Prevention of Substance Abuse in Persons with Neurological Disabilities

Case Management for Traumatic Brain Injury Survivors With Alcohol Problems.

“…This theory emphasizes the need to work with individuals in ways that are consistent with their current awareness of the problem and to focus on improving this awareness and their desire to change through the introduction of dissonance between substance use and the achievement of their goals. Programs for the treatment of substance abuse following brain injury also have emphasized the role of the family in generalization to the home environment and the use of other resources to assist in generalization to the community (Blackerby & Baumgarten, 1990;Langley, 1991;Langley & Kiley, 1992;Sparadeo, 1993;Sparadeo et al, 1992). In outpatient settings, a case manager is often considered to be critical to the process, to assist in providing access to community resources and supports for the family and the patient (Sparadeo et al, 1992).…”

“…A few models for the secondary prevention or treatment of substance abuse following brain injury have emerged in response to this concern (Blackerby & Baumgarten, 1990; Langley & Kiley, 1992; Sparadeo, 1993; Sparadeo, Strauss, & Kapsalis, 1992). Almost all models have emphasized the development of behaviors incompatible with substance abuse and have recognized that readiness for change is an important factor in determining whether the program will be effective.…”

Alcohol and other drug use in traumatic disability.

“…Reviews and metaanalyses of interventions based on motivational interviewing support the efficacy and applicability of this intervention (Burke, Arkowitz, & Menchola, 2003;Dunn, Deroo, & Rivara, 2001;Noonan & Moyers, 1997). Numerous authors have recommended motivational interviewing as a potentially effective intervention among rehabilitation patients (Bombardier & Rimmele, 1999;Cardoso et al, 2006;Jones, 1992;Langley & Kiley, 1992), and two studies have described adaptations of this method in people with TBI (Bombardier & Rimmelle, 1999). In another relevant study, Gentilello et al (1999) randomized 366 general trauma patients to a 30-minute motivational interview whereas 396 control participants received usual care during their acute medical or surgical hospital stay.…”

Alcohol and traumatic disability.

“…AA has not been studied in a way that permits conclusions about its efficacy (Miller, Brown, et al, 1995). Many believe that AA and other similar treatments are not effective for people with TBI (NHIF, 1988); however, it can be difficult t o find treatment programs in the community that offer something else (Langley & Kiley, 1992). The documented ineffectiveness of a number of therapies-educational lectures and films, general psychotherapy, general alcohol counseling, relaxation therapy, and anti-anxiety medications-is worth noting (Miller, Brown, et al, 1995).…”

“…Core mood regulation topics include managing negative thinking and coping with drinkingrelated belief's, triggers, and cravings. Coping and social skills training has been adapted for people with TBI and is highly recommended for those with significant alcohol dependence (Langley & Kiley, 1992).…”