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Best Practice Standards in the Treatment of Substance Abuse Disorders

Last modified: 3/1/2012 6:08 PM

General Description

A review of the research and literature relating to the most effective elements and dynamics of a successful treatment program was conducted to determine what are considered best practices in the treatment of substance abuse disorders. The current research-based best practices tend to merge the biopsychosocial, theoretical perspective of addictive disorders. This includes supportive counseling, motivating client readiness for change, and coping-skills training techniques. The goals of treatment are:

  • To establish and maintain abstinence from the illicit use of all psychoactive drugs;
  • To foster development of (non-chemical) coping and problem-solving skills;
  • To stop and ultimately eliminate impulses to "self-medicate" with psychoactive drugs; and
  • To enhance and sustain client motivation for change.

The approach is based on 12-Step facilitation therapy and cognitive-behavioral, motivational, and insight-oriented techniques according to each client's individual needs. These best practices counseling standards can be applied in any level of care and throughout the continuum of addictions treatment.

The therapeutic approach is empathic, client centered, and flexible. Strong emphasis is placed on developing a good working alliance with the client to facilitate behavioral change. With clients who are referred from Criminal or Dependency Courts, the counselor takes advantage of the leverage from this referral to help motivate the client to participate in a treatment/recovery process.

The counselor attempts to work with and through (rather than against) a client's resistance to change. Aggressive confrontation of denial -- the hallmark of traditional addiction counseling -- is seen as counterproductive and antithetical to this approach.

Group and individual counseling are delivered within the context of a flexible treatment program that also includes psycho-education (PE), pharmacotherapy for coexisting psychiatric disorders, and (where indicated) urine testing and alcohol breathalyzer tests to encourage and verify abstinence. Client participation in self-help is encouraged, but not mandated.