Learning the Language of Addiction Counseling

Geri Miller, PhD, Diplomate in Counseling Psychology, ABPP, is a Professor in the Department of Human Development and Psychological Counseling at Appalachian State University. Dr. Miller is a Licensed Clinical Addictions Specialist and a Substance Abuse Professional Practice Board-Certified Clinical Supervisor. She has been a Council for Accreditation of Counseling and Related Educational Programs (CACREP) Site Team Member since 1992. She is the author of two books and was awarded the 2009 Ella Stephens Barrett Award for excellence in professional leadership, the most coveted honor bestowed by the North Carolina Counseling Association.

Preface xi Acknowledgments xv CHAPTER 1 INTRODUCTION 1 Personal Reflections 1 Addiction Counseling Influences 2 Theories of Addiction 8 CHAPTER 2 THEORIES OF COUNSELING RELATED TO ADDICTION TREATMENT 19 Personal Reflections 19 Development of a Theoretical Framework for Addiction Counseling 19 Dangers in Developing a Theoretical Framework and Recommendations 21 General Counseling Theories 24 CHAPTER 3 ASSESSMENT AND DIAGNOSIS OF ADDICTION 37 Personal Reflections 37 Interviews 38 Behavioral Observations 45 Physiological Instruments 46 Psychometric Instruments 46 Diagnosis 55 Stages of Change 58 CHAPTER 4 ASSESSMENT, DIAGNOSIS, AND TREATMENT OF CO-OCCURRING DISORDERS 63 Personal Reflections 63 Historical Struggles Between the Fields 65 General Guidelines 66 Problems with Diagnosing 67 Type of Co-Occurring Diagnoses 69 Related Issues 79 Screening 85 Recognition of Problems in Different Settings 85 Treatment Modifications and General Guidelines 86 CHAPTER 5 THE TREATMENT PROCESS FOR ADDICTIONS 97 Personal Reflections 97 Crisis Intervention 97 Individual Therapy 103 Group Therapy 110 Family Therapy 122 Specific Approaches 129 CHAPTER 6 TREATMENT-RELATED ISSUES 145 Personal Reflections 145 Sexual Issues 146 HIV/AIDS 154 Intimate Partner Violence 162 CHAPTER 7 RELAPSE PREVENTION 183 Personal Reflections 183 Counselor Approaches 183 Relapse-Prevention Models 187 Counseling Techniques 193 Case Studies of Special Populations 200 Co-Occurring Disorders 203 CHAPTER 8 SELF-HELP GROUPS 209 Personal Reflections 209 Suggestions for Counselors 209 12-Step Groups 211 Women for Sobriety 219 16 Steps 221 Rational Recovery 223 Secular Organizations for Sobriety 225 Self-Management and Recovery Training (Smart Recovery1) 226 Matching Self-Help Groups to Meet Client Needs 228 Special Issues 234 Appendix Stories of Recovery 241 CHAPTER 9 CURRENT AND EVOLVING THERAPY APPROACHES AND TECHNIQUES 243 Personal Reflections 243 Positive Psychology 243 Client Resilience 246 Stages-of-Change Model 248 Motivational Interviewing 250 Brief Therapy 255 Evaluation of Effectiveness 267 CHAPTER 10 CULTURALLY SENSITIVE ADDICTION COUNSELING 273 Personal Reflections 273 Defining Multicultural 274 Social-Environmental Aspects 275 Breakdown of Communication 277 Multicultural Competence 277 Dialogue 278 General Counseling Suggestions 279 Assessment, Treatment, and Aftercare Issues 280 CHAPTER 11 INCORPORATING SPIRITUALITY INTO ADDICTION COUNSELING 329 Personal Reflections 329 Definition of Spirituality 329 The History of the Merger: Spirituality and Addiction Counseling 330 Bridges and Barriers 332 Influencing Factors 334 Assessment and Treatment 334 Counseling Resources and Techniques 336 Counselor Self-Care 339 Ethical Issues 342 CHAPTER 12 CHRONIC PAIN ASSESSMENT, TREATMENT, AND AFTERCARE 345 Personal Reflections 345 Definition of Pain 347 Issues of Living Sober with Chronic Pain 347 Assessment and Treatment 349 CHAPTER 13 PERSONAL AND PROFESSIONAL DEVELOPMENT OF THE COUNSELOR 359 Personal Reflections 359 Ethical Issues 359 Testifying in Court 368 Working with Difficult Others 372 Self-Care 377 Working with Addicts 383 CHAPTER 14 PREPARING FOR CERTIFICATION AND LICENSURE AS AN ADDICTION PROFESSIONAL 393 Personal Reflections 393 Self-Care on the Journey 395 Supervision 397 Credentialing 399 References 407 Author Index 447 Subject Index 457