Chemical Dependency Counseling (eBook)

Preface to the Fifth Edition
Acknowledgments
1. First Contact
Treatment Works
The Motivational Interview
How to Develop the Therapeutic Alliance
How to Do a Motivational Interview
What to Do If There Are One or More Red Flags
Natural History of Addiction
How to Diagnose an Addiction Problem
How to Intervene
How to Assess Motivation
The Stages of Motivation
Motivating Strategies
2. First Hours of Treatment
The First Hours
How to Greet Clients
Examples
Beginning the Therapeutic Alliance
The Importance of Trust
Dealing With Early Denial
Example of an Initial Contact
How to Check for Organic Brain Dysfunction
The Initial Assessment
Referral
How to Conduct a Crisis Intervention
American Society of Addiction Medicine Patient Placement Criteria
Diagnostic and Statistical Manual
Criteria for Diagnosis
Diagnosis: Substance Use Disorder
Gambling Disorder
How to Determine the Level of Care Needed
Criteria for Outpatient Treatment (Adults)
Criteria for Inpatient Treatment (Adults)
Criteria for Outpatient Treatment (Adolescents)
Criteria for Inpatient Treatment (Adolescents)
The Client’s Reaction to Intoxication
What to Do With an Intoxicated Client
Detoxification
How Clients React in Detoxification
The AMA Threat
Example of an AMA Intervention
How to Develop and Use the AMA Team
How to Use the In-House Intervention
How to Respond to Clients Who Leave AMA
3. Biopsychosocial Interview
The Biopsychosocial Interview
How to Conduct the Interview
Summary and Impression
Diagnosis
Disposition and Treatment Plan
A Sample Biopsychosocial Interview
4. Treatment Plan
How to Build a Treatment Plan
The Diagnostic Summary
The Problem List
How to Develop a Problem List
Goals and Objectives
How to Develop Goals
Examples of Developing Goals
Examples of Goals
How to Develop Objectives
Examples
How to Develop Interventions
Examples
How to Evaluate the Effectiveness of Treatment
How to Select Goals, Objectives, and Interventions
Examples
Treatment Plan Review
Documentation
How to Write Progress Notes
Examples
Formal Treatment Plan Review
Discussion of Continuing Care
5. Individual Treatment
The Therapeutic Alliance
How to Develop a Therapeutic Alliance
How to Be Reinforcing
How to Use Empathy
Transference and Countertransference
Examples of Empathic Statements
How to Be Confrontive
Behavior Therapy
How Clients Learn
Habits
Changing a Habit
What Is Reinforcement?
What Is Punishment?
The Behavior Chain
The Importance of Reinforcement
How to Use Punishment
When a Client Breaks a Rule
Why We Concentrate on Behavior Therapy
Cognitive Therapy
How Chemically Dependent People Think
Defense Mechanisms
Applying Cognitive Therapy
Automatic Thoughts
How to Correct Inaccurate Thoughts
Interpersonal Therapy
How to Develop Healthy Relationships
Building a Relationship With a Higher Power
Developing a Relationship With Self
Building Relationships With Others
How Clients Use Feelings Inappropriately
How Clients Learn Relationship Skills
How to Change Relationships
How to Handle Grief
How to Choose the Therapeutic Modality
6. Group Therapy
Benefits of the Group Process
Preparation for the Group
The Preparation Statement
The Agenda Group
How to Choose the Order of the Agenda
How to Give Good Feedback
How to Receive Feedback
How to Run a Group
How to Know Which Therapy to Use
The Honesty Group
Example of the Honesty Group
Uncovering the Lies
How to End Each Group
The Euphoric Recall Group
How to Uncover Euphoric Recall
How to Help the Clients See the Truth
The Reading Group
The Relapse Prevention Group
The Trigger Group
How to Uncover the Triggers
The Drug Refusal Skills
The Inaccurate Thinking Group
The Feelings and Action Group
The Lapse Group
The Spirituality Group
How to Develop Healthy Relationships
How to Develop a Healthy Relationship With a Higher Power
The Eleventh Step Group
The Meditation Group
The Childhood Group
How to Explore Early Parental Relationships
How to Begin to Heal Early Childhood Pain
Men’s Group/Women’s Group
The Community Group
The Personal Inventory Group
Skills Training Group
Assertiveness Skills Group
Skills
Problem-Solving Skills Group
Skill Set 1
Skill Set 2
7. Drugs of Abuse
Drugs of Abuse
Central Nervous System Depressants
Central Nervous System Stimulants
The Hallucinogens
The Reinforcing Properties of Drugs
Tolerance and Dependence
Cross-Tolerance
Alcohol
Alcohol-Induced Organic Mental Disorders
Alcohol Intoxication
Alcohol Amnesic Disorder (Blackout)
Wernicke-Korsakoff Syndrome
Alcohol Withdrawal
Alcohol Withdrawal Seizures
Alcohol Withdrawal Delirium (Delirium Tremens)
Sedatives, Hypnotics, and Anxiolytics
Opioids
Cocaine and Amphetamines
Phencyclidine
Dissociative Anesthetics (Phencyclidine, Ketamine, Dextromethorphan, and FLAKKA)
Hallucinogens
The Psychedelic State
Cannabis
Synthetic Designer Drugs
Inhalants
Nicotine
Club Drugs
MDMA
GHB
Ketamine
Rohypnol
Polysubstances
Treatment Outcome
8. Recovery Skills
The Chemical Use History
Honesty
Love, Trust, and Commitment
Feelings
Relationship Skills
Addictive Relationships
Communication Skills
Self-Discipline
Impulse Control
Relapse Prevention
Stress Management
9. Steps
The Committee
Step One
Step Two
How to Help Clients Accept a Higher Power
Step Three
How to Help Clients Embrace Step Three
Step Four
Step Five
Step Six
Step Seven
Step Eight
Step Nine
Step Ten
Step Eleven
Step Twelve
10. Lectures
The Disease Concept
Addiction Is Not a Moral Problem
Addiction Is Not Due to a Weak Will
Addiction Has Genetic Components
Addiction Is a Social Problem
Addiction Is a Psychological Problem
Addiction Is a Physiological Problem
The Obsession
The Problems
Defense Mechanisms
Minimization
Rationalization
Denial
How to Begin to Live in the Truth
The Great Lie
How the Great Lie Works
We Never Feel Accepted
The Promise of the Disease
Truth
A Program of Rigorous Honesty
Normal Development
The Primary Caregiver
The Struggle for Independence
The Fear of Abandonment
Learning the Rules
The Development of Insecurity
The Peer Group
Adolescence
Adulthood
Physical Addiction and Recovery
How Drugs Affect the Cell
How Drugs Affect Behavior
Tolerance
Cross-Tolerance
Withdrawal
How We Learn
Alcoholics Anonymous
A Spiritual Awakening
Two Alcoholics Talking to Each Other
The “Big Book”
The 12 Steps
Meetings
Feelings
All Feelings Are Adaptive
Assertive Skills
11. Special Problems
The Psychiatric/Psychological Assessment
How to Develop the Treatment Plan
The Depressed Client
How to Assess Depression
How to Treat Depression
Psychopharmacology
Behavior Therapy
Cognitive Therapy
Interpersonal Therapy
Grief
Suicide
The Angry Client
How to Handle a Violent Client
How to Handle an Angry Client
Assertiveness Skills
The Importance of Forgiveness
How to Teach the Client to Recognize Anger
Disengagement
Time-Out
How to Keep Your Cool as a Counselor
The Homicidal Client
The Duty to Warn
Personality
What Is Personality?
The Antisocial Personality
A Disorder of Empathy
How to Treat the Antisocial Personality
How to Deal With a Rule Violation
Moral Development
How to Deal With the Family of an Antisocial Client
The Borderline Client
Interpersonal Relationships
Emotional Regulation
How to Treat the Borderline Client
Setting Limits
Dealing With Transference
Stress Tolerance
Dealing With the Family
The Narcissistic Client
The Anxious Client
How to Measure Anxiety
The Psychological Component of Anxiety
How to Use Relaxation Techniques
The Daily Log
Cognitive Therapy
Post-Traumatic Stress Disorder
Panic Attacks
The Psychotic Client
Hallucinations and Delusions
How to Treat the Psychotic Client
The Family of the Psychotic Client
Acquired Immune Deficiency Syndrome
The High-Risk Client
The Client With Low Intellectual Functioning
How to Treat the Client With Low Intelligence
The Client Who Cannot Read
The Family of the Client With Low Intelligence
The Elderly Client
The Client With Early Childhood Trauma
How to Deal With Sexual Abuse
Cognitive Therapy
How to Learn Forgiveness
Love in the Treatment Center
The Importance of the Unit Rules
How to Deal With Clients in Love
The Pathological Gambler
Honesty
Gambling Step One
Gambling Step Two
Gambling Step Three
Gambling Step Four
Gambling Step Five
Gambling Step Six
Gambling Step Seven
Gambling Step Eight
Gambling Step Nine
Gambling Step Ten
Gambling Step Eleven
Gambling Step Twelve
Gambling Relapse Prevention
12. Adolescent Treatment
The Normal Adolescent
Puberty
Ages 13 to 16
Ages 16 to 19
Interesting Adolescent Facts
The Chemically Dependent Adolescent
The Adolescent Chemical Dependency Counselor
The Point System
The Primary Elements in Adolescent Treatment
The Rules
Communication Skills
Honesty
Exercise
Fun in Sobriety
The Reinforcers
Spirituality
Group Therapy
Peer Pressure
Continuing Education
Continuing Care
The Parents Support Group
The Behavioral Contract
Phases of Adolescent Treatment
13. The Family Program
The First Family Contact
How to Handle the Early Against Medical Advice Risk
Common Family Problems
Codependency
Guilt
Loss of Control
Shame
Caretaking
Enabling
Inability to Know Feelings
Inability to Know Wants
Lack of Trust
People Pleasing
Feelings of Worthlessness
Dependency
Poor Communication Skills
How to Treat Family Members
The Family Program Schedule
How to Work With the Family in Group
The Conjoint Session
14. The Clinical Staff
The Physician/Addictionologist
The Psychologist/Psychiatrist
The Social Worker/Mental Health Counselor
The Nurse
The Clinical Director
The Clinical Supervisor
The Chemical Dependency Counselor
The Rehabilitation Technician or Aide
The Recreational Therapist
Clinical Staffing
How to Present a Client
Team Building
Commitment to Coworkers
Boundaries
Staff–Client Problems
What to Do When a Client Does Not Like a Counselor
What to Do When a Client Complains About a Rule
The Work Environment
15. Discharge and Continuing Care
Outpatient Discharge Criteria
Inpatient Discharge Criteria
How to Develop a Discharge Summary
The Discharge Summary
Saying Good-Bye
16. The Good Counselor
Good Counselors Are Caring
Good Counselors Love Their Work
Good Counselors Do Not Become Overly Involved
Good Counselors Do Not Lie
Good Counselors Are Gentle
Good Counselors Like Themselves
Good Counselors Are Supersensitive
Good Counselors Have a Sixth Sense
Good Counselors Do Not Become Overly Emotional
Good Counselors Are Active Listeners
Good Counselors Do Not Talk Too Much
Good Counselors Maintain Boundaries
Good Counselors Are Client Centered
Good Counselors Have Effective Relationship Skills
Good Counselors Have a Sound Code of Ethics
Appendix 1- Cognitive Capacity Screening
Appendix 2- Short Michigan Alcoholism Screening Test
Appendix 3- DSM–5 Psychoactive Substance Use Disorder
Appendix 4- Alcohol Withdrawal Scale
Appendix 5- Narcotic Withdrawal Scale
Appendix 6- Sample Biopsychosocial Interview
Appendix 7- Chemical Use History
Appendix 8- Honesty
Appendix 9- Love, Trust, and Commitment
Appendix 10- Feelings
Appendix 11- Relationship Skills
Appendix 12- Addictive Relationships
Appendix 13- Communication Skills
Appendix 14- Self-Discipline
Appendix 15- Impulse Control
Appendix 16- Relapse Prevention
Appendix 17- Step One
Appendix 18- Step Two
Appendix 19- Step Three
Appendix 20- Step Four
Appendix 21- Step Five
Appendix 22- Adolescent Unit Level System
Appendix 23- Peer Pressure
Appendix 24- The Behavioral Contract
Appendix 25- Family Questionnaire
Appendix 26- Codependency
Appendix 27- Personal Recovery Plan
Appendix 28- Sample Discharge Summary
Appendix 29- Stress Management
Appendix 30- Hamilton Depression Rating Scale
Appendix 31- Biopsychosocial Assessment
Appendix 32- Anger Management
Appendix 33- Narcissism
Appendix 34- Honesty for Gamblers
Appendix 35- Step One for Gamblers
Appendix 36- Step Two for Gamblers
Appendix 37- Step Three for Gamblers
Appendix 38- Step Four for Gamblers
Appendix 39- Step Five for Gamblers
Appendix 40- Relapse Prevention for Gamblers
Appendix 41- Adolescent Unit Point System
Appendix 42- Results From the 2013 National Survey on Drug Use and Health: Summary of National Findings
Appendix 43- Drug Categories for Substances of Abuse
Appendix 44- Adult Inpatient Program Schedule
Appendix 45- Adolescent Inpatient Program Schedule
Appendix 46- Adult Outpatient Program Schedule
Appendix 47- Adolescent Outpatient Program Schedule
Appendix 48- Gambling Inpatient Program Schedule
Appendix 49- Gambling Outpatient Program Schedule
Appendix 50- Day Treatment Program Schedule
Appendix 51- Pressure Relief Group Meeting and Budget Form
Appendix 52- Heroin
Appendix 53- South Oaks Gambling Screen
Appendix 54- Barriers in Thinking
Appendix 55- Psychotherapeutic Medications 2011
Appendix 56- Drug Abuse Screening Test
Appendix 57- Clinical Opiate Withdrawal Scale
Appendix 58- Adult Nurses Intake
Appendix 59- Adolescent Nurses Intake
Appendix 60- National Cancer Institute Guide to Quitting Smoking
Appendix 61- Post-Traumatic Stress Disorder (PTSD) Checklist Civilian Version
Appendix 62- Post-Traumatic Stress Disorder (PTSD) Checklist Military Version
Appendix 63- Alcohol Abstinence Self-Efficacy Scale
Appendix 64- Hamilton Anxiety Rating Scale
Appendix 65- Strengths, Needs, Abilities, and Preferences
Appendix 66- Daily Craving Record
Appendix 67- National Association of Alcohol and Drug Abuse Counselors (NAADAC) Code of Ethics
Appendix 68- Gambling History
Appendix 69- Diagnostic/Integrated Summary
Appendix 70- Mental Health Screening
Appendix 71- Fagerstrom Test for Nicotine Dependence
References
Index
About the Author