1st Edition

Combining Medication and Psychosocial Treatments for Addictions
The BRENDA Approach

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ISBN 9781572306189
Published May 3, 2001 by Guilford Press
208 Pages

USD $45.00

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Book Description

Recent studies have shown a combination of psychosocial support and medications to lead to better addiction treatment outcomes than talk therapy alone. This practical manual provides an empirically supported framework for managing biopsychosocial treatment of alcohol and drug dependence. Fully compatible with cognitive-behavioral and 12-step models, BRENDA is a collaborative, case-management approach to treatment. It incorporates the use of newly developed medications that target the biological underpinnings of addiction, and maximizes treatment compliance through working with patients in a nonjudgmental manner and enhancing their motivation to change. Illustrated with extended case examples, the book describes how to conduct a thorough assessment, make recommendations for a variety of individualized interventions, and coordinate service delivery with other providers as needed. The approach has been demonstrated effective in more than 80% of alcohol-dependent referrals to the authors' treatment program.

Table of Contents

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
Patients' Frequently Asked Questions about Naltrexone
Medication Tips for Patients

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Joseph R. Volpicelli, MD, PhD, Associate Professor and Senior Scientist, University of Pennsylvania

Helen M. Pettinati, PhD, Associate Professor, Department of Psychiatry, Treatment Research Center, University of Pennsylvania

A. Thomas McLellan, PhD, Senior Scientist, Treatment Research Institute, Philadelphia, PA

Charles P. O'Brien, MD, PhD, Treatment Research Center, University of Pennsylvania


This is a groundbreaking book--the first in the field to provide a clear, clinically useful, and practical explication of how to enhance patient compliance with medication and addictions treatment. While there have been other publications that have addressed this important issue in the age of increasing attention to neurobiological treatments for addiction, none has been as comprehensive or as solidly grounded in research findings. It is a 'must read' for all clinicians working with addicted patients in settings where medications are a part of treatment, or where other treatment compliance issues are important to address. It will also be useful in professional training for physicians, psychologists, social workers, and addiction counselors. --Frederick Rotgers, PsyD, Assistant Chief Psychologist, Smithers Addiction Treatment and Research Center, St. Luke's-Roosevelt Hospital Center, New York, NY

This book describes treatment principles that are helpful to 80% of drug and alcohol patients! Within the BRENDA approach, psychosocial and pharmacological treatment choices are individualized, with emphasis on naltrexone for alcohol addiction. These talented researcher-practitioners have produced a much-needed guide that will be readily understood and used in practice and teaching by psychologists, counselors, social workers, nurse practitioners, and others. --Lester Luborsky, PhD, Professor of Psychology in Psychiatry, School of Medicine, University of Pennsylvania

Medications for treating addiction are usually not successful unless combined with appropriate psychosocial methods. Unfortunately, many programs lack the necessary sophistication in one or the other of these to carry out the combination. BRENDA offers an easily taught and understood way of integrating the two components. It has been tested and improved for over 5 years by one of the most outstanding teams of addiction clinical researchers in the United States and could significantly improve treatment outcome. --Herbert D. Kleber, MD., Professor of Psychiatry, Director, Division on Substance Abuse, Columbia University College of Physicians and Surgeon