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KAP KEYS Based on TIP 34
Brief Interventions and Brief Therapies for
Substance Abuse
        CSATs
Knowledge Application Program
KAP Keys
For Clinicians
Based on TIP 34
Brief Interventions and
Brief Therapies for
Substance
Abuse 
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Substance Abuse and Mental Health Services Administration
Center for Substance Abuse Treatment
www.samhsa.gov
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KAP KEYS Based on TIP 34
Brief Interventions and Brief Therapies for Substance Abuse 
These KAP Keys were developed to accompany the Treatment
Improvement Protocol (TIP) Series published by the Center for
Substance Abuse Treatment (CSAT), Substance Abuse and
Mental Health Services Administration. These KAP Keys are
based entirely on TIP 34 and are designed to meet the needs
of the busy clinician for concise, easily accessed "how-to" infor
mation.
For more information on the topics in these KAP Keys, readers
are referred to TIP 34.
Introduction
TIP 25, Substance Abuse Treatment and Domestic Violence
(1997) BKD139
TIP 26, Substance Abuse Among Older Adults (1998) BKD250
TIP 29, Substance Use Disorder Treatment for People with
Physical and Cognitive Disabilities (1998) BKD288
TIP 32, Treatment of Adolescents With Substance Use
Disorders (1999) BKD307
TIP 35, Enhancing Motivation for Change in Substance Abuse
Treatment (1999) BKD342
Other Treatment Improvement Protocols (TIPs)
that are relevant to these KAP Keys:
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The Stages of Change 1
KAP KEYS Based on TIP 34
Brief Interventions and Brief Therapies for Substance Abuse 
Precontemplation: The user is not considering change, is
aware of few negative consequences, and is unlikely to take
action soon.
Contemplation: The user is aware of some pros and cons of
substance abuse but feels ambivalent about change. This
user has not yet decided to commit to change.
Preparation: This stage begins once the user has decided to
change and begins to plan steps toward recovery.
Action: The user tries new behaviors, but these are not yet sta
ble. This stage involves the first active steps toward change.
Maintenance: The user establishes new behaviors on a long-
term basis.
Source: Adapted from Prochaska and DiClemente 1984.
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Sample Battery of Brief
Assessment Instruments
2
KAP KEYS Based on TIP 34
Brief Interventions and Brief Therapies for Substance Abuse 
Assessment Domain
Quantity/Frequency of Use
Sample Instrument
Timeline Follow Back Technique
Assessment Domain
Severity of Dependence
Sample Instrument
 Short Alcohol Dependence Data (SADD)
 Severity of Dependence Scales (SDS)
Assessment Domain
Consequences of Use
Sample Instrument
 Michigan Alcoholism Screening Test (MAST)
 Drug Abuse Screening Test (DAST)
 Substance Abuse Subtle Screening Inventory (SASSI)
 DRINK
Assessment Domain
Readiness to Change
Sample Instrument
 Commitment to Change Algorithm
 SOCRATES
Assessment Domain
Problem Areas
Sample Instrument
 Problem Checklist (from Comprehensive Drinker Profile)
 Problem-Oriented Screening Instrument for Teenagers
(POSIT)
 Adolescent Assessment/Referral System (AARS)
Continued on Back
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KAP KEYS Based on TIP 34
Brief Interventions and Brief Therapies for Substance Abuse 
Assessment Domain
Treatment Placement
Sample Instrument
Addiction Severity Index (ASI)
Assessment Domain
Goal choice and commitment
Sample Instrument
Intentions Questionnaire
Sources: Allen and Columbus 1995; Miller 1991
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Fifteen Common Cognitive Errors 3
1. Filtering: Taking negative details and magnifying them,
while filtering out all positive aspects of a situation
2. Polarized thinking: Thinking of things as black or white,
good or bad, perfect or failure, with no middle ground
3. Overgeneralization: Jumping to a general conclusion based
on a single incident or piece of evidence. Expecting some
thing bad to happen over and over again if one bad thing
occurs
4. Mind reading: Thinking that you know, without any external
proof, what people are feeling and why they act the way they
do; believing you can tell how others feel about you
5. Catastrophizing: Expecting disaster; hearing about a prob
lem and then automatically considering the possible nega
tive consequences (e.g. "What if it happens to me?")
6. Personalization: Thinking that everything people do or say is
some kind of reaction to you; comparing yourself to others,
trying to determine who's smarter or better looking
7. Control fallacy: Feeling externally controlled (helpless or a
victim of fate) or feeling internally controlled (responsible for
the pain and happiness of everyone around)
8. Fallacy of fairness: Feeling resentful because you think you
know what is fair, even though others do not agree
9. Blaming: Holding other people responsible for your pain or
blaming yourself for every problem
10. Shoulds: Having a list of ironclad rules about how you and
other people "should" act; becoming angry at those who
break the rules and feeling guilty if you violate them
11. Emotional reasoning: Believing that what you feel must be
true, automatically (e.g., if you feel stupid, you must be stupid)
Continued on Back
KAP KEYS Based on TIP 34
Brief Interventions and Brief Therapies for Substance Abuse 
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KAP KEYS Based on TIP 34
Brief Interventions and Brief Therapies for Substance Abuse 
12. Fallacy of change: Expecting that other people will change
to suit you if you pressure them enough; having to change
people because your hopes for happiness depend on them
13. Global labeling: Generalizing one or two qualities into a
negative global judgment
14. Being right: Proving that your opinions and actions are cor
rect on a continual basis; thinking that being wrong is
unthinkable; going to any lengths to prove you are correct
15. Heaven's reward fallacy: Expecting all sacrifice and self-
denial to pay off, and feeling disappointed and even bitter
when the reward does not come
Source: Beck 1976
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Selected Criteria for Providing
Brief Therapy
4
 Dual diagnosis issues such as a coexisting psychiatric disor
der or developmental disability
 The range and severity of presenting problems
 The duration of abuse
 Availability of familial and community supports
 The level of client motivation (brief therapy may require more
work on the part of the client but a less extensive time com
mitment)
 The clarity of the client's short- and long-term goals (brief
therapy will require more clearly defined goals)
 The client's belief in the value of brief therapy ("buy in")
 Large number of clients needing treatment
The following criteria are derived from clinical experience:
 Less severe substance abuse, as measured by an instru
ment like the Addiction Severity Index (ASI)
 Level of past trauma affecting the client's substance abuse
 Insufficient resources available for more prolonged therapy
 Limited amount of time available for treatment (e.g., 7-day
average length of stay in county-jail-level correctional facili
ties; 30- to 45-day limitation in Job Corps program)
 Presence of coexisting medical or mental diagnoses
 Large numbers of clients needing treatment leading to wait
ing lists for specialized treatment
KAP KEYS Based on TIP 34
Brief Interventions and Brief Therapies for Substance Abuse 
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Characteristics of All Brief
Therapies
5
 They are either problem focused or solution focused; they
target the symptom and not what is behind it.
 They clearly define goals related to a specific change or
behavior.
 They should be understandable to both client and clinician.
 They should produce immediate results.
 They can be easily influenced by the personality and the
counseling style of the therapist.
 The therapeutic style is highly active, empathic, and some
times directive.
 Responsibility for change is placed clearly on the client.
 Early in the process, the focus is to help the client have expe
riences that enhance self-efficacy and confidence that
change is possible.
 Termination is discussed from the beginning.
 Outcomes are measurable.
KAP KEYS Based on TIP 34
Brief Interventions and Brief Therapies for Substance Abuse 
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Professionals Outside of Substance Abuse
Treatment Who Can Administer Brief Interventions
6
KAP KEYS Based on TIP 34
Brief Interventions and Brief Therapies for Substance Abuse 
 Primary care physicians
 Substance abuse treatment providers
 Emergency department staff members
 Nurses
 Social workers
 Health educators
Lawyers
 Mental health workers
 Teachers
 EAP counselors
 Crisis hotline workers, student counselors
 Clergy
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Criteria for Longer Term
Treatment
The following criteria can help identify clients who could benefit
from longer term treatment:
 Failure of previous shorter treatment
 Multiple concurrent problems
 Severe substance abuse (i.e., dependence)
 Acute psychoses
 Acute intoxication
 Acute withdrawal
 Cognitive inability to focus
 Long-term history of relapse
 Many unsuccessful treatment episodes
 Low level of social support
 Serious consequences related to relapse
7
KAP KEYS Based on TIP 34
Brief Interventions and Brief Therapies for Substance Abuse 
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Ordering Information
           TIP 34
Brief Interventions and Brief Therapies for
Substance Abuse 
Easy Ways to Obtain Free Copies 
of All TIPs Products
1. Call SAMHSA's National Clearinghouse for Alcohol and
Drug Information (NCADI) at 800-729-6686, 
TDD (hearing impaired) 800-487-4889.
3. Visit CSAT's Website at www.csat.samhsa.gov
Do not reproduce or distribute this publication for a fee with
out specific, written authorization from the Office of
Communications, Substance Abuse and Mental Health
Services Administration, U.S. Department of Health and
Human Services.
DHHS Publication No. (SMA) 01-3601
Printed 2001