This book is the first complete guide to implementing the Community
Reinforcement Approach (CRA), an empirically based, highly effective
cognitive-behavioral program for treating alcohol problems. An ideal
program for any practitioner trying to reconcile the needs of their
clients with mandates of HMOs and insurance providers, this approach has
been deemed one of the most cost-effective treatments available by
recent research. CRA acknowledges the powerful role of environmental
contingencies in encouraging or discouraging drinking, and attempts to
rearrange these contingencies so that a non-drinking lifestyle is more
rewarding than a drinking one. Unique in its breadth, the approach
utilizes social, recreational, familial, and vocational strategies to
aid clients in the recovery process. This authoritative manual is a
hands-on guide to applying these therapeutic procedures.
Opening with an account of the history of CRA and the empirical support
for its efficacy, the book addresses the clinical concerns of those
treating substance abusing clients. Specific instructions are provided
for conducting detailed assessments of the client and interviewing
concerned others. Sobriety sampling and disulfiram use within CRA are
discussed in chapters of their own.
The authors then present a step-by-step guide to each component of the
treatment plan, many of which have been shown to be effective forms of
treatment in themselves. Topics include
* behavioral skills training
* social and recreational counseling
* marital therapy
* motivational enhancement
* job counseling
* relapse prevention
Each chapter provides detailed instructions for conducting a procedure,
describes what difficulties to expect, and presents strategies for
overcoming them. Sample dialogues between clients and therapists,
annotated by the authors, further illuminate the treatment process. The
book concludes with a chapter that both addresses the common mistakes
made when implementing CRA, and emphasizes the flexibility and benefits
of this total treatment plan.
An accessible and practical program, CRA can be implemented by all
clinicians who treat alcohol abusing clients, regardless of orientation.
Providing a cost-effective approach that is highly efficacious,
Clinical Guide to Alcohol Treatment is an invaluable resource for the
wide range of practitioners working in today's managed-care environment,
including psychologists, psychiatrists, substance abuse counselors, and
social workers.
