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Brief Integrated Motivational Intervention - a Treatment Manual for Co-occuring Mental Health Andsubstance Use Problems
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Table of Contents

About the Companion Website xi

About the Authors xii

Acknowledgments xv

1 Introduction 1

A Window of Opportunity 1

Brief Integrated Motivational Intervention (BIMI) 4

Approach 4

Timing 4

Structure 5

2 Getting Started: Engagement and Brief Assessment 8

Staying Motivated 8

STEP 1: Building Engagement and Assessment 9

Session One Overview 10

Session One Outline 10

BIMI Brief Assessment 12

Generating the Personalized Assessment Feedback Sheet 31

Session Two Overview 36

Session Two Outline 36

Frequently Asked Questions (FAQs) 42

Alcohol 43

Drugs and Mental Health 46

Additional Resources 52

3 Making Decisions About Change 53

How to Decide on the Next STEP 53

How to Decide What STEP Is Appropriate for the Client 53

STEP 2: Making Decisions with Your Client 56

Outline of Sessions 57

Identifying the "Benefits" of Using 57

Identifying Positive Thoughts and Mis-held Beliefs About Alcohol and Drugs 58

Taking Another Look at What You Think About Alcohol and Drugs 60

Relationship Between Mental Health Problems and Substance Use 62

Reviewing Any "Costs" of Using 65

4 Change 69

STEP 3: Change Plans and Social Support 69

Outline of Sessions 71

Taking Steps Toward My Goals 71

Coping with Setbacks 72

Strategies to Cope with Cravings and Urges 73

Social Support for Change 75

Developing Supportive Social Networks 76

Outline of Sessions 76

Helpful Information for Family Members or Supportive Social Network Members 78

Understanding Cannabis, Alcohol, and Other Substance Use, and How It Impacts on Family and Others 79

Do Others Experience Similar Problems? 80

How Do I Make Sense of This? 80

Why Do I Feel So Stressed? 81

To Sum It Up 82

How Can I Best Support My Family Member or Friend? 83

5 Boosting Change 85

Booster Session Content 85

Booster Session Outline 86

Review Self-Motivational Statements of

Concern and Intention to Change 87

Review the Maintenance Cycle for Mental Health Problems and Substance Use 87

Review Progress with Substance-related Goal and Skills to Tackle Setbacks 88

Review Social Support for Change 88

Link in with Community-based Substance Misuse Treatment Services 89

APPENDIX Worksheets and Handouts 90

Worksheet 1: What Do I Enjoy About Using or What Keeps Me Using? 97

Worksheet 2: What I Enjoy About Using or What Keeps Me Using (Table) 99

Worksheet 3: How Does My Use Sometimes Affect Me? 100

Worksheet 4: Taking Steps Toward My Goal 101

Handout 1: Helpful Information for Family Members or Supportive Social Network Members 102

Understanding Cannabis, Alcohol, and Other Substance Use, and How It Impacts on Family and Others 102

Do Others Experience Similar Problems? 103

How Do I Make Sense of This? 104

Why Do I Feel So Stressed? 105

To Sum It Up 105

Handout 2: How Can I Best Support My Family Member or Friend? 107

Keeping Communication Open 107

Supporting His or Her Goals 107

References 108

Index 115

About the Author

Hermine L. Graham is a Consultant Clinical Psychologist and Lecturer at the University of Birmingham, UK. She has expertise in cognitive behavioural therapy, and has led the development and research of service models and treatment approaches for people with severe mental health and co-occurring alcohol and drug problems in Birmingham. This work has been highlighted as a model of "good practice," and is referenced in national policy guidelines for the treatment of "dual diagnosis" (DoH, 2002). She has published widely in academic peer-reviewed journals and is co-author of Cognitive-Behavioural Integrated Treatment (C-BIT) (Wiley, 2004) and co-editor of Substance Misuse in Psychosis (Wiley, 2003). Alex Copello is Professor of Addiction Research at the School of Psychology at the University of Birmingham, UK, and Consultant Clinical Psychologist with the Birmingham and Solihull NHS Foundation Trust. His career has combined clinical and academic work, and his research has had a major impact on addiction treatment in the UK in recent years. He has published widely in academic journals and books. Max Birchwood is Professor of Youth Mental Health at the University of Warwick, UK. He pioneered the concept and practice of early intervention in psychosis, and opened the UK's first Early Intervention in Psychosis service in 1994. He has published widely in the field of psychosis, and is the author of many books. Emma Griffith is a Lecturer and Clinical Tutor at the University of Bath, UK, and a Clinical Psychologist in Avon and Wiltshire Partnership Mental Health NHS Trust. She is accredited as a Cognitive Behavioural Psychotherapist by the British Association for Behavioural & Cognitive Psychotherapies (BABCP).

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