Contingency management (CM) programs are often effective, but they can be expensive, with typical incentives costing $900–$3,000 for a 12-week program. Expensive CM programs are referred to as “high magnitude.” In this new study, researchers tested an “ultra-low magnitude” program (basically, a very cheap program) to see if offering inexpensive reinforcers would be effective for an opioid-abusing clientele.

The post-test for this issue is available for one year after the publication date to subscribers. By successfully completing the test you will be awarded a certificate for 2 CME credits.

How can you help increase the odds that Robert, or any of your patients, will succeed in recovery? Here are eight key strategies that support long-term recovery.

Addiction treatment often begins with high hopes and apparent success, but it’s important to remember that addiction is a disease with a relapse rate of 40%–60%. Be realistic: Expect that patients will go through cycles of relapse and recovery. Learn the warning signs for relapse, the measures you can take to prevent it, and what to do after it has occurred.

For many people, the word “recovery” means being in AA or another 12-step program where the goal is to stay abstinent. It’s a culture of mutual support where people help and assist each other toward the goal of sobriety.

As director of psychiatry at Hebrew SeniorLife for 18 years, Dr. Metzger has witnessed a number of changes in how we manage agitation and other elements of BPSD. In this article, he outlines current thinking about such symptoms, as well as the latest techniques—both pharmacologic and non-pharmacologic—for managing them.

The latest official statement on psychotherapies from the American Psychological Association more or less states that all techniques are equally effective, and it’s likely that the skills of individual therapists are as important as the specific technique they choose. This is all well and good, but meanwhile, in the real world, we need to make decisions about how to treat specific patients. If we wait for the definitive answers from research, we will be waiting for a very long time. This article details certain well-known techniques drawn from the broad umbrella of cognitive behavior therapy.

Insomnia is so ubiquitous and misunderstood with respect to its health consequences and “treatability.” At the core of this is the widespread misconception that insomnia is primarily a symptom of other things. Insomnia is also identified in DSM-5 as an independent disorder (780.52) which, when occurring with other DSM-5 disorders, is considered a comorbid disorder rather than a symptom.

Tourette’s disorder (TD), also known as Tourette syndrome, is a fascinating yet complex neurodevelopmental disorder that can be challenging to treat. Dr. Georges Gilles de la Tourette, a French neurologist who described the first nine cases in 1885, had it right when he described the “peculiar” symptoms as a syndrome, later reporting that “fears, phobias, and arithmomania” were part of the picture.

As marijuana has gained acceptance—it can now be prescribed to treat a wide variety of medical conditions in 28 states and Washington, DC—there has also been a shift in attitudes toward other mind-altering substances that, despite their reputation as drugs of abuse, show promise as therapeutic agents.