SUD-Rx principles

16th October 2013

What is it?

The Substance use disorder - treatment module within AMBIT has been developed within the CASUS team, and is based on a critical review of the most recent international trials evidence on "What Works for Whom" for children and Adolescents by Dr DickonBevington. The Substance use disorder - treatment module (sometimes abbreviated to SUD-Rx) is designed as a relatively brief intervention (up to 6 sessions). It is accepted that a proportion of young people will require a lengthier intervention, especially if there are significant Comorbidities present. Local teams may wish to adapt their manual to recognise this.

What substances is it for?

Most of its principles are applicable across a wide range of substances, although it was specifically designed with Cannabis as the primary target substance. More entrenched use of harder drugs (heroin, crack cocaine, etc) is likely to require additional measures, including, potentially, prescribing interventions - these are not part of this manual, but can be used alongside (see Pharmacological interventions.)

Before Starting:

  1. Initial AMBIT training is recommended.
  2. Familiarise yourself with this TiddlyManual.
  3. Read through the four core principles (below) and the more general Core Features of AMBIT.
  4. Read through the structure of the 5 - 6 sessions in SUD-Rx Sessions - CheckLists

Four Core Principles of AMBIT Substance Use Disorder Treatment

There are FOUR core principles that underly the intervention. These are drawn from the best available trials evidence about "What Works for Whom"...

Note: These priciples overlap with and/or build upon the Core Features of AMBIT, and these foundation principles and practices should also be borne in mind.
  1. Assessment for SUD-Rx - which identifies the specific problems for which specific interventions are required, and informs your Formulation and Treatment Aims.
  2. Adapt your Discourse - which sets the style of communication according to a mentalized understanding of the young person, and offers the best chance of this being understood, accepted, and acted upon.
  3. Balancing INSIDE and OUTSIDE change work - which addresses the Multiple interacting aetiologies that initiate and sustain substance use.
  4. Maintaining Mind-mindedness - which offers a focus that is normative, offers opportunities for enrichment (beyond the simple 'giving up' of something that has previously been valued) and fosters a respectful engaged relationship between worker and client.