Healthcare and Medicine Reference
Short-Term Treatment of Substance Abuse
Herman (2000) believes that individual psychotherapy can be helpful to
substance abusers and suggests five situations where therapy would be indi-
cated: (1) as an appropriate introduction to treatment; (2) as a way of helping
mildly or moderately dependent drug abusers; (3) when there are clear signs
of emotional problems such as severe depression, since these problems will
interfere with the substance abuse treatment; (4) when clients progressing in
12-step programs begin to experience emerging feelings of guilt, shame, and
grief; (5) when a client's disturbed interpersonal functioning continues after
a long period of sustained abstinence. Therapy might help prevent a relapse.
One of the most frequently discussed treatment approaches to addic-
tion in the literature is brief counseling. Bien, Miller, and Tonigan (1993)
reviewed 32 studies of brief interventions with alcohol abusers and found
that, on average, brief counseling reduced alcohol use by 30%. In an eval-
uation of a larger report by Consumers Reports on the effectiveness of
psychotherapy, Seligman (1995) notes that, “Alcoholics Anonymous (AA)
did especially well, ... significantly bettering mental health professionals
[in the treatment of alcohol and drug related problems]” (p. 10).
Bien et al. (1993) found that two or three 10 15 minute counseling
sessions are often as effective as more extensive interventions with older
alcohol abusers. The sessions include motivation-for-change strategies,
education, assessment of the severity of the problem, direct feedback,
contracting and goal setting, behavioral modification techniques, and the
use of written materials such as self-help manuals. Completion rates using
brief interventions are better for elder-specific alcohol programs than for
mixed-age programs ( Atkinson, 1995 ), and late-onset alcoholics are also
more likely to complete treatment and have somewhat better outcomes
using brief interventions ( Liberto & Oslin, 1995 ).
Miller and Sanchez (1994) summarize the key components of brief
intervention using the acronym FRAMES:
advice, menu of strategies, empathy, and self-efficacy.
1. Feedback: Includes the patient's risk for alcohol problems, his or her
reasons for drinking, the role of alcohol in the patient's life, and the
consequences of drinking.
2. Responsibility: Includes strategies to help patients understand the
need to remain healthy, independent, and financially secure. This is
particularly important when working with older clients and clients
with health problems and disabilities.
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