Knowledge guides

LG 15: Psychological and pharmacological approaches to treatment

Clinical sciences

Advanced Trainees will describe the principles of the foundational sciences.

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Eligibility considerations

Advanced Trainees will assess the patient’s current condition and plan the next steps.

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Less common or more complex patient considerations

Advanced Trainees will understand the resources that should be used to help manage patients.

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Undertaking therapy

Advanced Trainees will monitor the progress of patients during the therapy.

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Post therapy

Advanced Trainees will know how to monitor and manage patients post-therapy.

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Important specific issues

Advanced Trainees will identify important specialty-specific issues and the impact of these on diagnosis and management, and integrate these into care.

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  • Pharmacology and therapeutics of medications used in treatment
  • Pharmacology and toxicology of substances commonly consumed in Australia, excluding opioids
  • Pharmacology, treatment effect size, risks, benefits, and costs
  • Psychological approaches, including:
    • cognitive-behavioural treatments
    • contingency management
    • mindfulness-based therapies
    • motivational interviewing
    • narrative and family-based treatments
    • screening and brief interventions
    • structured problem solving
  • Determination of risks associated with substance use in individual patients
  • Stepped-care approach
  • Stratification of response against severity and complexity
  • Substance dependence or substance use disorder, together with other relevant clinical diagnoses
  • Use of multiple substances and associated risks, particularly alcohol and sedatives
  • Complex presentations, such as:
    • mixed intoxications
    • withdrawals
  • Management of substance use disorders during acute hospital admissions
  • Multiple substance use disorders, and risks this may present
  • Pregnancy and substance use disorders
  • Substance use disorders in patients with:
    • hepatic disease
    • kidney disease
    • respiratory disorders
    • severe cardiac disorders
    • sleep disorders
  • Treatment in patients with comorbid mental health disorders
  • Treatment in patients with impaired capacity / cognitive impairment
  • Collaborative treatment matching
  • Ensuring that treatment services are culturally safe for Aboriginal and Torres Strait Islander people and Māori
  • Monitoring treatment, including:
    • functional improvements
    • hospital presentations
    • treatment outcome measures
    • urine toxicology
  • Ongoing case management and multidisciplinary planning
  • Problem and goal definition, and care planning
  • Showing empathy and understanding, and demonstrating appropriate professional behaviour
  • Tailoring treatment in specific populations including groups, such as:
    • homeless people
    • the LBGTQIA+ community
    • young people
  • Treatment fidelity
  • Long term trajectories of patients who have engaged in treatment
  • Optimising transitions between specialist services and primary care or custodial services, and government and non-government organisations
  • Planned treatment cessation
  • Unplanned treatment cessation
  • Awareness of medications prescribed for a range of psychological disorders, and advise accordingly where there is potential for misuse
  • Designing and operating services and service systems to meet the needs of Aboriginal and Torres Strait Islander people and Māori
  • Developing and operating services for diverse and/or underserviced populations
  • Ensuring health practitioners and hospitals have guidelines for ongoing management of patients with common substance use-related problems, including withdrawal management and acute stimulant presentations
  • Ensuring transitions are as smooth as possible between:
    • colleagues in private practice
    • custodial services
    • government services
    • non-government services
    • primary care
    • specialist services
  • High priority patients for treatment
  • Ongoing advocacy and actual supporting structures for identifying and addressing risky substance use in primary care, such as:
    • advisory services
    • screening
    • other supports
    • pathways
  • Roles of pharmacological approaches to substance use disorders (non-opioid), and synergies with psychological approaches