Volume 3

COGNITIVE-BEHAVIORAL COPING SKILLS THERAPY MANUAL

A Clinical Research Guide for Therapists Treating Individuals With Alcohol Abuse and Dependence

Compiled and edited by:

Ronald Kadden, Ph.D.
Kathleen Carroll, Ph.D.
Dennis Donovan, Ph.D.
Ned Cooney, Ph.D.
Peter Monti, Ph.D.
David Abrams, Ph.D.
Mark Litt, Ph.D.
Reid Hester, Ph.D.

Project MATCH Monograph Series Editor:
Margaret E. Mattson, Ph.D.

U.S. Department of Health and Human Services
Public Health Service
National Institutes of Health

National Institute on Alcohol Abuse and Alcoholism
5635 Fishers Lane
Bethesda, Maryland 20892–9304

Project MATCH is supported by grants under a cooperative agreement funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and implemented by nine clinical research units and a data coordinating center. It was initiated and is administered by the Treatment Research Branch, NIAAA.

COPYRIGHT STATUS

This volume is adapted from copyrighted material that is reproduced herein with the permission of the copyright holders. Before reprinting any part, readers are advised to determine the copyright status and to secure permission of the copyright holders. The authors would particularly like to thank Guilford Press for their kind permission to use extensive portions of the book Treating Alcohol Dependence: A Coping Skills Training Guide in the original version of the Project MATCH manual and in the overview of this volume.

The views and opinions expressed on the following pages arc solely those of the authors and do not necessarily constitute an endorsement, real or implied, of the Institute or the U.S. Department of Health and Human Services.

NIH Publication No. 94–3724

Reprinted 2004

CONTENTS

Acknowledgments
Foreword
Preface
Introduction

Modifications to Monti et al.

Additions
Group Versus Individual Therapy
Length of Treatment

Supporting Data
References

Overview of the Program

Rationale for Outpatient Treatment
Treatment Goals
Client Role
Therapist Role
Adherence to the Manual
Menu of Topics
Outpatient Versus Aftercare Settings
Discussion of Clients’ Recent Problems
Structure of Sessions
Guidelines for Behavior Rehearsal Role Plays
Homework
Coping Skills Training With Significant Others
Preventing Attrition
Alcohol and Other Drug Use
Absences
Lateness
Extra Sessions
Concurrent Treatment
Clinical Deterioration
Termination

Core Sessions
Session 1: Introduction to Coping Skills Training
  Building Rapport
  Conceptualizing Treatment: What Is Alcoholism?
  Assessing High-Risk Situations
  Motivation
  Contract and Ground Rules
  Homework

Session 2: Coping With Cravings and Urges to Drink
  Rationale
  Skill Guidelines
  In-Session Exercises

Session 3: Managing Thoughts About Alcohol and Drinking
  Rationale
  Skill Guidelines
  Introducing the Practice Exercise

Session 4: Problem Solving
  Rationale
  Skill Guidelines
  Behavior Rehearsal Role Plays
  Reminder Sheet and Practice Exercise

Session 5: Drink Refusal Skills
  Rationale
  Skill Guidelines
  In-Session Practice
  Modeling
  Behavioral Rehearsal Role Play
  Reminder Sheets and Practice Exercises

Session 6: Planning for Emergencies and Coping With a Lapse
  Rationale
  Skill Guidelines
  Practice Exercise
  Reminder Sheets

Session 7: Seemingly Irrelevant Decisions
  Rationale
  Group Discussion
  Exercise in Group
Final Core Session: Termination

Elective Sessions
Elective Session: Starting Conversations
Elective Session: Nonverbal Communication
Elective Session: Introduction to Assertiveness
  Skill Guidelines
  Behavior Reversal Role Play
  Modeling
  Practice Exercise

Elective Session: Receiving Criticism
  Rationale
  Skill Guidelines
  Modeling
  Behavior Reversal Role Play
  Practice Exercise
Elective Session: Awareness of Anger
Elective Session: Anger Management
Elective Session: Awareness of Negative Thinking
Elective Session: Managing Negative Thinking
Elective Session: Increasing Pleasant Activities

Skill Guidelines
Elective Session: Managing Negative Moods and Depression
  Rationale
  Skill Guidelines
  Thinking Errors
  In-Session Exercise

Elective Session: Enhancing Social Support Networks
  Rationale
  Skill Guidelines
  In-Session Exercise

Elective Session: Job-Seeking Skills
  Rationale
  Skill Guidelines
  The Resume
  The Job Application
  Generating Job Leads
  Telephone Skills Training
  Rehearsal of Interview Process
  Goal Setting

Elective Session: Couples/Family Involvement I
  Rationale
  Skill Guidelines
  In-Session Exercise
  Introducing the Practice Exercise

Elective Session: Couples/Family Involvement II
  Review of Practice Exercises
  Rationale
  Skill Guidelines
  Behavioral Rehearsal Role Plays
  Wrap-Up
  Introducing the Practice Exercise

Appendix A—Bibliography
Appendix B—Therapist Selection, Training, and Supervision in Project MATCH
  Therapist Selection
  Therapist Training
  Ongoing Monitoring