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Difficult Rewards: Chronic Pain and Opioid Use

By Allen R. Miller, PhD, MBA Many therapists tell me that they don’t want to work with clients who have chronic pain, particularly clients who rely on opioids to manage their pain. They cite the complexities of understanding the cases, the attitudes of the clients, and poor outcomes as reasons to avoid working with these cases when there is an abundance of other “easier” cases with which to work. To…
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Treating Substance Misuse Disorders with CBT

Treating Substance Misuse Disorders with CBT Cory Newman, PhD If you plan to treat patients suffering from substance misuse disorders, I have good news and bad news. First, the bad news. When people habitually misuse a psychoactive chemical – whether it is alcohol, marijuana, benzodiazepines, stimulants, opioids, hallucinogens, or any other – they typically receive significant, immediate positive reinforcement (e.g., a sense of “high”) as well as powerful, immediate negative…
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A Group Cognitive Behavioral Intervention for People in Supported Employment Programs: CBT-SE

 Abstract INTRODUCTION: Supported employment programs are highly effective in helping people with severe mental illness obtain competitive jobs quickly. However, job tenure is often a problem for many. Of the various obstacles to job tenure documented, dysfunctional beliefs regarding the workplace and one's own abilities has been proposed as a therapeutic target. OBJECTIVES: The purpose of this article is threefold: (1) to describe the development and the content of a…
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Therapeutic Alliance in Face-to-Face and Telephone-Administered Cognitive Behavioral Therapy

Abstract OBJECTIVE: Telephone-administered therapies have emerged as an alternative method of delivery for the treatment of depression, yet concerns persist that the use of the telephone may have a deleterious effect on therapeutic alliance. The purpose of this study was to compare therapeutic alliance in clients receiving cognitive behavioral therapy (CBT) for depression by telephone (T-CBT) or face-to-face (FtF-CBT). METHOD: We randomized 325 participants to receive 18 sessions of T-CBT…
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