Foundations of Addictions Counseling

Cover......Page 1
Title Page......Page 2
Copyright Page......Page 3
Preface......Page 4
Acknowledgments......Page 7
Contributors......Page 8
Brief Contents......Page 20
Contents......Page 21
by David Capuzzi, Mark D. Stauffer, and Chelsea Sharpe......Page 34
Approaches to the Prevention of Addiction in the United States......Page 35
Current Policies Influencing Prevention......Page 38
Models for Explaining the Etiology of Addiction......Page 39
Psychological Models......Page 40
Family Models......Page 42
The Public Health Model......Page 43
Biological Models......Page 44
Sociocultural Models......Page 45
Multicausal Models......Page 46
Summary and Some Final Notations......Page 47
Useful Websites......Page 48
References......Page 49
by Laura J. Veach, Jennifer L. Rogers, Regina R. Moro, and E. J. Essic......Page 51
Neurobiology and the Physiology of Addiction......Page 52
Depressants......Page 59
Opioids......Page 67
Stimulants......Page 68
Hallucinogens and Other Psychedelics......Page 74
Summary and Some Final Notations......Page 76
References......Page 77
by Laura J. Veach, Jennifer L. Rogers, Regina M. Moro, E. J. Essic, and James W. McMullen......Page 81
Sexual Addiction......Page 83
Case Study......Page 84
Gambling Addiction......Page 85
Case Study 2......Page 87
Work Addiction......Page 89
Compulsive Buying......Page 92
Food Addiction and Disordered Eating......Page 93
Summary and Some Final Notations......Page 95
References......Page 96
Professional Issues Pertaining to Counselors......Page 99
Counselor Competence......Page 100
Credentialing......Page 109
Managed Care, Treatment Funding, and Provider Reimbursement......Page 113
Measuring Outcomes and Efficacy of Treatment......Page 114
Summary and Some Final Notations......Page 116
References......Page 117
by Mark D. Stauffer, David Capuzzi, and Kelly Aissen......Page 122
Hope......Page 123
Strength-Based Approaches......Page 124
A Whole Person Approach......Page 125
Motivation......Page 126
Advocacy......Page 127
Protect Client Welfare and Information......Page 128
Recognize Uniqueness and Diversity......Page 129
Continue to Assess Over Time and in Relation to Stage of Treatment......Page 130
Flow of Addictions Assessment......Page 131
Screening......Page 132
Structured, Semistructured, and Unstructured Interviews......Page 133
Assessment Dimensions Related to Level of Care......Page 134
Gathering Background and Contextual Information......Page 136
Client Presentation and Functioning......Page 137
Stage of Change Theory......Page 141
Prior Treatment Related to Addiction......Page 142
Family Systems and Peer Relationships......Page 143
Useful Websites......Page 146
References......Page 147
by John M. Laux, Dilani M. Perera-Diltz, Stephanie A. Calmes, Malvika Behl, and Jennifer Vasquez......Page 152
Why Use Standardized Assessments?......Page 154
Philosophical Underpinning of Instrument Construction......Page 155
Sensitivity and Specificity......Page 156
Diagnosis......Page 157
Substance Abuse Subtle Screening Inventory-3 (SASSI-3)......Page 159
The Michigan Alcoholism Screening Test (MAST)......Page 160
The CAGE......Page 161
Alcohol Use Disorders Identification Test (AUDIT)......Page 162
Substance Abuse Scales Found on Personality Assessment Instruments......Page 163
Minnesota Multiphasic Personality Inventory—2 (MMPI-2)......Page 164
Personality Assessment Inventory (PAI)......Page 166
Millon Clinical Multiaxial Inventory—III (MCMI-III)......Page 167
Counselor-Initiated Comprehensive Substance Abuse Assessment......Page 168
The Addiction Severity Index (ASI)......Page 169
T-ACE......Page 170
TWEAK......Page 171
Summary and Some Final Notations......Page 172
References......Page 174
Overview: Motivational Interviewing......Page 180
The Stages of Change Model......Page 181
Resistance......Page 184
Motivational Interviewing: Helping Clients Achieve Change......Page 185
The Primary Principles of Motivational Interviewing......Page 186
Five Techniques to Use Early and Often......Page 187
The Role of Resistance in the Change Process......Page 190
Reducing Resistance......Page 191
Enhancing Confidence......Page 194
Advantages and Disadvantages of Motivational Interviewing......Page 195
Useful Websites......Page 196
References......Page 197
Counselor Beliefs and Behaviors......Page 198
Empirically Supported Treatment Approaches......Page 199
Behavioral and Cognitive-Behavioral Assumptions and Practices......Page 201
Functional Analysis......Page 202
Cognitive-Behavioral Interventions that Target Triggers......Page 203
Contingency Management and Behavior Contracting......Page 205
Community Reinforcement Approach......Page 206
Mindfulness-Based Relapse Prevention......Page 207
Brief Interventions......Page 208
Solution-Focused Counseling......Page 209
Encouragement from Research......Page 210
Solution-Focused Integration......Page 212
Solution-Focused Assumptions and Practices Useful in Substance Abuse Counseling......Page 213
Case Study: A Reframe for Exceptional Anton......Page 215
Harm Reduction......Page 217
Useful Websites......Page 220
References......Page 221
History of How Mental Health Systems Have Adapted to Meet the Needs of Clients with Multiple Disorders......Page 225
Prevalence of Comorbidity......Page 226
Case Study......Page 228
Assessment......Page 230
Cultural Issues Related to Assessment......Page 231
Treatment and Care Needs......Page 233
Case Study......Page 234
Disease Concept Model......Page 235
Case Study......Page 236
Alternative Models......Page 237
Multidisciplinary Treatment Team......Page 238
A Brief Description of the Counseling Process that Leads to Treatment Planning......Page 239
Case Study: A Case Study of Dwayne......Page 241
Useful Websites......Page 247
References......Page 248
Theory Behind Group Work......Page 250
Group Treatment of Addiction......Page 251
Psychoeducational Groups......Page 252
Psychotherapeutic Groups......Page 253
Self-Help Groups......Page 255
Ethical and Legal Issues with Groups......Page 256
Screening of Participant......Page 257
Confidentiality......Page 258
Voluntary Versus Involuntary Participation......Page 259
Managing Diversity in Group Settings......Page 260
Gender......Page 261
Sexuality......Page 262
Group Counseling for Family Members of Addicts......Page 263
Case StudIES: Case Study I: Development of a Six-Session Alcohol and Drug Education Group......Page 264
Case Study II: Psychotherapeutic Group, Open Focus......Page 266
Strategies for Effective Group Treatment......Page 269
Useful Websites......Page 270
References......Page 271
Rationale for a Chapter on Pharmacotherapy of Addiction......Page 273
Key Concepts of Neurology in Pharmacotherapy......Page 274
Diversity and Pharmacotherapy......Page 276
Pharmac otherapy Case Study I: Generalized Anxiety Disorder (DSM 5 300.02), Alcohol Use Disorder (DSM 5 303.90 Severe), and Sedative, Hypnotic, or Anxiolytic Dependence Use Disorder (DSM 5 304.10 Moderate)......Page 278
Key Concepts of Neurotransmitters in Pharmacotherapy......Page 279
Key Concepts of Pharmacodynamics in Pharmacotherapy......Page 280
A Biological Theory of Craving......Page 281
The Professional Counselor’s Role in Addiction Pharmacotherapy......Page 283
Alcohol Withdrawal Treatment......Page 284
Pharmacotherapy Case Study II: Alcohol Withdrawal (DSM 5 291.81) and Alcohol Use Disorder (DSM 5 303.90 Severe) in a Pregnant Patient (ICD-10-CM O99.3)......Page 285
Anticraving Treatment: First-Line: Naltrexone (ReVia, Depade)......Page 286
Pharmacotherapy Case Study III: Alcohol Use Disorder (DSM 5 305.00 Mild) and Major Depressive Disorder—Moderate (DSM 5 296.22)......Page 287
Anticraving Treatment: Alternative Medications......Page 288
Glossary of Pharmacotherapy Terms......Page 289
Summary and Some Final Notations......Page 291
References......Page 292
Alcoholics Anonymous......Page 296
Narcotics Anonymous......Page 298
Other Support Groups......Page 299
Goals......Page 300
The Twelve Steps and Twelve Traditions......Page 301
The Role of Sponsors in Recovery......Page 302
Do 12-Step Programs Really Work?......Page 303
Advantages......Page 304
Disadvantages......Page 305
Using the 12-Step Group as Part of Treatment......Page 307
The Role of the Counselor......Page 308
Summary and Some Final Notations......Page 312
Useful Websites......Page 313
References......Page 314
Relapse Prevention for Addictive Behaviors......Page 318
Self-Efficacy......Page 320
Coping......Page 321
Social Support......Page 322
High-Risk Situations......Page 323
Seemingly Irrelevant Decisions (SIDs)......Page 325
The Abstinence Violation Effect......Page 326
Lifestyle Change......Page 327
Case Study of Relapse Prevention......Page 329
Self-Assessment of HRSs......Page 330
Lapse and Relapse Prevention Techniques......Page 331
Support Systems and Lifestyle Changes......Page 332
The Reality of Relapse Prevention......Page 334
References......Page 335
by Misty K. Hook......Page 338
Family Counseling......Page 339
Stages in Addicted Family Systems......Page 343
Parenting in an Addicted Family System......Page 344
The Impact of Alcohol on Couple Relationships......Page 345
Addiction and the Children......Page 348
Psychosocial Outcomes......Page 350
Assessment of Addicted Family Systems......Page 352
Treatment Strategies for Addicted Family Systems......Page 353
Useful Websites......Page 355
References......Page 356
Introduction......Page 361
Characteristics and Status of People with Disabilities and Addictions......Page 365
Case Study: The Case of Rita......Page 367
Risk Factors for Persons with Disabilities......Page 368
Psychological Risk Factors......Page 369
Economic and Employment Risk Factors......Page 370
Access Risk Factors......Page 371
Case Study: The Case of Abram......Page 372
Sociocultural Factors......Page 373
Treatment Utilization and Outcomes......Page 374
Intervention Strategies in Rehabilitation Settings......Page 376
Summary and Some Final Notations......Page 380
References......Page 381
The Need for Prevention Programs Across the Life Span......Page 386
Primary Prevention Programs......Page 390
Evidenced-Based Prevention Programs......Page 391
Prevention Program Strategies......Page 392
Early Diagnosis and Treatment of Emotional Problems......Page 393
Juvenile Drug Court Diversionary Programs......Page 394
School-Based Substance Abuse Prevention Programs......Page 395
Evaluative Reviews of D.A.R.E.......Page 396
Early Action Against Teen Drug Use......Page 397
In-School Drug Testing......Page 398
Multimodal Programs......Page 399
Harm Reduction Programs......Page 401
Mass Media Campaigns Aimed at Young Adult Population......Page 402
Risk Reduction and Protective Programs......Page 403
Prevention and Treatment Programs for Pregnant Adolescents and Adults......Page 404
Home Visit Programs......Page 405
Military Personnel......Page 406
Prevention Programs for Senior Adults......Page 407
Substance Abuse Prevention Outcomes......Page 408
Summary and Some Final Notations......Page 409
References......Page 410
by Jane E. Rheineck and Melissa M. Lugo......Page 416
Why Does Culture Matter in Substance Abuse Treatment?......Page 417
How Did We Get to This Point?......Page 418
Racial and Ethnic Minorities......Page 420
Racial and Cultural Identity Models......Page 426
Association of Multicultural Counseling and Development (AMCD) Multicultural Counseling Competencies......Page 427
LaDonna......Page 429
Alicia......Page 430
References......Page 434
Introduction......Page 439
Gender, Alcohol, and Drug Use and Abuse in the United States......Page 440
Biological Considerations......Page 443
Psychological Considerations......Page 444
Social Considerations......Page 445
Special Considerations for Addicted Women......Page 446
Biological Considerations......Page 448
Psychological Considerations......Page 449
Social Considerations......Page 450
Treatment Overview and History......Page 451
Gender-Specific Treatment Needs: Women......Page 452
Case Studies: Sandra and Tom......Page 453
Gender-Specific Treatment Needs: Men......Page 454
Gender-Specific Treatment Needs: Intersex Clients......Page 456
Useful Websites......Page 457
References......Page 458
by Anneliese A. Singh and Pamela S. Lassiter......Page 461
Common Terms for and Myths About LGBTQ People......Page 463
Coming Out, Cultural Differences, and Addiction......Page 464
LGBTQ-Affirmative Addiction Treatment and Assessment......Page 466
LGBTQ-Specific Assessment of Addiction......Page 467
LGBTQ-Specific Treatment of Addiction......Page 470
Modality Issues......Page 471
Case Study : A Gay Transgender Man with a Relapse Crisis......Page 472
Role of Addictions Counselors Working with LGBTQ Clients......Page 473
Creating a Safe Environment for LGBTQ People......Page 474
How to Be an Advocate for LGBTQ-Affirmative Treatment......Page 475
Case Study: The Story of Sonali......Page 477
Useful Websites......Page 478
References......Page 479
Introduction......Page 482
Levels of Care......Page 483
Types of Inpatient Services......Page 487
Clinician Determination of Inpatient Treatment......Page 488
Use of Motivational Interviewing to Assess Readiness to Change......Page 489
Challenges Facing Rehabilitation Centers......Page 490
Client Inpatient Experience......Page 491
Outpatient Treatment......Page 493
Drug and Alcohol Legislation Affecting Treatment......Page 494
Residential Drug Abuse Program......Page 499
Advocacy......Page 502
Useful Websites......Page 503
References......Page 504
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