Learning the Language of Addiction Counseling

GERI MILLER, PHD, is a Diplomate in Counseling Psychology, American Board of Professional Psychology (ABPP); Licensed Psychologist (LP); Licensed Clinical Mental Health Counselor (LCMHC); Master Addiction Counselor (MAC) (NCCAP); NCASPPB Licensed Clinical Addictions Specialist (LCAS) and Certified Clinical Supervisor (CCS). She is a Professor in the Department of Human Development and Psychological Counseling at Appalachian State University. Dr. Miller has worked in the mental health counseling profession since 1976 and in the addiction counseling field since 1979. She has published and presented research related to mental health and addiction counseling. She has also presented extensively to mental health counselors and addiction counselors.

• Preface ixAcknowledgments xiiiChapter 1 Introduction 1Personal Reflections 1Addiction Counseling Influences 6Models of Addiction 17Appendix 1A: Language of Recovery 25Appendix 1B: Summary of Peer Recovery Movement (June 2019) 27Appendix 1C: SAMHSA-NAADAC Addiction Professional Education & Career Ladder 29Chapter 2 Theories of Counseling Applied To Addiction Treatment 31Personal Reflections 31Development of a Theoretical Framework for Addiction Counseling 32Dangers in Developing a Theoretical Framework and Recommendations 34General Counseling Theories Applied to Addiction Treatment 38Chapter 3 Assessment and Diagnosis of Addiction 49Personal Reflections 49Stages of Change 50DWI/DUI/OWI/OUI Assessments 51Assessment 51Interviews 53Behavioral Observations 61Physiological Instruments 62Psychometric Instruments 62Diagnosis 77Chapter 4 Co-Occurring Disorders and Behavioral Addictions 82Personal Reflections 82Co-Occurring Disorders 83Collaboration Between the Mental Health and Substance Abuse Fields 85Assessment 87Treatment 90Behavioral Addictions 104Chapter 5 The Core Treatment Process of Addictions 113Personal Reflections 113Integrated Care 114The Experience of the Addict as It Relates to Treatment 115Crisis Intervention 115Individual Therapy 122Group Therapy 131Family Therapy 144Chapter 6 Treatment-Related Issues and Counseling Approaches 154Personal Reflections 154Sexual Issues 156HIV/AIDS 165Intimate Partner Violence 173Homelessness 184Specific Counseling Approaches 188Chapter 7 Relapse Prevention 202Personal Reflections 202Counselor Approaches 203Relapse-Prevention Models 208Counseling Techniques 216Influencing Factors 224Case Studies of Special Populations 225Co-Occurring Disorders 228Chapter 8 Self-Help Groups 231Personal Reflections 231Suggestions for Counselors 23312-step Groups 23512-step Alternative Groups 244Matching Self-help Groups to Meet Client Needs 251Special Issues 258Appendix 8A: Stories of Recovery 265Chapter 9 Elaboration On Specific Therapies and Techniques Relevant To Addiction Counseling 267Personal Reflections 267Client Resilience 268Positive Psychology 271Stages of Change Model 275Overview of Evidence-Based Practice (EBP) 280Motivational Interviewing 282Brief Therapy 289Behavioral/Cognitive-Behavioral 296Chapter 10 Culturally Sensitive Addiction Counseling 302Personal Reflections 302Defining Multicultural 305Social-Environmental Aspects 306Breakdown of Communication 310Multicultural Competence/Multicultural Orientation 310Dialogue 313General Counseling Suggestions 316Assessment, Treatment, and Aftercare Issues 316Overall Substance Use/Abuse Exploration Multicultural Exercises 377Chapter 11 Chronic Pain Assessment and Treatment 381Personal Reflections 381Definition of Pain 386Issues of Living Sober with Chronic Pain 387Assessment and Treatment 389Appendix 11A: Opiate Addiction & Pain Management: Overview of Counseling Approaches 409Chapter 12 Incorporating Spirituality Into Addiction Counseling 411Personal Reflections 411The History of Incorporating Spirituality into Addiction Counseling 412Incorporation Barriers and Bridges 414Spiritual Identity Development 419Spiritual Identity Development with Addicted Clients 420Counseling Resources and Techniques 421Appendix 12A: Emotional Sobriety 430Chapter 13 Personal and Professional Development of The Counselor 437Personal Reflections 437Ethical Issues 441Testifying in Court 451Working in Difficult Systems 456Working with Addicts 463Self-Care 469Appendix 13A: Suggestions for Dealing with Stress 482Chapter 14 Obtaining Addiction Professional Credentials 483Personal Reflections 483Self-Care on the Journey 485Credentialing 488Chapter 15 Supervision and Mentoring 494Personal Reflections 494Supervision 494A Definition 496Choosing a Supervisor 497Notes to the Supervisee 499Notes to the Supervisor 499Specific Diversity Concerns 501Ethical Concerns 502Mentoring 505A Definition 506Choosing a Mentor/Mentee 506Appendix 15A: North Carolina Substance Abuse Professional Practice Board (NCSAPPB) Supervisor Credential Requirements 511Clinical Supervision Contract: LCAS 515Sample Supervision Documentation 518Ethics Decisional Model 519References 521Name Index 585Subject Index 609