Treating Substance Abuse

Frederick Rotgers, PsyD, ABPP
Jon Morgenstern, PhD
Scott T. Walters, PhD

Course Outline

This widely used reference and text captures the breadth of current knowledge about substance abuse and its treatment. Noted theoreticians and practitioners provide an authoritative introduction to the six most prominent psychosocial treatment approaches. For each approach, a chapter on basic assumptions and theories is followed by clinical chapter that describes specific therapist actions and strategies and offers a start to finish view of treatment. In addition, a single chapter discusses psychopharmacological intervention. Comprehensive, clear, and accessible, the text concludes by discussing ways to integrate elements of multiple approaches into carefully planned work with individual clients.

About the Authors

Frederick Rotgers, PsyD, ABPP, is Associate Professor and Associate Director of Clinical Training in the Department of Psychology at the Philadelphia College of Osteopathic Medicine. Dr. Rotgers has lectured, taught, and published extensively on a variety of topics related to behavior therapy and addictions. His current research interests include measuring and enhancing motivation to change addictive and other problematic behaviors in underserved populations, and the integration of substance abuse screening and brief intervention into primary care settings.

Jon Morgenstern, PhD, is Vice President and director of the Division of Health, Treatment Research, and Analysis at the National Center of Addiction and Substance Abuse at Columbia University (CASA). He is also Associate Professor of Psychiatry and Health Policy at the Mount Sinai School of Medicine, where he directs a substance abuse treatment program for disadvantaged mothers. Dr. Morgenstern has expertise in substance abuse treatment and health services research. His areas of interest include cognitive-behavioral treatments, strategies to improve community-based substance abuse programs, and the coordination of treatment across substance abuse, welfare, and child welfare system. Dr. Morgenstern’s research program in substance abuse treatment and health services has been supported by the National Institutes of Health since 1990.

Scott T. Walters, PhD, is Assistant Professor of Behavioral Sciences at the University of Texas School of Public Health, Dallas Regional Campus. His research interest include college student health and substance abuse, brief motivational approaches to treatment, and electronic and mailed interventions. He has authored more than two dozen articles on theoretical and applied aspects of psychology, and two books for children. Dr. Walters has acted as a consultant for several universities, is a frequent speaker to campus, community, and medical groups, and has received national and international awards for his work.

Learning Objectives

1. Explain the consequences and utility of employment of a “biopsychosocialspiritual consequences/maintenance model” to the treatment of substance abuse.
2. Explain the psychological effects of chronic consumption of large quantities of alcohol and other psychoactive substances.
3. Explain the central role of abstinence for the achievement of recovery in all disease models and 12-step-oriented programs.
4. Explain why symptoms of depression and anxiety which are commonly seen in many addicts in the beginning of treatment usually resolve within three weeks of treatment.
5. Explain the two phases of early recovery among alcoholics and addicts of other substances.
6. Explain why the similarities among alcoholics and addicts of other substances, not the differences, are important within the 12-step model of recovery.
7. Define the term “denial” in the nomenclature of the 12-step recovery model.
8. Describe Al-Anon and Nar-Anon meetings and their purpose and function within the 12-step recovery model.
9. Describe the essence of object relations theory on substance abuse.
10. Critique the psychoanalytic theories of addiction and explain the difficulties with psychoanalytic studies of addiction according to Blatt et al. (1984).
11. Explain how an integrated model of psychodynamic and cognitive-behavioral therapy works.
12. Explain the cognitive-behavioral techniques and goals involved in the early and middle phases of treatment of substance abuse.
13. Describe the basic areas of focus in the advanced phase of psychoanalytic treatment with substance abusers.
14. Describe and explain “co-dependency” in the context of substance abuse.
15. Explain the reasons to involve families in the treatment of substance abuse.
16. Describe “enabling” in the context of substance abuse.
17. Explain the intervention techniques “joining” and “restructuring” according to the family systems model in the treatment of substance abuse.
18. Explain the three basic learning theory mechanisms that contribute to the initiation, maintenance, and change of behavior.
19. Explain the SLT theory postulated by Albert Bandura and its relevance to the treatment of substance abuse.
20. Describe the core tasks of treatment of substance abuse from a cognitive-behavioral perspective.
21. Describe the behavioral technique of “covert sensitization” in the treatment of substance abuse.
22. Explain the difference between “lapse” and “relapse” in the context of substance abuse treatment.
23. Explain the concept of “cross-price elasticity of demand” in the context of substance abuse.
24. Describe the melioration theory of addiction.
25. Explain the concept of “negative reinforcement” in the context of substance abuse and treatment.
26. Explain the purposes of methadone use in the treatment of substance abuse and describe its effects on users.
27. Describe the three basic psychological needs that drive humans according to the self-determination theory.
28. Explain the principles of motivational interviewing and their utility in the context of substance abuse treatment.
29. Explain common roles for pharmacotherapy in the treatment of substance dependence disorders.
30. Describe the author’s opinion on forcing clients in substance abuse treatments to accept labels such as “addict”.

Course Contents

1. 1. Theory of 12-Step-Oriented Treatment
John Wallace
2. Facilitating 12-Step Recovery from Substance Abuse and Addiction
Joseph Nowinski
3. Psychoanalytic Theories of Substance Abuse
Jeremy Leeds and Jon Morgenstern
4. Exploration in the Service of Relapse Prevention: A Psychoanalytic Contribution to Substance Abuse Treatment
Daniel S. Keller
5. Theoretical Bases of Family Approaches to Substance Abuse Treatment
Barbara S. McCrady, Elizabeth E. Epstein, and Rene D. Sell
6. Family Therapy Techniques
William Fals-Steward, Timothy J. O’Farrell, and Gary R. Birchler
7. Cognitive-Behavioral Theories of Substance Abuse
Frederick Rotgers
8. Behavioral Treatment Techniques for Psychoactive Substance Use Disorders
Thomas J. Morgan
9. Behavioral Economic Concepts in the Analysis of Substance Abuse
Rudy E. Vuchinich and Jalie A. Tucker
10. Contingency Management in the Substance Abuse Treatment Clinic
Alan J. Bundey, Stacey C. Sigmon, and Stephen T. Higgins
11. Theoretical Perspectives on Motivation and Addictive Behavior
Scott T. Walters, Frederick Rotgers, Bill Saunders, Celia Wilkinson, and Tania Towers
12. Motivational Interviewing: Destination, Direction, and Means
Theresa B. Moyers, and V. Ann Waldorf
13. Integrating Psychotherapy and Pharmacotherapy in Substance Abuse Treatment
Kathleen M. Carroll
14. Integration of Theory, Research, and Practice: A Clinician’s Perspective
Edward Rubin


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