Best Practices : Substance Abuse Treatment and Rehabilitation

9. Glossary of Treatment Definitions

Alcohol/Drug Education: Provision and discussion of factual information on alcohol (alcoholism, problem drinking) and other drugs (addiction, drug abuse) through, for example, lectures, films or readings, in order to stimulate attitudinal and behavioural change.

Anticraving Drug Therapy: The use of drugs to reduce the craving for alcohol.

Antidipsoptropic Drug Therapy: The use of drugs such as disulfiram (Antabuse) or citrated calcium carbimide (Temposil) to produce an aversive reaction when alcohol is consumed.

Aversion Therapy: Therapy designed to induce a conditioned avoidance of alcohol by pairing either images or consumption of alcohol with unpleasant experiences, such as electric shocks, nausea or vomiting, or imagined adverse consequences.

Behavioural Contracting: The use of specific environmental contingencies such as behaviour prompts, and the reinforcement of behaviours that are incompatible with drinking or drug use.

Behavioural Self-control Training: Activities aimed at teaching the client methods to modify his or her use of alcohol, usually with a moderate drinking goal. Among other things, it teaches strategies for dealing with high-risk situations. The approach may involve self-help manuals and is sometimes referred to as self-management training.

Brief Treatment: Brief motivational counselling generally targeted to people with low to moderate problems and up to eight sessions of behavioural treatment.

Cognitive Therapy: The identification and modification of maladaptive thoughts or beliefs that contribute to problem substance use.

Community Reinforcement: A broad spectrum approach which attempts to change the individual's drinking or drug use environment by providing interventions such as pharmacotherapies, help with job finding, relationship and leisure counselling, etc.

Confrontational Intervention: A very intensive and challenging approach to individual and group activities aimed at questioning current behaviour and motivating the client toward attitudinal and behavioural changes.

Continuing Care (after-care): Resources or services that provide continuing encouragement and additional services as needed following a client's completion of a treatment plan.

Cue Exposure: Exposure of drinkers or drug users to cues (e.g. sight, taste, smell) to alcohol or drug use without providing the substance with the assumption that such exposure will extinguish the craving or withdrawal.

Day/Evening Treatment: Intensive, structured non-residential treatment, typically provided five days a week (e.g. 3-4 hours per day). Such programs may also be provided in institutional settings (e.g. Corrections).

Family/Marital Therapy: Involvement of spouse, family members and/or significant others in the therapeutic process in order to improve communication, problem solving and other skills in the family, thereby modifying alcohol and other drug use by the client and providing support to the family. In some cases, family members may be clients in their own right.

Group Therapy: Provision of treatment in a group format. It may include group psychotherapy, as well as other types of groups such as support groups and counselling groups.

Hypnosis: Putting the person in a hypnotic trance and then giving specific instructions in order to change future substance use.

Insight-oriented Psychotherapy: Individual or group activities which view alcohol or other drug problems as a symptom of underlying psychopathology and which seek to resolve underlying conflicts through the use of interpretations and the development of insight. It is sometimes referred to as insight-oriented therapy, as distinct from the more present-oriented, problem-solving, counselling approach.

Methadone Maintenance Treatment: The use of methadone in a prescribed and systematic fashion as a substitute for opiates in order to stabilize the user while lifestyle and interpersonal changes are attempted.

Methadone Maintenance Treatment - high dose: Average dosage of 60 to100 mg/day.

Methadone Maintenance Treatment - low dose: Average dosage of 30 to 50 mg/day.

Outpatient Treatment: Treatment provided on a non-residential basis, usually in regularly scheduled sessions (e.g. 1-2 hours per week).

Relapse Prevention: Activities aimed specifically at teaching clients skills to cope with high-risk situations for relapse and to increase the clients' confidence (i.e. self-efficacy) so that they can successfully cope with these situations.

Residential Treatment (long-term): Treatment and/or rehabilitation services provided for a period of time typically longer than 40 days. These programs include recovery homes, halfway houses, three-quarter-way houses and therapeutic communities.

Residential Treatment (short-term): Treatment provided for an intensive, structured period of time while the client resides in-house. The length of stay is typically less than 40 days.

Social Skills Training: This refers to training in behavioural skills to build and maintain interpersonal relationships.

Stress Management: Activities aimed at improving the client's ability to relax and cope with stress. This may involve progressive relaxation training, biofeedback, meditation, systematic desensitization and other techniques.

Therapeutic Community: Long-term, highly structured, intensive residential milieu therapy program for those with severe problems, often including involvement with the criminal justice system. It is modelled after the original US programs such as Synanon.

Twelve-Step Self-help: Treatment activities based on the disease perspective of alcoholism and other chemical dependencies, and the 12-step approach of AA or similar self-help groups.

Video Self-Confrontation: Videotaping a drinker while intoxicated and playing it back when he or she is sober in order to confront the person with his or her behaviour while drinking.