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Chemical Dependency Counseling
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Chemical Dependency Counseling
A Practical Guide

Sixth Edition


December 2021 | 856 pages | SAGE Publications, Inc
Helping individuals recover from addiction is one of the most rewarding professions in the world. Chemical Dependency Counseling: A Practical Guide is the most comprehensive text written for those counselors and professionals who work with or plan to work with clients struggling with chemical dependency in a variety of settings.

Following the model of twelve-step programs, providing a ground-up introduction to guide the counselor through treatment from A to Z, and can be used as a core text for courses in addiction or substance abuse counseling. Author Robert R. Perkinson presents state-of-the-art tools necessary to deliver outstanding treatment and meet the highest standards demanded by accrediting bodies. 

This 6th edition continues to outline the best evidence-based treatment in the world, with a concentration on the following: cognitive behavioral therapy; motivational enhancement; medication assisted treatment, skills training; and 12-step facilitation. 
 
Preface
 
Acknowledgments
 
1. First Contact
Treatment Works

 
The Motivational Interview

 
How to Assess Motivation

 
 
2. First Hours of Treatment
The First Hours

 
How to Greet Clients

 
Beginning the Therapeutic Alliance

 
Dealing With Early Denial

 
How to Check for Organic Brain Dysfunction

 
The Initial Assessment

 
How to Conduct a Crisis Intervention

 
American Society of Addiction Medicine Patient Placement Criteria

 
Diagnostic and Statistical Manual

 
Diagnosis: Substance Use 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

 
How Clients React in Detoxification

 
The AMA Threat

 
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

 
A Sample Biopsychosocial Interview

 
 
4. Treatment Plan
How to Build a Treatment Plan

 
The Diagnostic Summary

 
The Problem List

 
Goals and Objectives

 
How to Develop Goals

 
How to Develop Objectives

 
How to Develop Interventions

 
How to Evaluate the Effectiveness of Treatment

 
How to Select Goals, Objectives, and Interventions

 
Treatment Plan Review

 
Documentation

 
How to Write Progress Notes

 
Formal Treatment Plan Review

 
 
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

 
When a Client Breaks a Rule

 
Why We Concentrate on Behavior Therapy

 
Cognitive Therapy

 
Interpersonal Therapy

 
How to Choose the Therapeutic Modality

 
 
6. Group Therapy
Benefits of the Group Process

 
Preparation for the Group

 
The Agenda Group

 
The Honesty Group

 
How to End Each Group

 
The Euphoric Recall Group

 
The Reading Group

 
The Relapse Prevention Group

 
The Spirituality Group

 
The Childhood Group

 
Men’s Group/Women’s Group

 
The Community Group

 
The Personal Inventory Group

 
Skills Training Group

 
Problem-Solving Skills Group

 
 
7. Drugs of Abuse
Drugs of Abuse

 
Alcohol

 
Alcohol-Induced Organic Mental Disorders

 
Opioids

 
Hallucinogens

 
Cannabis

 
Inhalants

 
Nicotine

 
Club Drugs

 
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

 
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

 
Defense Mechanisms

 
The Great Lie

 
Normal Development

 
Physical Addiction and Recovery

 
Alcoholics Anonymous

 
Meetings

 
Feelings

 
 
11. Special Problems
The Psychiatric/Psychological Assessment

 
How to Develop the Treatment Plan

 
The Depressed Client

 
The Angry Client

 
Personality

 
The Antisocial Personality

 
The Borderline Client

 
The Narcissistic Client

 
The Anxious Client

 
Post-Traumatic Stress Disorder

 
Panic Attacks

 
The Psychotic Client

 
Acquired Immune Deficiency Syndrome

 
The Client With Low Intellectual Functioning

 
The Client Who Cannot Read

 
The Elderly Client

 
The Client With Early Childhood Trauma

 
Love in the Treatment Center

 
The Pathological Gambler

 
 
12. Adolescent Treatment
The Normal Adolescent

 
Puberty

 
Ages 13 to 16

 
Ages 16 to 19

 
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

 
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

 
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 Summary 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. Short Michigan Alcoholism Screening Test (SMAST)
 
Appendix 2. AUDIT Questionnaire
 
Appendix 3. CRAFFT Interview
 
Appendix 4. Biopsychosocial Assessment
 
Appendix 5. Rethinking Drinking: Alcohol and Your Health
 
Appendix 6. Alcohol Withdrawal Scale
 
Appendix 7. Clinical Opiate Withdrawal Scale (COWS)
 
Appendix 8. DSM-5 Psychoactive Substance Use Disorder
 
Appendix 9. Daily Craving Record
 
Appendix 10. Sample Biopsychosocial Interview
 
Appendix 11. Hamilton Depression Rating Scale
 
Appendix 12. Step One
 
Appendix 13. Personal Recovery Plan
 
Appendix 14. Feelings
 
Appendix 15. Chemical Use History
 
Appendix 16. Relapse Prevention
 
Appendix 17. Codependency
 
Appendix 18. Anger Management
 
Appendix 19. Stress Management
 
Appendix 20. Relationship Skills
 
Appendix 21. Honesty
 
Appendix 22. Love, Trust, and Commitment
 
Appendix 23. Barriers in Thinking
 
Appendix 24. Self-Discipline
 
Appendix 25. Communication Skills
 
Appendix 26. Drug Categories for Substances of Abuse
 
Appendix 27. Heroin
 
Appendix 28. National Cancer Institute Guide to Quitting Smoking
 
Appendix 29. Drug Abuse Screening Test
 
Appendix 30. Impulse Control
 
Appendix 31. Addictive Relationships
 
Appendix 32. Alcohol Abstinence Self-Efficacy Scale
 
Appendix 33. Step Two
 
Appendix 34. Step Three
 
Appendix 35. Step Four
 
Appendix 36. Step Five
 
Appendix 37. Psychotherapeutic Medications
 
Appendix 38. Narcissism
 
Appendix 39. Hamilton Anxiety Rating Scale
 
Appendix 40. Post-traumatic Stress Disorder (PTSD) Checklist Civilian Version
 
Appendix 41. Post-traumatic Stress Disorder (PTSD) Checklist Military Version
 
Appendix 42. Gambling History
 
Appendix 43. Pressure Relief Group Meeting and Budget Form
 
Appendix 44. Honesty for Gamblers
 
Appendix 45. Step One for Gamblers
 
Appendix 46. Step Two for Gamblers
 
Appendix 47. Step Three for Gamblers
 
Appendix 48. Step Four for Gamblers
 
Appendix 49. Step Five for Gamblers
 
Appendix 50. Relapse Prevention for Gamblers
 
Appendix 51. Adolescent Unit Level System
 
Appendix 52. Adolescent Unit Point System
 
Appendix 53. Peer Pressure
 
Appendix 54. The Behavioral Contract
 
Appendix 55. Family Questionnaire
 
Appendix 56. Sample Discharge Summary
 
Appendix 57. NAADAC Code of Ethics
 
Appendix 58. Fagerström Test for Nicotine Dependence
 
Appendix 59. Diagnostic/Integrated Summary
 
Appendix 60. Mental Health Screening
 
Appendix 61. Adult Nurses Intake
 
Appendix 62. Adolescent Nurses Intake
 
Appendix 63. Adult Inpatient Program Schedule
 
Appendix 64. Adolescent Inpatient Program Schedule
 
Appendix 65. Gambling Inpatient Program Schedule
 
Appendix 66. Adult Outpatient Program Schedule
 
Appendix 67. Adolescent Outpatient Program Schedule
 
Appendix 68. Gambling Outpatient Program Schedule
 
Appendix 69. Day Treatment Program Schedule
 
Appendix 70. Strengths, Needs, Abilities, and Preferences
 
References
 
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