Community reinforcement approach

Roozen HG, Kerhof AJ, van den Brink W Experiences with an outpatient relapse program (community reinforcement approach) combined with naltrexone in the treatment of opioid-dependence effect on addictive behaviors and the predictive value of psychiatric comorbidity. Eur Addict Res 9 53—58, 2003 Rosen TS, Johnson HL Long-term effects of prenatal methadone maintenance. NIDA Res Monogr 59 73-83, 1985... 

A number of psychosocial treatments for alcohol and other substance use disorders exist and are widely used. In this chapter, we discuss six of these psychotherapies as they are applied to alcohol, cocaine, and opioid dependence brief interventions, motivational enhancement therapy, cognitive-behavioral therapy, behavioral treatments (including contingency management and community reinforcement approaches), behavioral marital therapy, and 12-step facilitation. We also describe studies that examined the efficacy of a medication in combination with one or more of the six psychotherapies. In the second section of the chapter, we highlight research that directly studied the interaction between psychosocial and pharmacological treatments. 

Anton RF, Pettinati H, Zwehen A, et al A multi-site dose ranging smdy of nalmefene in the treatment of alcohol dependence. J Clin Psychopharmacol 24 421 28, 2004 Azrin NH Improvements in the community reinforcement approach to alcoholism. Behav Res Ther 14 339-348, 1976... 

Schottenfeld RS, Chawarski MC, Pakes JR, et al Methadone versus buprenorphine with contingency management or performance feedback for cocaine and opioid dependence. Am J Psychiatry 162 340-349, 2003 Smith JE, Meyers RJ, Delaney HD Community reinforcement approach with homeless alcohol-dependent individuals. J Consult Clin Psychol 66 341-348, 1998... 

While pharmacologic agents may help prevent relapse, psychotherapy should be the core therapeutic intervention. Motivational enhancement therapy (MET), cognitive-behavioral therapy (CBT), 12-step facilitation (TSF), behavioral couples therapy (BCT), community reinforcement approaches, and contingency management are the best-studied forms of psychotherapy in this group of patients. 

Another technique that seems to be effective in treating illicit drug users is couples or family treatment (Stanton Shadish, 1997). It is notable that the community reinforcement approach includes a family/couples (conjoint) component that is based in social learning principles (sec Table 15.4). 

April). A community reinforcement approach to treating cocaine addiction. NIDA publication No. 98-4309. 

Hunt, G. M., 8c Azrin, N. H. (1973). A community reinforcement approach to alcoholism. Behavior Research and Therapy, 11, 91-104. 

Bohn MJ, Kranzler HR, Beazoglou D, et al Naltrexone and brief counseling to reduce heavy drinking results of a small clinical trial. Am J Addict 3 91—99, 1994 Budney AJ, Higgins ST A Community Reinforcement Plus Vouchers Approach Treating Cocaine Addiction. (NIDA Puhl No 98 309). Rockville, MD, National Institute on Drug Abuse, 1998... 

Despite these slight anomalies, in general the findings reinforce those from the strategy survey and indicate that the problems are either inadequate tools and techniques or the need to implement them with a properly resourced and communicated change management approach firmly in hand before implementation begins. 

This approach is reflective and reinforcing of the characteristics of today s and tomorrow s global economy and networked information society that are enabled by information and communications technologies (ICT) in particular, or digital development in general. Therefore, intelligent development is practiced on a modem widely accessible ICT inlfastmcture and it ... 

---