Drug Addiction Counseling

Learning Objectives Upon completing the course, you will able to:

An Individual Drug Counseling Approach to Treat Cocaine Addiction

Chapter 1: Introduction

  1. Describe the beliefs and philosophy of 12-step approach to recovery.

Chapter 2: Overview

  1. Distinguish between addiction counseling and psychotherapy.

Chapter 3: Logistics of the Model

  1. Discuss the logistics of the individual drug counseling model to treat cocaine addiction, such as frequency, duration, target population and setting of sessions. 

Chapter 4: Assessment

  1.  Describe the application of Addiction Severity Index in the assessment of drug addiction.

Chapter 5: The Role of the Addiction Counselor

  1.  Describe the patient-counselor relationship and list behaviors that the counselor should not indulge in.
  2.  List behaviors that a counselor should not indulge in.

Chapter 6: The Individual Drug Counseling Model

  1. List 12 objectives of individual drug counseling.
  2. Describe 4 stages of addiction treatment: Treatment initiation, Early abstinence, Maintenance of abstinence, Advanced recovery.

Chapter 7: Treatment Initiation

  1.  List some of the erroneous beliefs that a patient experiencing denial may exhibit.
  2.  Outline 3 goals of the treatment plan and make detailed plans for introductory sessions.

Chapter 8: Early Abstinence

  1. List 5 goals of the second stage in the treatment of addiction, i.e., abstinence, and discuss 10 treatment issues with the patient.

Chapter 9: Maintaining Abstinence

  1. Establish goals for maintaining abstinence and discuss various treatment issues with the patient as part of the ongoing recovery program.
  2. Identify 11 steps that will carry a patient toward relapse. 
  3. Define codependency and enabling behavior and explain how they can contribute to a person's continued abuse of drugs.
  4. Identify "character defects" that are obstacles to further recovery and outline the process for working on changing defects.

Chapter 10: Advanced Recovery  

  1. Discuss with the patient patient's thoughts and feelings about ending treatment in the final active treatment session. 
  2. Explain the purpose and goals of treatment booster sessions.

Chapter 11: Dealing With Problems That Arise

  1. Identify 3 levels of severity of relapse and list appropriate interventions to be used in each case. 
  2. Discuss strategies for dealing with crises and relapses.

Chapter 12: Counselor Characteristics and Training

  1. List ideal personal characteristics of an addiction counselor.

Chapter 13: Supervision

  1. Explain the purpose and application of adherence scale in the IDC model. 

Cognitive-Behavioral Therapy: An Overview

  1. Identify 6 important features of cognitive-behavioral therapy that make it particularly promising as a treatment for cocaine abuse and dependence.
  2. Distinguish between cognitive-behavioral therapy (CBT) and 12-step or disease-model approach.
  3. Compare CBT to other psychosocial treatments for substance abuse, such as cognitive therapy, community reinforcement approach, motivational enhancement therapy, 12-step facilitation and interpersonal psychotherapy.
  4. Discuss two critical components of CBT: functional analysis and skills training.
  5. Define various parameters of CBT such as format, length, setting, patients and compatibility with other adjunctive treatments.
  6. List essential and unique interventions of CBT, interventions that are recommended but not unique, acceptable interventions and interventions that are not part of CBT.
  7. Describe 7 strategies a counselor would use to help the patient master new skills.

Basic Principles of CBT

  1. Enunciate the basic principles of cognitive-behavioral therapy and describe how functional analysis and skills training are used to treat cocaine addiction.
  2. Describe the CBT principle that holds forth the three ways individuals learn to use drugs: modeling, operant conditioning, and classical conditioning.

The Structure and Format of Sessions

  1. Describe the structure and format of a typical CBT session using the "20/20/20 Rule" and list tasks to be completed during each part of the session.
  2. List 8 skill topics covered in CBT for cocaine dependence.

Integrating CBT and Medication

  1. Outline the pharmacotherapy approach as used in cognitive-behavioral therapy.

Session 1: Introduction to Treatment of CBT

  1. Explain the treatment goal of cognitive-behavioral therapy.
  2. List six strategies a counselor can use during a treatment session to enhance motivation and avoid resistance.
  3. Outline the CBT model providing an explanation and rationale for the treatment.

Topic 1: Coping With Craving

  1. Help the patient understand craving.
  2. Elicit from the patient the experience of craving.
  3. List 5 strategies to cope with craving.

Topic 2: Shoring Up Motivation and Commitment to Stop

  1. Provide key interventions to shore up motivation and commitment to stop.

Topic 3: Refusal Skills/Assertiveness

  1. List three basic principles in effective refusal of cocaine and other substances.

Topic 4: Seemingly Irrelevant Decisions

  1. Identify examples of Seemingly Irrelevant Decisions and their relationship to high-risk situations.

Topic 5: An All-Purpose Coping Plan

  1. Help the patient identify high-risk situations and develop a coping plan.

Topic 6: Problemsolving

  1. Help the patient practice problemsolving skills within the session by listing 5 basic steps.

Topic 7: Case Management

  1. Develop a concrete support plan for addressing psychosocial problems that present a barrier to treatment.

Topic 8: HIV Risk Reduction

  1. Assess the patient's risk for HIV infection and build motivation to change risk behaviors.
  2. Set behavior change goals.
  3. Formulate specific HIV risk-reduction guidelines

Significant Other Session

  1. Involve significant others so that they can help patients become and remain abstinent.
  2. Identify 6 strategies in which the significant other can offer support to the patient in his or her recovery.
  3. Explore strategies through which significant others in the patient's life can help the patient become and remain abstinent.

Appendix A: Therapist Selection, Training and Supervision

  1. List guidelines for effective supervision.
  2. Identify some of the common problems encountered in supervision.

Appendix B: Clinical Research Supporting CBT

  1. Review clinical research supporting CBT and compare its effectiveness against Interpersonal Therapy and Clinical Management.

A Community Reinforcement Approach: Treating Cocaine Addiction

  1. Relate the efficacy of CRA+Vouchers approach over standard drug counseling and cite research studies to support this conclusion.

Clinical Approach

  1. Adopt a counseling style and techniques consistent with the CRA+Vouchers treatment program.

Intake

  1. List 3 categories of patients generally acceptable for the CRA+Vouchers program.
  2. Outline the intake process listing various self-administered questionnaires.
  3. Conduct the initial treatment session taking the patient through several steps.

Early Counseling Sessions

  1. List the tasks a therapist should complete in Sessions One and Two of the program.

Drug Avoidance Skills

  1. Explain the concepts and procedures concerning functional analysis as the first step of CRA+Vouchers treatment plan.
  2. Instruct the patient on the four components of the functional analysis.
  3. Help the patient develop self-management plans for handling triggers to reduce the risk of cocaine use.
  4. Instruct the patient in five components of effective refusal.

Lifestyle Change Components

  1. List at least 6 lifestyle change components for cocaine abusers in treatment.
  2. Explain the importance of time management in achieving and maintaining abstinence from cocaine, and help the patient develop time-management skills.
  3. Provide a rationale for working on lifestyle changes in social and recreational areas.
  4. List 5 basic steps for problem-solving.
  5. Help patients develop assertiveness skills, and distinguish between passive, aggressive and assertive behaviors.

Relationship Counseling

  1. Describe the purpose of relationship counseling and take the patient through various steps to improve the quality of his or her relationship.

Other Substance Abuse

  1. Outline the general strategy for dealing with concurrent alcohol and cocaine use.
  2. Introduce disulfiram protocol and develop compliance procedures.
  3. Outline the general strategy for dealing with marijuana use concurrent with cocaine.

Other Psychiatric Problems

  1. Describe the treatment protocol for dealing with depressive symptomatology and anxiety
  2. following abstinence from cocaine.

Clinical Supervision

  1. Describe the function of clinical supervision of therapists in the CRA+Vouchers program.

Behavioral Change Through Treatment

  1. Describe the behavioral treatment in drug abuse treatment as contingency management.

    2.  

Evaluation of Individual Objectives

To assess the effectiveness of the course material, we ask that you evaluate your achievement of each learning objective on a scale of A to D (A=excellent, B=good, C=fair, D=unsatisfactory). Please indicate your responses next to each learning objective and return it to us with your completed exam.