Broad Spectrum Treatment (BST) and Naltrexone for Alcohol Dependence is a 3- to 6-month program that uses manual-guided cognitive behavioral therapy in combination with naltrexone pharmacotherapy (50 mg daily) to treat adults with alcohol dependence. BST therapists deliver 8-14 individual sessions incorporating components of motivational enhancement therapy (MET), community reinforcement, and 12-step approaches.
BST begins with two MET sessions. MET is an individualized, nonconfrontational counseling approach that seeks to maximize a client’s motivation to become abstinent by emphasizing the client’s own control over drinking behavior. The first MET session, conducted in 90 minutes, is used to review the client’s level of functioning across six psychosocial domains (cognitive, marital or significant other relationship, family, work, residential stability, and social network) and provide feedback on tests of liver function and neuropsychological performance. This session emphasizes the effects of drinking on the client’s life as a motivational basis for change to achieve a goal of abstinence from alcohol. The session concludes with a planned change worksheet that becomes the basis for the second MET session, conducted in 30 minutes, that focuses on reviewing goals and redefining them if necessary.