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Evidence-Based and Best Practice Treatment Resources

This section offers resources focused on implementing evidence-based (EBP) and best practices in addiction treatment. Information is offered regarding adoption and evaluation issues of EBP as well as guidelines for and resources on specific EBPs and best practices. Similar to the other sections within the science-service initiative, this section is truly a work in progress. It does not represent a complete list of EBPs or best practices.

Evidence-Based Practice: Adoption, Considerations, and Evaluation

Best Practices in Addiction Treatment: A workshop facilitator’s guide: This step-by-step guide will assist you in developing and implementing a "Best Practices in Addiction Treatment Workshop." This workshop model provides treatment practitioners with information about the value of using evidence-based practices in their treatment design. The 120-page manual provides templates for Powerpoint presentations and workshop handouts. Available to download only.

Bridging the Gap Between Practice and Research: Forging Partnerships with Community-Based Drug and Alcohol Treatment, Institute of Medicine. This online book examines the community-based drug abuse treatment system with the goal of facilitating new strategies for partnership and increasing synergy among those working in a variety of settings to reduce the individual and societal costs of drug addiction.

Criteria for Evaluating Evidence-Based Practices: This site provides the IOWA Practice Improvement Collaborative outline of criteria in evaluating EBPs. http://www.uiowa.edu/~iowapic/files/

Empirically Based Decision Making in Clinical Practice: Beutler, L. E. (2000, September). Prevention & Treatment, 3(27). This article presents an example of an alternative standard that offers the hope of using clinician experience in ways that enhance the application of scientific principles and that advance the generalization of research to clinical practice.

Evidence-Based Practices: An implementation guide for community-based substance abuse treatment agencies: This manual provides definitions, a review of EBP literature, adoption and implementation challenges and barriers, assessment of readiness to change, and evaluation guidelines for EBPs.

Ingredients of Effective Treatment for Alcohol, Ensuring Solutions to Alcohol Problems, The George Washington University Medical Center: All the elements for treating alcohol problems using the chronic care model exist. Research has demonstrated alcohol problems can be treated effectively with a combination of active ingredients that can be shaped into an individualized treatment plan. When used in the right mix, much as physicians now recommend behavior change and medications to treat hypertension and other chronic diseases, these elements can dramatically improve outcomes for people in alcohol treatment. Several of the effective ingredients addressed at this site include, but are not limited to, early detection, comprehensive assessment, care management, social skill training, and participation in support groups.

Organizational Readiness for Treatment Innovations, Institute of Behavioral Research at Texas Christian University: This article focuses on the process of program change, organization readiness for change assessments, and other references.

Turning Knowledge into Practice: A manual for behavioral health administrators and practitioners about understanding and implementing evidence-based practices: This manual initially provides an overview of evidence-based practices in the mental health and addiction fields. It provides practical approaches in moving the field forward and in addressing the limitations and realities of translating scientific research findings into the real world of service delivery.

Evidence-Based Practices and Best Practice Guidelines

Anger Management: Anger Management for Substance Abuse and Mental Health Clients. A manual (http://kap.samhsa.gov/products/manuals/pdfs/anger1.pdf) and a participant workbook (http://kap.samhsa.gov/products/manuals/pdfs/anger2.pdf) are available for clinicians who work with substance abuse and mental health clients with concurrent anger problems. Along with a participant workbook, this manual describes a 12-week cognitive behavioral anger management group treatment. CSAT/SAMHSA

Approaches to Drug Abuse Counseling: This book is about treatment. In particular, it is about the basic component of most treatment programs. The intent of this book is to present information on various counseling approaches used in some of the best known and most respected treatment programs in the United States. NIDA. Author: Kathleen M. Carroll, Ph.D.

Behavioral Couples Therapy (BCT): This site, “Family and Addiction Treatment and Prevention,” at the Research Institute on Addictions, University of Buffalo, provides information on BCT. Manuals, presentations, and publications are available that highlight BCT as well as relationship and family. The purpose of this web page is to provide an overview of what is known about the impact of substance abuse (both alcohol and other drugs) on marital relationships and how the power of the family system can be used as a mechanism of change to address problem drinking or drug use.

Best Practice Initiative, U.S. Department of Health and Human Services: This initiative highlights public health best practices from around the country, which have been successful and which have measurable outcomes. The aim of this initiative is to foster an environment of peer learning and collaboration.

Brief Strategic Family Therapy (BSFT): This manual introduces counselors to concepts that are needed to understand the family as a vital context within which adolescent drug abuse occurs. It also describes strategies for creating a therapeutic relationship with families, assessing and diagnosing maladaptive patterns of family interaction, and changing patterns of family interaction from maladaptive to adaptive. This manual assumes that therapists who adopt these BSFT techniques will be able to engage and retain families in drug abuse treatment and ultimately cause them to behave more effectively.

Cannabis Youth Treatment Series: This site provides access to five manuals focused on adolescent cannabis use. The areas of focus are motivational enhancement therapy, cognitive behavioral therapy, family support networks, the community reinforcement approach, and multidimensional family therapy. CSAT/SAMHSA

The CENAPS Model of Relapse Prevention Therapy: The CENAPS® Model of Relapse Prevention Therapy (CMRPT®) is a comprehensive method for preventing chemically dependent clients from returning to alcohol and other drug use after initial treatment and for early intervention should chemical use occur. This site provides an overview of this relapse model.

A Cognitive-Behavioral Approach: Treating Cocaine Addiction: This manual demonstrates cognitive-behavioral coping skills treatment (CBT) as a short-term, focused approach to helping cocaine-dependent individuals become abstinent from cocaine and other substances. The underlying assumption is that learning processes play an important role in the development and continuation of cocaine abuse and dependence. These same learning processes can be used to help individuals reduce their drug use. http://www.drugabuse.gov/TXManuals/CBT/CBT1.html

A Community Reinforcement Approach (CRA): Treating Cocaine Addiction: This treatment manual integrates a community reinforcement approach (CRA), originally developed as an effective treatment for alcohol dependence (Myers and Smith 1995), with an incentive program (Vouchers) wherein patients can earn points exchangeable for retail items by remaining in treatment and cocaine abstinent. This multi-component treatment as a whole and several of its components have been demonstrated to be efficacious in controlled clinical trials conducted with cocaine-dependent adults in outpatient clinics. Its applicability to younger individuals and in other settings has not been tested. NIDA.

Contingency Management (CM): Incentives for Sobriety: This article provides a outline CM. CM is a strategy used in alcohol and other drug abuse treatment to encourage positive behavior change in patients by providing reinforcing consequences when patients meet treatment goals and by withholding those consequences or providing punitive measures when patients engage in undesirable behavior.

Counseling for Cocaine Addiction: The Collaborative Cocaine Treatment Study Model: As a result of the significant health and social problems caused by cocaine abuse and addiction, the National Institute on Drug Abuse (NIDA) has sponsored a number of studies of different cocaine treatment approaches. This Group Drug Counseling (GDC) manual describes one of the psychosocial treatments developed for use in a multi-site clinical trial called the Collaborative Cocaine Treatment Study (CCTS).

An Individual Drug Counseling Approach to Treat Cocaine Addiction:
The Collaborative Cocaine Treatment Study Model:
This manual is intended as a guide for the individual treatment of cocaine addiction by addiction counselors. This model was based on the counseling in the outpatient, drug-free program in the Addiction Recovery Unit and in the methadone maintenance program (Woody et al. 1977), which are both part of the Veterans Affairs Medical Center. Twelve-step philosophy and participation is a central component of the model. This individual counseling model can be viewed as a component within a comprehensive outpatient treatment program for cocaine addiction. Alternatively, the model can be offered independently of other treatments, and referrals can be made for any additional services as needed. NIDA.

Evidence-Based Practices for Co-Occurring Disorders: Understanding Evidence-Based Practices: This is a Report to Congress on the Prevention and Treatment of Co-Occurring Substance Abuse Disorders and Mental Disorders. This chapter provides an overview of evidence based practices, highlighting specific interventions for adults with co-occurring disorders.

The Matrix Model: This model of outpatient treatment was developed during the 1980s in response to an overwhelming demand for stimulant abuse treatment services. The intent was to create an outpatient model responsive to the needs of stimulant-abusing patients while constructing a replicable protocol that could be evaluated. Treatment materials draw heavily upon published literature pertaining to the areas of relapse prevention (Marlatt and Gordon,1985), family and group therapies, drug education, self help participation and drug abuse monitoring. This site provides an overview and a list of references.

Multidimensional Family Therapy (MDFT) for Adolescent Substance Abuse, Center for Treatment Research on Adolescent Drug Abuse, University of Miami School of Medicine: Multidimensional family therapy (MDFT) has been recognized as one of the most promising interventions for adolescent drug abuse in a new generation of comprehensive, multicomponent, theoretically-derived and empirically-supported treatments. This site provides an overview, core components, results, contact information, and references.

Pharmacological Interventions: Naltrexone: This site, New Approaches Seek To Expand Naltrexone Use in Heroin Treatment, provides an overview and resource on Naltrexone. Naltrexone, an opiate treatment medication, is used to help patients make the transition from illicit opiate use to a drug-free life. The medication provides a safety net for patients because it blocks the euphoric effects they normally would feel if they slip and use heroin or any other opiate.

A Provider’s Introduction to Substance Abuse Treatment for Lesbian, Gay, Bisexual, and Transgender Individuals: This manual seeks to inform administrators and clinicians about appropriate diagnosis and treatment approaches that will help ensure the development or enhancement of effective lesbian, gay, bisexual, and transgender (LGBT) – sensitive programs. Serving as both a reference tool and program guide, it provides statistical and demographic information, prevalence data, case examples and suggested interventions, treatment guidelines and approaches, and organizational policies and procedures. CSAT/SAMHSA.

Seeking Safety: A Treatment Manual for PTSD and Substance Abuse: Seeking Safety is a present-focused therapy to help people attain safety from both PTSD and substance abuse.  The treatment is available as a book, providing both client handouts and guidance for clinicians. The treatment was designed for flexible use.  It has been conducted in group and individual format; for women, men, and mixed-gender; using all topics or fewer topics; in a variety of settings (e.g., outpatient, inpatient, residential); and for both substance abuse and dependence.  It has also been used with people who have a trauma history, but do not meet criteria for PTSD. This site provides an overview and links to information on Seeking Safety.

Treatment Improvement Protocols (TIPs): TIPS are best practice guidelines for the treatment of substance abuse. While each TIP strives to include an evidence base for the practices it recommends, Center for Substance Abuse Treatment (CSAT) recognizes that the field of substance abuse treatment is evolving, and research frequently lags behind the innovations pioneered in the field. A major goal of each TIP is to convey "front-line" information quickly but responsibly. This site offers links to the entire set of TIPs.

Voucher-Based Reinforcement Therapy in Methadone Maintenance Treatment: This summary provides a brief description and references on this novel and promising voucher-based reinforcement system. http://www.nida.nih.gov/BTDP/Effective/Silverman.html

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