Preface xvii Acknowledgments xxi Part I: Abused Substances and their Effects Abused drugs 2 Opiates 2 Depressants 4 Stimulants 7 Cannabis 9 Hallucinogens 10 Inhalants 12 Steroids (Anabolic-Androgenic ) 12 Designer drugs 13 Control schedules for Abused drugs 15 Prescribing drugs 30 The five control schedules 30 Controlled substance analogues 32 Government decision making 32 Part II: Conceptual tools Definitions of addiction 35 Moral model 35 Self-medication model 35 Medical/disease model 36 Spirituality model 36 Impulse-control disorder 36 Reward deficiency and Neurophysiological adaption 37 Genetic model 37 Biomedical model 37 Social learning model 38 Erroneous thought pat terns 38 Biopsychosocial model 38 Public health model 39 Characteristics of addiction 39 Compulsive use 40 Loss of control 40 Continued use despite adverse consequences 40 Tolerance 40 Withdrawal 41 Types of addictive disorders 41 The brain and psychoactive drugs 41 The brain and addictive behaviors 42 Addictive interaction disorder 45 Drug-use stages 46 Initiation 46 Escalation 47 Maintenance 47 Discontinuation and Relapse 47 Recovery 48 Levels of drug use 49 Type 1-Abstainers 50 Type 2-Social users 50 Type 3-Drug abusers 51 Type 4-Physically but not Psychologically dependent users 51 Type 5-Physically and Psychologically dependent users 52 Stages of behavioral change 53 Stage 1-Precontemplation 53 Stage 2-Contemplation 54 Stage 3-Preparation 54 Stage 4-Action 55 Stage 5-Maintenance and Relapse prevention 55 Stage 6-Termination 55 Prevention types and principles 56 The traditional classification 56 The institute of medicine classification 57 Prevention principles 57 Relapse prevention 59 Part III: Treatment planning and Assessment resources Treatment planning 64 Competencies and goals 64 Screening and Assessment 65 Diagnostic summary 67 Treatment 68 Client placement criteria 68 Writing a treatment plan 69 Sample treatment plan 70 Levels of care 71 Assessment resources 75 Alcohol Assessment instruments 75 Other Drug Assessments 81 Nonchemical addictions 84 Mental health (dual diagnosis) Assessments 85 Recovery potential Assessments 89 Multiple measures resources 93 Dual diagnoses: Psychiatric illness with addiction 93 The diagnostic and statistical manual (Dsm-Iv-Tr) 94 Psychiatric diagnostic categories 94 Part IV: Clinical skills and resources Clinical models 102 Sizgmund Freud's psychoanalytic therapy 102 Carl G. Jung's analytic psychoanalysis 103 Alfred Adler's individual psychology 103 Carl Rogers's person-centered therapy 104 Fritz Perls's Gestalt therapy 104 Irvin Yalom's existential psychotherapy 105 Viktor Frankl's logotherapy 106 Albert Ellis's rational-emotive behavior therapy 106 William Glasser's choice theory and Reality therapy 107 Aaron Beck's cognitive behavioral therapy 108 Eric Berne's transactional analysis 108 Other behavioral approaches 109 Counseling techniques 109 Clinical microskills 115 Client homework exercises 117 Client health and Stress management 131 Nutritional counseling 131 Exercise counseling 132 Affect-regulation coping skills counseling 132 Stress-management training 134 Shaffer coping models 135 Common styles of negative self-talk 137 Rewriting old beliefs 138 Rewriting irrational beliefs 139 Part V: Treatment resources Addiction recovery tools 142 Motivational tools 142 Medical and pharmaceutical tools 143 Cognitive-behavioral tools 146 Psychosocial tools 148 Holistic tools 150 Addiction Recovery programs 153 Residential and outpatient treatment programs 153 Support groups 155 Recovery programs for selected populations 167 Harm reduction programs 181 Characteristics of Harm reduction programs 183 Harm reduction goals 183 Harm reduction techniques 184 Other Harm reduction techniques 186 Part VI: Professional management Record keeping 190 Crisis management 206 Crisis types 206 Crisis reactions 207 Crisis management goals 207 Crisis intervention principles 207 Crisis management steps 208 Chronically relapsing clients 208 Difficult Clients 209 Safety issues 210 When threats occur 211 Clients with weapons 212 Clients who appear dangerous to self 212 Suicide Prevention 213 Critical incident Stress debriefing 213 Legal and Ethical responsibilities 214 Universal professional values 214 Ethical codes 215 Ethical decision making 216 Confidentiality 216 Informed consent 217 Dual relationships 217 Duty to warn 217 Referral obligation 218 Rights of minors 218 Malpractice 218 Ethical dilemmas 219 Part VII: Career enhancement resources Educational resources 222 Basic knowledge, skills, and attitudes expected of Addiction counselors 222 Selecting a training program 228 Certification and licensing 232 Continuing education 245 Business plan 248 Setting fees 248 Discussing fees 249 Home-based practices 249 Referrals 250 Multidisciplinary teams 251 Wellness plan 251 Burnout 251 Avoiding burnout 252 Malpractice insurance 253 Part VIII: Information resources National and International organizations 258 Federal substance abuse agencies 258 Regional substance abuse agencies 266 State substance abuse agencies 266 Educational and training institutions 279 Professional addiction-related organizations 286 Canadian agencies 299 International substance abuse organizations 303 Grassroots alcohol and other Drugs Information 307 Grant-funding resources 309 Federal granting agencies 309 International granting agencies 310 Private granting agencies 311 Other funding databases 313 Publishing resources 314 Academic and professional journals 314 Addiction magazines and websites 336 Addiction newsletters and websites 341 Drug policy advocates 346 The Drug policy alliance 347 National organization for the reform of Marijuana laws 347 Harm reduction coalition 347 Law enforcement against prohibition 348 Multidisciplinary association for Psychedelic studies 348 Religious leaders for a more just and Compassionate Drug policy 348 Educators for sensible Drug policy 349 Canadian foundation for Drug policy 349 Glossary 353 References 381 Author Index 395 Subject Index 401
ROBERT HOLMAN COOMBS, PhD, is Professor of Biobehavioral Sciences at UCLA School of Medicine, a Certified Addiction Specialist (CAS), and a Fellow of the American Association for the Advancement of Science. He serves on the International Advisory Committee of the American Academy of Healthcare Providers in the Addictive Disorders and is author or editor of more than 200 publications, including eighteen books. WILLIAM A. HOWATT, PhD, EdD, is a faculty member of the Nova Scotia Community College School of Human Services. An Internationally Certified Addiction Specialist (ICAS), he recently completed a postdoctoral fellowship at the UCLA School of Medicine. Author of numerous publications, he is currently coediting (with Robert Holman Coombs) the Wiley Series on Treating Addictions.
"?is an internationally known, classic work spanning 75 years of research.... This book is laid out in a clear and easy-to-use format that provides nearly all information an addiction counselor might need in one resource." (The American Reference Books Annual, March 2007) "In the final analysis, the authors are to be commended for bringing a compendium of information together in one volume." (PsycCRITIQUES, 5/31/2006)