What is Brief-TSF?

Brief-TSF can be used with males, females and youth of any age and is readily adaptable to various cultures or lifestyles.

Brief-TSF is ideally suited to primary care as well inpatient clinics, outpatient clinics or office practice.

Brief-TSF incorporates screening and assessment instruments and methods for differentiating between alcohol abuse and alcoholism.

Brief-TSF is ideally suited for counseling that is a required component of craving reduction medication prescribing.

The generic spiritual principles are acceptable to most treatment organizations and religions.

The basic Brief-TSF principles can be adapted and applied to drug addiction, excessive gambling, eating disorders and emotional problems that have psychological, emotional, physical, spiritual and mental aspects.

Brief-TSF is a both a Harm Prevention and a Harm Minimization strategy. By intervening earlier in the progression of alcoholism much harm will be prevented.

The overall recovery goal of the program is the restoration of health and freedom from the effects of addiction to the drug alcohol or alcoholism.

Brief-TSF addresses the medical, psychological, social and spiritual effects of alcoholism.

Brief-TSF can be utilized by doctors, nurses, psychologists, social workers, faith based workers, trained volunteers and counselors.

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How does Brief-TSF work for the alcoholic?

The process of Brief-TSF disturbs denial and highlights the negative effects of alcohol on their lives, to such an extent, that alcoholics are motivated to take action and to sample Alcoholics Anonymous. Brief-TSF is not a therapy program per se; it is the facilitation of patients helping themselves (self help) in a mutual help paradigm.

Brief-TSF can be utilized in three situations as adjunctive to your normal program of practice:

• As a ‘discrete’ structured intervention.
• As an ‘opportunistic intervention’ or relapse prevention, where you can utilize elements as necessary.
• As a ‘knowledge base’ – You will have an awareness and understanding of Brief-TSF theory and methods, and AA practices and culture; you will be able to respect and support a patients choice of treatment while addressing other issues in your special area of practice.

Professional Intervention Program

BriefTSF is suitable for use by generalist healthcare workers; including doctors, nurses, psychologists, social workers, faith based workers and counselors.

Universality of BriefTSF

The basic Brief-TSF principles can be adapted and applied to drug addiction, excessive gambling, eating disorders and emotional problems that have psychological, emotional, physical, spiritual and mental aspects.

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AA is often recommended as adjunctive to formal alcoholism treatment

The following are some governments and significant organizations who recommend Alcoholics Anonymous and craving reduction medication as an adjunctive components of professional alcoholism treatment. Some examples are -

Australia ;

• McCabe D., and Holmwood C. (2003), Co morbidity of mental disorders and substance use in General Practice. Commonwealth of Australia, Department of Health and Ageing.
• Shand F, Gates J, Fawcett J, and Mattick R. (2003), Guidelines for the Treatment of Alcohol Problems, Australian National Drug and Alcohol Research Centre (NDARC).
• Dale A. , and Marsh A. (2000), Evidence Based Practice Indicators for Alcohol and Other Drug Interventions; Literature Review, Best Practice in Alcohol and Other Drug Interventions Working Group. Western Australian Government.

Britain ;

• Strang J., (Chair) , (1999), Drug Misuse and Dependence – Guidelines on Clinical Management. Department of Health, England, Scotland, Wales and Northern Ireland.
• Slattery J, Chick J, Cochrane M, Craig J, Godfrey C, MacPherson K, Parrott S. (2002), Health Technology Assessment of Prevention of Relapse in Alcohol Dependence. Health Technology Board for Scotland. National Health Service.

Canada ;

• Roberts G & Roberts A., (1999), Best Practices in Substance Abuse Treatment and Rehabilitation. Office of Alcohol, Drugs and Dependency Issues, Health Canada.

New Zealand;

• Bushnell J., (1999). Guidelines for Recognizing, Assessing and Treating Alcohol and Cannabis Abuse in Primary Care. New Zealand National Health Committee. July 1999.

United States;

• The National Institute on Drug Abuse (NIDA), (July 2002), Principles of Drug Addiction Treatment; A Research Based Guide. National Institute Health Publication No. 00-4180.
• American Society of Addiction Medicine (ASAM).
• USA – National Institute on Alcohol Abuse and Alcoholism (NIAAA)

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Alcohol Consumption, Alcoholics Anonymous Membership, and Homicide Mortality Rates in Ontario 1968 to 1991.

BACKGROUND: Research has shown a strong link between alcohol use and a variety of problems, including violence.

Parker and colleagues have presented a selective disinhibition theory for the link between alcohol use and homicide (and other violence) that posits a causal relationship that is also influenced by other situational and contextual factors.

This model is particularly well suited for aggregate-level investigations.

In this study, we examine the impact of alcohol factors, including consumption measures and Alcoholics Anonymous (AA) membership rates, on homicide mortality rates in Ontario, and test predictions derived from the selective disinhibition model.

METHODS: Time series analyses with ARIMA modeling were applied to total, male, and female homicide rates in Ontario between 1968 and 1991.

The analyses performed included total alcohol consumption, spirits consumption, beer consumption, and wine consumption.

Missing AA membership data were interpolated with cubic splines.

RESULTS: For the total population and males, homicide rates were significantly and positively related to total alcohol consumption and to the consumption of beer and spirits.

They were also negatively related to AA membership rates in the analyses involving spirits and wine and positively related to unemployment rates in the analyses involving beer, wine, and total alcohol.

Among females, none of the measures were significant predictors of homicide mortality rates.

CONCLUSIONS: These data provide important support for the selective disinhibition model and confirm important relationships between per capita consumption measures and homicide mortality rates, especially among males, seen in other studies.

Additionally, the results for AA membership rates are consistent with the hypothesis that AA membership and treatment for misuse of alcohol can exert beneficial effects observable at the population level.

Mann RE, Zalcman RF, Smart RG, Rush BR, Suurvali H. Alcohol consumption, alcoholics anonymous membership, and homicide mortality rates in Ontario 1968 to 1991. Alcohol Clin Exp Res. 2006 Oct;30(10):1743-51.

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Partner Brief-TSF

Brief-TSF includes intervention with significant others in an alcohol dependents life. Significant others may be family members such as partners of alcoholics, children of alcoholics, adult children of alcoholics, parents of alcoholics, grand parents of alcoholics and work colleagues. These are sometimes known as co-dependents of alcoholism.

Partner Brief-TSF has similar goals and methods to Brief-TSF. The overall goal is referral of the significant other to Al-anon or Alateen. This is achieved by disturbing the denial of enabling behaviors, promotion of selfhood and making contact with an Al-anon peer sponsor.

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The 8-year course of alcohol abuse: Gender differences in social context and coping.
Women and men with alcohol use disorders were compared in terms of social context and coping methods and in terms of changes in these indexes associated with participation in professional treatment and Alcoholics Anonymous (AA).

The participants, initially untreated problem drinkers (230 women and 236 men), were followed for 8 years.

Women and men did not differ in the type of help received, but women had longer professional treatment.

At baseline, women had more stressors and fewer resources from family and relied more on avoidance coping and drinking to cope.

During the next 8 years, women, more than men, increased approach coping and reduced their use of avoidance coping and drinking to cope.

With control for baseline status, women had better social resource, coping, and drinking outcomes than men did at 1 year and 8 years.

Among men, but not among women, longer duration of professional treatment during year 1 was associated with improved approach coping.

A longer duration of AA attendance during year 1 and the full 8 years was associated with more resources from friends, more use of approach coping, and less drinking to cope.

In turn, more friends resources and approach coping and less drinking to cope were associated with better drinking outcomes.

Decreases in avoidance coping and drinking to cope were more strongly associated with better drinking outcomes among men than among women.

Thus it may be important to target men for formal services or self-help to increase their use of approach coping in efforts to maintain abstinence. Women’s strategies for improving their social context need further investigation for adaptation to male problem drinkers.

Timko, Christine; Finney, John W.; and Moos, Rudolf H.  The 8-year course of alcohol abuse: Gender differences in social context and coping.  Alcoholism: Clinical & Experimental Research 29(4):612-621, April 2005.

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Alcoholism and Brief-TSF

Have you ever been frustrated by a patients heavy drinking?

Or, is there poor treatment compliance with alcoholism?

Health, work or relationships decline while drinking continues?

You want to help, and have tried, but are at your wits end.

Do you have time to train as an alcohol specialist? If not,

Brief Twelve Step Facilitation can help, allowing you to get on with your primary role.

BriefTSF is an adjunctive alcoholism intervention

The primary aim of Brief Twelve Step Facilitation (Brief-TSF) is to introduce patients to the Twelve Step Fellowship – Alcoholics Anonymous. Then, in a support role, encourage maintenance of AA membership to enable sustained sobriety and rehabilitation.

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What are the social and economic effects of gambling addiction?

In 1998 the National Gambling Impact Study Commission funded a study to determine the overall cost to society posed by problem and pathological gamblers in the United States.

The results showed that approximately $5 billion was lost annually, with an additional $40 billion in lifetime costs for productivity reductions, social services and creditor losses. Studies have concluded that two out of three pathological gamblers commit illegal acts in order to pay gambling-related debts. This places a hardship on our legal systems, prison systems and public assistance programs.

The following consequences of problem gambling all result in economic costs for states, communities and individuals:

• Job loss, unemployment
• Debt, bankruptcy
• Embezzlement, fraud, check forgery
• Eviction, forced home sales
• Crime, arrest, incarceration
• Poor physical and mental health, suicide
• Alcohol and drug abuse

The families of problem gamblers also suffer greatly from physical and psychological abuse; harassment and threats from bill collectors and creditors; increased stress stemming from neglect and divorce; and the extra financial burden placed on them to repay debts.

Sadly, children are negatively affected by gambling addiction in several ways.

• Physical and emotional abandonment is a very real phenomenon.
• “Casino kids” are left in cars or on the periphery of the gambling action while their parents gamble, or may spend hours with babysitters, thus missing the nurturing they need.
• Children of pathological gamblers are typically abused verbally, mentally and physically by the gambler, and often even more so by the co-dependent spouse.
• Finally, these children are much more likely to develop gambling addiction than their peers.

Excerpted from research: Effects of Problem Gambling. California Council on Problem Gambling (Anaheim, CA); 2006.

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