Learning the Language of Addiction Counseling, 3rd Edition

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