The Addiction Treatment Planner. Группа авторов

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Название The Addiction Treatment Planner
Автор произведения Группа авторов
Жанр Психотерапия и консультирование
Серия
Издательство Психотерапия и консультирование
Год выпуска 0
isbn 9781119707936



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those psychological treatments with the best available supporting evidence, added Objectives and Interventions consistent with them in the pertinent chapters, and identified these with this symbol:
. As most practitioners know, research has shown that although these treatment methods may have demonstrated efficacy, factors such as the individual psychologist (e.g. Wampold, 2001), the treatment relationship (e.g. Norcross, 2019), and the patient (e.g. Bohart & Tallman, 1999) are also vital contributors to optimizing a client's response to psychotherapy. As noted by the APA, “Comprehensive evidence-based practice will consider all of these determinants and their optimal combinations.” (APA, 2006, p. 275). For more information and instruction on constructing evidence-based psychotherapy treatment plans, see our 12 DVD-based training videos entitled Evidence-based Psychotherapy Treatment Planning (Jongsma & Bruce, 2010–2012).

      Although sources may vary slightly in the criteria they use for judging levels of empirical support, we favored those that use more rigorous criteria, typically requiring demonstration of efficacy through randomized controlled trials or clinical replication series, good experimental methodology, and independent replication. Our approach was to evaluate these various sources and include those treatments supported by the highest level of evidence and for which there was consensus across most of these sources. For any chapter in which EBP is indicated, references to the sources used to identify them can be found online at www.wiley.com/go/jongsma/addictiontp6e. In addition to these references to empirical support, we have also included a Professional Reference appendix listing references to Clinical Resources. Clinical Resources are books, manuals, and other resources for clinicians that describe the details of the application, or the “how to,” of the treatment approaches described in a chapter.

      We recognize that there is debate regarding EBP among mental health professionals, who are not always in agreement regarding the best treatment, what factors contribute to good outcomes, or even what constitutes “evidence.” We also recognize that some practitioners are skeptical about changing their practice based on psychotherapy research. Our intent in this book is to accommodate these differences by providing a range of treatment plan options, including those consistent with the “best available research” (APA, 2006), those reflecting common clinical practices of experienced clinicians (that may have not been subjected to study), and some that reflect promising emerging approaches. Our intent is to allow users of this planner an array of options so that they can construct what they believe to be the best plan for their particular client.

      More recently, psychotherapy research is moving toward trying to identify evidence-based principles of psychotherapeutic change that cut across the various individual psychotherapies that have largely been the focus of outcome research. An example of this call in seen in Goldfried (2019), in which he advances the following principles:

       Promoting client expectation and motivation that therapy can help,

       Establishing an optimal therapeutic alliance,

       Facilitating client awareness of the factors associated with his or her difficulties,

       Encouraging the client to engage in corrective experiences, and

       Emphasizing ongoing reality testing in the client's life.

      We would also like to note that for those selecting EBT objectives and interventions in their treatment, fidelity to the EBT as it was delivered in the studies demonstrating its efficacy or effectiveness offers the best chance for reproducing its results for your client. A demonstration of this point was witnessed in a recently published meta-analysis examining 12-Step Facilitation Therapy (TSF; Kelly, Humphreys, & Kelly, 2020). The review found that TSF manualized interventions intended to increase Alcoholics Anonymous (AA) participation during and following alcohol use disorder (AUD) treatment lead to enhanced abstinence outcomes compared to other well-established treatments over the next few months and for up to three years. Of note was that fidelity to the TSF treatment model was critical to this outcome as conveyed in this statement by the authors:

      …when different types of TSF interventions were tested against each other, the more intensive TSF interventions (e.g. those that include actively prescribing AA participation and ongoing monitoring of AA attendance and related experiences; personal linkages to existing AA members) often worked better at improving drinking-related outcomes than the ‘“treatment as usual (TAU) TSF”’ intervention. This suggests that although many treatment professionals may believe that they “‘already do 12-step’” (i.e. implement TSF strategies) because they hand out 12-step literature or mention 12-step groups to patients, this alone may not be sufficient to achieve a superior benefit (Kelly, Humphreys, & Yeterian, 2013). The types of TSF strategies used do matter, and the more intensive strategies, such as those evaluated herein, enhance participation rates and outcomes compared to the more routine 12-step-oriented TAU. Some of these strategies could be clinical linkage to existing members (e.g. Manning, et al. 2012; Timko, Debenedetti, & Billow, 2006), or active prescription of attendance versus leaving it to people to decide for themselves whether they want to attend AA (e.g. Walitzer, Dermen, & Barrick, 2009) (p. 33).

      Throughout this Planner we cite references and include an appendix of clinical resources, including treatment manuals and books, which describe the how-to of delivering the EBT with high fidelity, and we recommend them for those who share the value of delivering treatment with the intent to maximize the client's outcome.