This TIP, Brief Interventions and Brief Therapies for Substance Abuse, is intended primarily for counselors and therapists working in the substance abuse treatment field, but parts of it will be of value to other audiences, including health care workers, social services providers, clergy, teachers, and criminal justice personnel. In fact, those portions of this TIP dealing with brief interventions will be of use to any professional service provider who may need to make an intervention to help persons with substance abuse disorders alter their use patterns or seek treatment. However, brief therapy should only be practiced by those who are properly qualified, educated, and licensed.

The first chapter of this TIP presents an overview of brief interventions and brief therapies, describing their basic characteristics and the reasons for increased interest in them. Chapter 2 describes the goals and components of brief interventions, and Chapter 3 discusses some of the basic elements of all brief therapies. Chapters 4 through 9 each highlight a different type of brief therapy, describing the theory behind it as well as some of the techniques developed from that theory that can be used to treat clients with substance abuse disorders. Separate chapters are presented describing cognitive-behavioral therapy, strategic/interactional therapies, humanistic and existential therapies, psychodynamic therapies, family therapy, and group therapy. Appendixes are also included that provide resources for further information and training, a glossary of terms used in the TIP, and a sample workbook for use in brief interventions.

The goal of this TIP is to make readers aware of the research, results, and promise of brief interventions and brief therapies in the hope that they will be used more widely in clinical practice and treatment programs across the United States.

Contents

• What Is a TIP?
• Editorial Advisory Board
• Consensus Panel
• Foreword
• Executive Summary and Recommendations
• Chapter 1—Introduction to Brief Interventions and Therapies
  • An Overview of Brief Interventions
  • An Overview of Brief Therapies
  • The Demand for Brief Interventions and Therapies
  • Barriers to Increasing the Use of Brief Treatments
  • Evaluating Brief Interventions and Therapies
• Chapter 2—Brief Interventions in Substance Abuse Treatment
  • Stages-of-Change Model
  • Goals of Brief Intervention
  • Components of Brief Interventions
  • Brief Intervention Workbooks
  • Essential Knowledge and Skills for Brief Interventions
  • Brief Interventions in Substance Abuse Treatment Programs
  • Brief Interventions Outside Substance Abuse Treatment Settings
  • Research Findings
• Chapter 3—Brief Therapy in Substance Abuse Treatment
  • Research Findings
  • When To Use Brief Therapy
  • Approaches to Brief Therapy
  • Components of Effective Brief Therapy
  • Therapist Characteristics
• Chapter 4—Brief Cognitive-Behavioral Therapy
  • Behavioral Theory
  • Behavioral Therapy Techniques Based on Classical Conditioning Models
  • Behavioral Therapy Techniques Based on Operant Learning Models
  • Cognitive Theory
  • Cognitive Therapy
  • Cognitive-Behavioral Theory
  • Cognitive-Behavioral Therapy
• Chapter 5—Brief Strategic/Interactional Therapies
  • Solution-Focused Therapy for Substance Abuse
  • Compatibility of Strategic/Interactional Therapies and 12-Step Programs
  • When To Use Strategic/Interactional Therapies
  • Case Study
  • Strategic/Interactional Therapies
• Chapter 6 --Brief Humanistic and Existential Therapies
  • Using Humanistic and Existential Therapies
  • The Humanistic Approach to Therapy
  • The Existential Approach To Therapy
• Chapter 7—Brief Psychodynamic Therapy
  • Background
  • Introduction to Brief Psychodynamic Therapy
  • Psychodynamic Psychotherapy for Substance Abuse
  • Psychodynamic Concepts Useful in Substance Abuse Treatment
  • Transference
  • Models of Brief Psychodynamic Therapy
  • Other Research
• Chapter 8—Brief Family Therapy
  • Appropriateness of Brief Family Therapy
  • Definitions of "Family"
  • Theoretical Approaches
  • Using Brief Family Therapies
  • Followup
  • Cultural Issues
• Chapter 9—Time-Limited Group Therapy
  • Appropriateness of Group Therapy
  • Group Therapy Approaches
  • Theories of Group Therapy
  • Use of Psychodrama Techniques in a Group Setting
  • Therapeutic Factors
  • Using Time-Limited Group Therapy
• Appendices
  • Appendix A --Bibliography
  • Appendix B—Information and Training Resources
  • Appendix C - Glossary
  • Appendix D—Health Promotion Workbook
  • Appendix E—Resource Panel
  • Appendix F—Field Reviewers

This publication is part of the Substance Abuse Prevention and Treatment Block Grant technical assistance program. This publication was written under contract number 270-95-0013 with The CDM Group, Inc. (CDM). Sandra Clunies, MS, ICADC, served as the CSAT government project officer. Rose M Urban, LCSW, JD, CCAS, served as the CDM TIPs project director. Other CDM TIPs personnel included Raquel Ingraham, MS, project manager; Jonathan Max Gilbert, MA, managing editor; Janet G Humphrey, MA, editor/writer; Cara Smith, production editor; Erica Flick, editorial assistant; Y-Lang Nguyen, former production editor; and Paul Seaman, former editorial assistant. Special thanks go to consulting writers Scott M Buchanan, MSEd; Dennis M Donovan, PhD; Jeffrey M Georgi, MDiv; Delinda E Mercer, PhD; Larry Schor, PhD; and George E Woody, MD.

The opinions expressed herein are the views of the Consensus Panel members and do not reflect the official position of CSAT, SAMHSA, or the U.S. Department of Health and Human Services (DHHS). No official support or endorsement of CSAT, SAMHSA, or DHHS for these opinions or for particular instruments or software that may be described in this document is intended or should be inferred. The guidelines proffered in this document should not be considered as substitutes for individualized client care and treatment decisions.