What is the best approach to treatment?
No definitive research has established a best approach to treatment, and many factors (such as client characteristics and duration of treatment) influence research outcomes. However, studies have found positive associations between several treatment approaches and client outcomes.
What is the best approach to intensive outpatient treatment?
Intensive Outpatient Treatment Approaches Intensive outpatient treatment (IOT) programs use a variety of theoretical approaches to treatment. No definitive research has established a best approach to treatment, and many factors (such as client characteristics and duration of treatment) influence research outcomes.
Why is it important that treatment be appropriate?
It is also important that treatment be appropriate to the individual’s age, gender, ethnicity, and culture. Remaining in treatment for an adequate period of time is critical. The appropriate duration for an individual depends on the type and degree of the patient’s problems and needs.
What can we learn from intensive reinforcement-based day hospitals?
As an example, the activity schedule of an intensive reinforcement-based day hospital program provided abstinence-contingent partial support of housing and food and access to recreational activities, social skills training, and job-finding groups ( Gruber et al. 2000 ).
Why should TC approaches be modified for women, adolescents, and those with co-occurring mental disorders?
TC approaches should be modified for women, adolescents, and those with co-occurring mental disorders because the confrontational nature and strict hierarchical structure of a standard TC may not be as effective with these groups.
How effective is the CM approach to substance use disorder?
Studies show that the CM approach to treating substance use disorders has proved effective in motivating clients to achieve and sustain abstinence as well as increase their compliance with other treatment objectives ( Bigelow and Silverman 1999; Higgins 1999; Morral et al. 1999 ). Generally, these studies have been conducted in outpatient settings in which delivery of incentives is coupled with traditional individual or group counseling and education services. More recently, the CM approach has been applied in intensive outpatient and day treatment settings.
What is CM in a treatment?
CM is an approach in its own right, but its operant interventions are also the main treatment tool used in CR. In CR, the positive and negative reinforcers that characterize CM are understood to be socially mediated. CR uses aspects of the client's life—relationships with family and friends, job, hobbies, social events—to provide the positive reinforcement that motivates the client to stop using substances. CR is successful when the client chooses the rewarding relationship and activities over substance use. (See Chapter 6 for a discussion of how CR can be used to motivate family members to support the client.) CR and CM approaches motivate clients' behavioral change and reinforce abstinence by systematically rewarding desirable behaviors and ignoring or punishing others. Reinforcers are typically positive, pleasurable, and rewarding events or objects, but some negative reinforcers also are effective. Removing a fine or restriction after a client has complied with a specified regimen is an example of negative reinforcement.
What is the Minnesota model of treatment?
The treatment approach of many IOT programs evolved from the Minnesota Model of treatment, so called because it was first conceptualized at Hazelden Foundation and Willmar State Hospital in Minnesota in the late 1940s ( White 1998 ). The Minnesota Model (also known as 12-Step facilitation) is based on the concepts of 12-Step fellowships, such as Alcoholics Anonymous (AA). These programs' efforts were guided by the philosophical belief that alcoholism was a primary, progressive disease, with biological, psychological, and spiritual features.
What is therapeutic community?
Therapeutic communities (TCs) have provided residential substance abuse treatment since the 1960s. Some programs have developed a modified, community-based IOT component either to provide treatment on an outpatient basis or to help graduates successfully transition from residential treatment into the community. Some traditional, community-based IOT programs serve clients who participated in TCs while the clients were incarcerated. IOT providers should understand the TC process to ensure continuity for clients.
What is MI in counseling?
MI is a client-centered, empathic, but directive counseling strategy designed to explore and reduce a person's ambivalence toward treatment. This approach frequently includes other problemsolving or solution-focused strategies that build on clients' past successes. Motivational approaches acknowledge that drugs of abuse have rewarding properties that can disguise, at least temporarily, their hazards and negative long-term effects. Through empathic listening and skillful interviewing, the counselor encourages the client to
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