functionally related to major problems in the patient’s life. Emphasis is placed on overcoming skill deficits and increasing the patient’s ability to cope with high-risk situations that commonly precipitate relapse. %0 Generic %A Baker, A. %A Kay-Lambkin, Frances %A Lee, NK %A Claire, M %A Jenner, Linda %C Canberra %D 2003 %F ndc:13632 %I Australian Government Department of Health and Ageing %T A brief cognitive behavioural intervention for regular amphetamine users. A treatment guide. %U http://www.drugsandalcohol.ie/13632/ %X A brief intervention using motivational and cognitive behavioural approaches to help change drug use. Also offer alternative brief interventions for clients not suited to the current approach. This manual is divided into five sections: Section 1. Context • Key points from the National Drug Strategy Monograph No 51. Models of Intervention and Care for Psychostimulant Users are included to present the evidence supporting this type of intervention for regular amphetamine users. • A flow-chart to place the intervention in a treatment context. Section 2. Brief background to the study and summary of results of evaluation • A brief description of how the study was developed, undertaken and evaluated. • A brief description of the evaluation outcome data (detailed results will be published separately). Section 3. The intervention • The CBT intervention is presented in a clear and easy to use format for practitioners. Section 4. Suggested alternative brief interventions for those not suitable for the current intervention • This section provides an overview of recommendations for alternative interventions for psychostimulant users who are unsuitable for the CBT intervention (e.g. those who are not considering change, experimental users etc). Section 5. Other available resources • This section lists a range of other resources that are currently available for practitioners working with psychostimulant users. This treatment guide has not been designed to stand alone. Rather, practitioners are encouraged to: 1. Acquaint themselves with the current research and clinical literature. The recently completed monograph Models of Intervention and Care for Psychostimulant Users is an excellent resource for current evidence supporting practice in this area. 2. Undertake training in CBT and motivational enhancement techniques if unfamiliar with these approaches. 3. Obtain ongoing clinical supervision. %0 Generic %A Marlatt, G. Alan %A Parks, George A. %A Witkiewitz, Katie %C Seattle %D 2002 %F ndc:13620 %I University of Washington %T Clinical guidelines for implementing relapse prevention therapy. %U http://www.drugsandalcohol.ie/13620/ %X A guideline outlining this cognitive behaviour therapy approach. Focuses on identification of individual high-risk situations and the person's ability to cope with them without relapsing, as well as learning new coping skills and enhancing self-efficacy. %0 Generic %A Webb, Charles %A Scudder, Meleney %A Kaminer, Yifrah %A Kadden, Ronald M %C Rockville, MD %D 2002 %F ndc:17832 %I Substance Abuse and Mental Health Services Administration %T The Motivational Enhancement Therapy and Cognitive Behavioral Therapy supplement: 7 sessions of Cognitive Behavioral Therapy for adolescent cannabis users. %U http://www.drugsandalcohol.ie/17832/ %V 2 %X This manual, a supplement to Motivational Enhancement Therapy and Cognitive Behavioral Therapy for Adolescent Cannabis Users: 5 Sessions, Cannabis Youth Treatment (CYT) Series, volume 1, presents a seven-session cognitive behavioral treatment (CBT7) approach designed especially for adolescent cannabis users. It addresses the implementation and evaluation of cognitive behavioral treatment for adolescent marijuana users as part of the Cannabis Youth Treatment Project: A cooperative agreement for evaluating the efficacy of five treatments for adolescents with self-reported marijuana use and problems associated with Its use. This volume provides instructions for sessions 6 through 12 of the cognitive behavioral therapy (CBT) for adolescent marijuana users. For other reports in the series, click on related publication links below. %0 Generic %A Kadden, Ronald M %C Connecticut %D 2001 %F ndc:13617 %I University of Connecticut %T Cognitive-behaviour therapy for substance dependence: coping skills training. %U http://www.drugsandalcohol.ie/13617/ %X This publication contains guidelines to address problematic drinking or drug use, which are conceptualised as learned behaviours. It outlines how to help clients deal with intrapersonal and interpersonal situations that support their substance use. %0 Generic %A Sampl, Susan %A Kadden, Ronald M %C Rockville, MD %D 2001 %F ndc:17831 %I Substance Abuse and Mental Health Services Administration %T Motivational Enhancement Therapy and Cognitive Behavioral Therapy for adolescent cannabis users: 5 Sessions. %U http://www.drugsandalcohol.ie/17831/ %V 1 %X This manual is designed to help train substance abuse treatment counsellors to conduct a brief five-session treatment intervention for adolescents with cannabis use disorders presenting for outpatient treatment. The treatment programme comprises: •Motivational Enhancement Therapy (MET) two sessions one to one •Cognitive Behavioural Therapy (CBT) three sessions in a group format The intervention can be carried out by drug workers with some additional competences in the above approaches and group work. The manual contains guidance on session content and useful handouts and other resources. For other reports in the series, click on related publication links below.