Combining Medication and Psychosocial Treatments for Addictions: The BRENDA Approach

Joseph R. Volpicelli, Helen M. Pettinati, A. Thomas McLellan, and Charles P. O'Brien
Copyright 2001
ISBN 9781572306189 
208 Pages 

ORDER CODE: 9781572306189 


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: Identifying 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


Authors

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