Nonpharmacologic Office-Based Interventions: Cognitive-Behavioral Therapy and Motivational Interviewing


There are myriad nonpharmacologic interventions that are used in traditional addiction treatment, ranging from individual and group psychotherapies, to self-control and social skills training, to aversion therapies. However, despite the vast array of treatment strategies, the literature suggests that when it comes to treating substance addiction, no one modality is superior to any other (1). Rather, there are a variety of treatments, and combinations of treatments, that can be helpful for the addicted patient. Unfortunately, for the majority of primary care physicians, obstacles such as limited time and lack of training in this area make the implementation of traditional interventions unfeasible. This chapter gives the physician an overview of two well-known and well-studied brief nonpharmacologic interventions—cognitive-behavioral therapy (CBT) and motivational interviewing (MI)—that can be administered by the physician in an office-based setting.


Family Therapy Motivational Interview Nonpharmacologic Intervention Cognitive Restructuring Motivational Interview 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Hester RK, Squires DD. Outcome research: alcoholism. In Galanter M, Kleber HD, eds. Textbook of Substance Abuse Treatment. Arlington, VA: American Psychiatric Association; 2004;129–135.Google Scholar
  2. 2.
    Parsons JT, Rosof E, Punzalan JC, DiMaria L. Integration of motivational interviewing and cognitive behavioral therapy to improve HIV medication adherence and reduce substance use among HIV-positive men and women: results of a pilot project. AIDS Patient Care STDS 2005 19: 31–39.PubMedCrossRefGoogle Scholar
  3. 3.
    Baker A, Lee NK, Claire M, Lewin TJ, Grant T, Pohlman S, Saunders JB, Kay-Lambkin F, Constable P, Jenner L, Carr VJ. Brief cognitive behavioural interventions for regular amphetamine users: a step in the right direction. Addiction 2005;100(3): 367–378.PubMedCrossRefGoogle Scholar
  4. 4.
    Bertholet N, Daeppen J-B, Wietlisbach V, Fleming M, Burnand B. Reduction of alcohol consumption by brief alcohol intervention in primary care: systematic review and meta-analysis. Arch Intern Med 2005;165: 986–995.PubMedCrossRefGoogle Scholar
  5. 5.
    Beck AT. A systematic investigation of depression. Compr Psychiatry 1961;2: 162–170.CrossRefGoogle Scholar
  6. 6.
    Beck AT. Thinking and depression. Arch Gen Psychiatry 1963;9: 324–333.PubMedGoogle Scholar
  7. 7.
    Beck AT. Depression. New York: Hoeber-Harper; 1967.Google Scholar
  8. 8.
    Beck A, Weisharr M. Cognitive therapy. In Freeman A, Simon KM, Butler LE, Arkowitz H, eds. Comprehensive Handbook of Cognitive Therapy. New York: Plenum Press; 1989.Google Scholar
  9. 9.
    Ellis A. Group rational-emotive and cognitive-behavioral therapy. Int J Group Psychother 1992;42(1): 63–80.PubMedGoogle Scholar
  10. 10.
    Persons JB. Cognitive Therapy in Practice: A Case Formulation Approach. New York: W.W. Norton & Company, 1989.Google Scholar
  11. 11.
    Botelho RJ, Novak S. Dealing with substance misuse, abuse, and dependency. Primary Care 1993;20(1): 51–70.PubMedGoogle Scholar
  12. 12.
    Bien TH, Miller WR, Tonigan JS. Brief interventions for alcohol problems: a review. Addiction 1993;88(3): 315–335.PubMedCrossRefGoogle Scholar
  13. 13.
    Haynes P, Ayliffe G. Locus of control of behaviour: is high externality associated with substance misuse? Br J Addict 1991;86(9): 1111–1117.PubMedCrossRefGoogle Scholar
  14. 14.
    Rollnick S, Heather N, Gold R, Hall W. Development of a short “readiness to change” questionnaire for use in brief, opportunistic interventions among excessive drinkers. Br J Addict 1992;87(5): 743–754.PubMedCrossRefGoogle Scholar
  15. 15.
    Secades-Villa R, Fernande-Hermida JR, Arnaez-Montaraz C. Motivational interviewing and treatment retention among drug user patients: a pilot study. Subst Use Misuse 2004;39(9): 1369–1378.PubMedCrossRefGoogle Scholar
  16. 16.
    Stotts AL, Schmitz JM, Rhoades HM, Grabowski J. Motivational interviewing with cocaine-dependent patients: a pilot study. J Consult Clin Psychol 2001;69(5): 858–862.PubMedCrossRefGoogle Scholar
  17. 17.
    Prochaska JO, DiClemente CC. The Transtheoretical Approach: Crossing Traditional Boundaries of Therapy. Homewood, IL: Dow Jones-Irwin; 1984.Google Scholar
  18. 18.
    Miller WR. Enhancing Motivation for Change in Substance Abuse Treatment. Treatment Improvement Protocol (TIP) Series (35) 1999. Rockville, MD: U.S. Department of Health and Human Services.Google Scholar
  19. 19.
    DiClemente CC, Prochaska JO, Fairhurst SK, Velicer WF, Velasquez MM, Rossi JS. The process of smoking cessation: an analysis of precontemplation, contemplation, and preparation stages of change. J Consult Clin Psychol. 1991;59(2): 295–304.PubMedCrossRefGoogle Scholar
  20. 20.
    Marlatt GA, Gordon JR, eds. Relapse Prevention: Maintenance Strategies in the Treatment of Addictive Behaviors. New York: Guilford Press; 1985.Google Scholar
  21. 21.
    Pattison M. Finding peace and joy in the practice of medicine. Health Prog 2006;87(3): 22.PubMedGoogle Scholar
  22. 22.
    Puchalski C. Spirituality in health: the role of spirituality in critical care. Crit Care Clin 2004;20(3): 487–504.PubMedCrossRefGoogle Scholar
  23. 23.
    Bennett M. Spirituality and addictions. What do we know? Addictions Newslett 1998;6: 5–26.Google Scholar
  24. 24.
    Carter JH. Religion/spirituality in African-American culture: an essential aspect of psychiatric care. J Natl Med Assoc 2002;94: 371–375.PubMedGoogle Scholar
  25. 25.
    Weinman HM. Doc-U-Tips. Baptist Health/Baptist Medical Center, September 2005. Available at: Scholar
  26. 26.
    Sophocles A. Time is of the essence: coding on the basis of time for physician services. Family Practice Management, June 2003: 27. Available at: fpm/20030600/27time.html.Google Scholar
  27. 27.
    McDaniel SH, Campbell TL, Hepworth J, Lorenz A, Satcher D. Family-Oriented Primary Care: A Manual for Medical Providers. New York, Springer; 2005.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Personalised recommendations