Chemical Dependency Counseling

Robert R. Perkinson is the clinical director of Keystone Treatment Center in Canton, South Dakota. He is a licensed psychologist; licensed marriage & family therapist; internationally certified alcohol and drug counselor; South Dakota certified chemical dependency counselor, Level III; and a nationally certified gambling counselor and supervisor. His specialty areas focus on treating alcoholics, addicts, and pathological gamblers. He is the author of Chemical Dependency Counseling: A Practical Guide (2nd ed.) (2003a), which is the leading treatment manual in the world for chemical dependency counselors. With Dr. Arthur E. Jongsma Jr. (2001) he is the coauthor of The Addiction Treatment Planner, which is the best-selling treatment planner and computer software program for mental health and addiction professionals. He has also written The Alcoholism and Drug Abuse Patient Workbook (2003c) and the Gambling Addiction Patient Workbook (2003b). These workbooks have all of the exercises patients need to enter a stable recovery. His book entitled Treating Alcoholism: How to Help Your Clients Enter Recovery (2004) trains professionals how to treat patients with alcohol problems. He is the author of the book God Talks to You (2000) and the meditation tape A Communication from God (2008) by cdbaby, which help addicts make their first conscious contact with a Higher Power of their own understanding. He is a composer and has completed his second CD, Peace Will Come, music that helps addicts learn the essentials of a spiritual journey. With Dr. Jean LaCour (2004), he wrote the Faith-Based Addiction Curriculum to teach professionals of faith how to treat addiction. Dr. Perkinson is an international motivational speaker and regular contributor to numerous professional journals. He is the webmaster of several web pages, including www.robertperkinson.com, www.alcoholismtreatment.org, and www.godtalkstoyou.com, where he gets over 2.6 million hits a year and answers questions on addiction for free. His biographies can be found in Who’s Who in America, Who’s Who in Medicine and Healthcare, Who’s Who in Science and Engineering, and Who’s Who in the World.

• PrefaceAcknowledgments1.First ContactTreatment WorksThe Motivational InterviewHow to Assess Motivation2.First Hours of TreatmentThe First HoursHow to Greet ClientsBeginning the Therapeutic AllianceDealing With Early DenialHow to Check for Organic Brain DysfunctionThe Initial AssessmentHow to Conduct a Crisis InterventionAmerican Society of Addiction Medicine Patient Placement CriteriaDiagnostic and Statistical ManualDiagnosis: Substance Use DisorderHow to Determine the Level of Care NeededCriteria for Outpatient Treatment (Adults)Criteria for Inpatient Treatment (Adults)Criteria for Outpatient Treatment (Adolescents)Criteria for Inpatient Treatment (Adolescents)The Client’s Reaction to IntoxicationWhat to Do With an Intoxicated ClientHow Clients React in DetoxificationThe AMA ThreatHow to Develop and Use the AMA TeamHow to Use the In-House InterventionHow to Respond to Clients Who Leave AMA3.Biopsychosocial InterviewThe Biopsychosocial InterviewHow to Conduct the InterviewA Sample Biopsychosocial Interview4.Treatment PlanHow to Build a Treatment PlanThe Diagnostic SummaryThe Problem ListGoals and ObjectivesHow to Develop GoalsHow to Develop ObjectivesHow to Develop InterventionsHow to Evaluate the Effectiveness of TreatmentHow to Select Goals, Objectives, and InterventionsTreatment Plan ReviewDocumentationHow to Write Progress NotesFormal Treatment Plan Review5.Individual TreatmentThe Therapeutic AllianceHow to Develop a Therapeutic AllianceHow to Be ReinforcingHow to Use EmpathyTransference and CountertransferenceExamples of Empathic StatementsHow to Be ConfrontiveBehavior TherapyWhen a Client Breaks a RuleWhy We Concentrate on Behavior TherapyCognitive TherapyInterpersonal TherapyHow to Choose the Therapeutic Modality6.Group TherapyBenefits of the Group ProcessPreparation for the GroupThe Agenda GroupThe Honesty GroupHow to End Each GroupThe Euphoric Recall GroupThe Reading GroupThe Relapse Prevention GroupThe Spirituality GroupThe Childhood GroupMen’s Group/Women’s GroupThe Community GroupThe Personal Inventory GroupSkills Training GroupProblem-Solving Skills Group7.Drugs of AbuseDrugs of AbuseAlcoholAlcohol-Induced Organic Mental DisordersOpioidsHallucinogensCannabisInhalantsNicotineClub DrugsPolysubstancesTreatment Outcome8.Recovery SkillsThe Chemical Use HistoryHonestyLove, Trust, and CommitmentFeelingsRelationship SkillsAddictive RelationshipsCommunication SkillsSelf-DisciplineImpulse ControlRelapse PreventionStress Management9.StepsThe CommitteeStep OneStep TwoStep ThreeStep FourStep FiveStep SixStep SevenStep EightStep NineStep TenStep ElevenStep Twelve10.LecturesThe Disease ConceptDefense MechanismsThe Great LieNormal DevelopmentPhysical Addiction and RecoveryAlcoholics AnonymousMeetingsFeelings11.Special ProblemsThe Psychiatric/Psychological AssessmentHow to Develop the Treatment PlanThe Depressed ClientThe Angry ClientPersonalityThe Antisocial PersonalityThe Borderline ClientThe Narcissistic ClientThe Anxious ClientPost-Traumatic Stress DisorderPanic AttacksThe Psychotic ClientAcquired Immune Deficiency SyndromeThe Client With Low Intellectual FunctioningThe Client Who Cannot ReadThe Elderly ClientThe Client With Early Childhood TraumaLove in the Treatment CenterThe Pathological Gambler12.Adolescent TreatmentThe Normal AdolescentPubertyAges 13 to 16Ages 16 to 19The Adolescent Chemical Dependency CounselorThe Point SystemThe Primary Elements in Adolescent TreatmentThe RulesCommunication SkillsHonestyExerciseFun in SobrietyThe ReinforcersSpiritualityGroup TherapyPeer PressureContinuing EducationContinuing CareThe Parents Support GroupThe Behavioral ContractPhases of Adolescent Treatment13.The Family ProgramThe First Family ContactHow to Handle the Early “Against Medical Advice” RiskCommon Family ProblemsHow to Treat Family MembersThe Family Program ScheduleHow to Work With the Family in GroupThe Conjoint Session14.The Clinical StaffThe Physician/AddictionologistThe Psychologist/PsychiatristThe Social Worker/Mental Health CounselorThe NurseThe Clinical DirectorThe Clinical SupervisorThe Chemical Dependency CounselorThe Rehabilitation Technician or AideThe Recreational TherapistClinical StaffingTeam BuildingCommitment to CoworkersBoundariesStaff–Client ProblemsWhat to Do When a Client Does Not Like a CounselorWhat to Do When a Client Complains About a RuleThe Work Environment15.Discharge Summary and Continuing CareOutpatient Discharge CriteriaInpatient Discharge CriteriaHow to Develop a Discharge SummaryThe Discharge SummarySaying Good-Bye16.The Good CounselorGood Counselors Are CaringGood Counselors Love Their WorkGood Counselors Do Not Become Overly InvolvedGood Counselors Do Not LieGood Counselors Are GentleGood Counselors Like ThemselvesGood Counselors Are SupersensitiveGood Counselors Have a Sixth SenseGood Counselors Do Not Become Overly EmotionalGood Counselors Are Active ListenersGood Counselors Do Not Talk Too MuchGood Counselors Maintain BoundariesGood Counselors Are Client-CenteredGood Counselors Have Effective Relationship SkillsGood Counselors Have a Sound Code of EthicsAppendix 1. Short Michigan Alcoholism Screening Test (SMAST)Appendix 2. AUDIT QuestionnaireAppendix 3. CRAFFT InterviewAppendix 4. Biopsychosocial AssessmentAppendix 5. Rethinking Drinking: Alcohol and Your HealthAppendix 6. Alcohol Withdrawal ScaleAppendix 7. Clinical Opiate Withdrawal Scale (COWS)Appendix 8. DSM-5 Psychoactive Substance Use DisorderAppendix 9. Daily Craving RecordAppendix 10. Sample Biopsychosocial InterviewAppendix 11. Hamilton Depression Rating ScaleAppendix 12. Step OneAppendix 13. Personal Recovery PlanAppendix 14. FeelingsAppendix 15. Chemical Use HistoryAppendix 16. Relapse PreventionAppendix 17. CodependencyAppendix 18. Anger ManagementAppendix 19. Stress ManagementAppendix 20. Relationship SkillsAppendix 21. HonestyAppendix 22. Love, Trust, and CommitmentAppendix 23. Barriers in ThinkingAppendix 24. Self-DisciplineAppendix 25. Communication SkillsAppendix 26. Drug Categories for Substances of AbuseAppendix 27. HeroinAppendix 28. National Cancer Institute Guide to Quitting SmokingAppendix 29. Drug Abuse Screening TestAppendix 30. Impulse ControlAppendix 31. Addictive RelationshipsAppendix 32. Alcohol Abstinence Self-Efficacy ScaleAppendix 33. Step TwoAppendix 34. Step ThreeAppendix 35. Step FourAppendix 36. Step FiveAppendix 37. Psychotherapeutic MedicationsAppendix 38. NarcissismAppendix 39. Hamilton Anxiety Rating ScaleAppendix 40. Post-traumatic Stress Disorder (PTSD) Checklist Civilian VersionAppendix 41. Post-traumatic Stress Disorder (PTSD) Checklist Military VersionAppendix 42. Gambling HistoryAppendix 43. Pressure Relief Group Meeting and Budget FormAppendix 44. Honesty for GamblersAppendix 45. Step One for GamblersAppendix 46. Step Two for GamblersAppendix 47. Step Three for GamblersAppendix 48. Step Four for GamblersAppendix 49. Step Five for GamblersAppendix 50. Relapse Prevention for GamblersAppendix 51. Adolescent Unit Level SystemAppendix 52. Adolescent Unit Point SystemAppendix 53. Peer PressureAppendix 54. The Behavioral ContractAppendix 55. Family QuestionnaireAppendix 56. Sample Discharge SummaryAppendix 57. NAADAC Code of EthicsAppendix 58. Fagerström Test for Nicotine DependenceAppendix 59. Diagnostic/Integrated SummaryAppendix 60. Mental Health ScreeningAppendix 61. Adult Nurses IntakeAppendix 62. Adolescent Nurses IntakeAppendix 63. Adult Inpatient Program ScheduleAppendix 64. Adolescent Inpatient Program ScheduleAppendix 65. Gambling Inpatient Program ScheduleAppendix 66. Adult Outpatient Program ScheduleAppendix 67. Adolescent Outpatient Program ScheduleAppendix 68. Gambling Outpatient Program ScheduleAppendix 69. Day Treatment Program ScheduleAppendix 70. Strengths, Needs, Abilities, and PreferencesReferencesAbout the Author