The heuristic system. Precision and creativity in addiction treatment.

The Heuristic System (HS) is a method of developing case formulations for use in addiction treatment. Pertinent guidelines, models, or rules of thumb (heuristics) are applied in a stepwise process in order to generate at least two competing or complementary hypotheses concerning the clinical dynamics of the case. These hypothesis are then integrated and/or their relative utility for use in treatment is appraised. Key elements of HS include (a) a model of addiction based on cycles of self-experience, (b) a structured method for arriving at clinical problem formulations, (c) a schematic of the recovery process, (d) a menu of fundamental principles of substance abuse treatment, and (e) a format for providing updatable guidance to the patient for use in treatment. A case developed from the HS approach is presented. This article concludes with a discussion of the implications of HS theory and methods for program design and research.