Recommended But Not Unique Interventions

Interventions or strategies that should be delivered, as appropriate, during the course of each patient's treatment but that are not necessarily unique to CBT include those listed below.

• Discussing, reviewing, and reformulating the patient's goals for treatment

• Monitoring cocaine abuse and craving

• Monitoring other substance abuse

• Monitoring general functioning

• Exploring positive and negative consequences of cocaine abuse

• Exploring the relationship between affect and substance abuse

• Providing feedback on urinalysis results

• Setting the agenda for the session

• Making process comments as indicated

• Discussing advantages of an abstinence goal

• Exploring the patient's ambivalence about abstinence

• Meeting resistance with exploration and a problemsolving approach

• Supporting patient efforts

• Assessing level of family support

• Explaining the distinction between a slip and a relapse

• Including family members or significant others in up to two sessions

Acceptable Interventions

Four interventions are not required or strongly recommended as part of CBT but are not incompatible with this approach:

• Exploring self-help involvement as a coping skill

• Identifying means of self-reinforcement for abstinence

• Exploring discrepancies between a patient's stated goals and actions

• Eliciting concerns about substance abuse and consequences

Interventions Not Part of CBT

Interventions that are distinctive of dissimilar approaches to treatment and less consistent with a cognitive-behavioral approach include those listed below.

• Extensive self-disclosure by the therapist

• Use of a confrontational style or a confrontation-of-denial approach

• Requiring the patient to attend self-help groups

• Extended discussion of 12-step recovery, higher power, "Big Book" philosophy

• Use of disease model language or slogans

• Extensive exploration of interpersonal aspects of substance abuse

• Extensive discussion or interpretation of underlying conflicts or motives

• Provision of direct reinforcement for abstinence (e.g., vouchers, tokens)

• Interventions associated with Gestalt therapy, structural interventions, rational-emotive therapy, or other prescriptive treatment techniques.