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Recent studies have shown combined addiction treatments to be more effective than either medication or talk therapy alone. This practical manual presents an empirically supported 6-stage framework for managing biopsychosocial treatment of alcohol and drug dependence. The BRENDA approach helps practitioners integrate emerging and established psychosocial and medical intervention approaches into a comprehensive treatment program that is tailored to the needs of the individual patient. Fully compatible with cognitive-behavioral and 12-step treatment models, BRENDA incorporates the use of newly developed medications, such as naltrexone, that target the biological underpinnings of addiction. The approach has been demonstrated effective in more than 80% of alcohol dependent referrals to the authors' treatment program. Illustrated with extended case examples, the manual describes how to conduct a thorough evaluation and assessment, select appropriate interventions, enhance the patient's motivation to change, coordinate service delivery with other providers as needed, and maximize treatment compliance.
I. The BRENDA Approach and How to Use It 1. The Biopsychosocial Understanding of Addiction 2. Managing Addiction Treatment Using the BRENDA Approach 3. Biopsychosocial Assessment: How to Conduct It 4. The Report: How to Prepare and Present the Assessment Results 5. Empathetic Understanding: Listening to the Patient 6. Needs: Indentifying Patient Needs and Priorities 7. Direct Advice: Matching Needs to Treatment Options 8. Assessment of the Patient's Reaction to Advice: Adjusting Advice to Patient Response 9. Dealing with Pharmacotherapy and Medication Compliance Issues 10. Applying the BRENDA Stages to Early Recovery Issues 11. Applying the BRENDA Stages to Later Recovery Issues II. The BRENDA Approach in Action 12. The Case of Bill: A Successful Businessman with Alcohol Addiction 13. The Case of Alissa: Cocaine and Alcohol Addiction with Severe Psychosocial Complications 14. The Case of Stephen: A Binge Drinker/Precontemplator APPENDIX A: Instruments Cage Questionnaire Alcohol Use Disorders Identification Test (AUDIT) Substance Use Disorders Screen Psychological Distress Inventory--32 (PDI-32) APPENDIX B: Naltrexone Pharmacotherapy for Alcohol Dependence Dosage and Administration Pharmacokinetics/Mechanism of Action Drug Interaction Precautions Side Effects Contraindications Patients' Frequently Asked Questions about Naltrexone Medication Tips for Patients
