Learning the Language of Addiction Counseling

FULLY REVISED, COMPREHENSIVE, AND PRACTICAL

Learning the Language of Addiction Counseling, Fourth Edition introduces counselors, social workers, and students to the field of addiction counseling and helps them acquire the knowledge and develop the skills needed to counsel individuals who are caught in the destructive cycle of addiction.

Drawing from her years of experience working in the addiction-counseling field, Geri Miller provides an engaging, balanced overview of the major theoretical foundations and clinical best practices in the field.

Fully updated, the Fourth Edition offers a positive, practice-oriented counseling framework and features:

• A research-based, clinical application approach to addiction counseling that practitioners can turn to for fundamental, practical, clinical guidelines
• Revised chapters that reflect important changes in research and practice, including new DSM^TM-5 criteria, new assessment instruments, and new and expanded treatments
• Case studies, interactive exercises, end-of-chapter questions, and other resources that facilitate the integration of knowledge into practice
• “Personal Reflections” sections at the beginning of each chapter provide an invaluable, unique perspective on the author’s evolving views of addiction counseling
• Updated and expanded online Instructor’s Manual that includes brief video clips, PowerPoint^® slides, test bank questions for each chapter, and sample syllabi

From assessment and diagnosis of addiction to preparing for certification and licensure as an addiction professional, this comprehensive book covers all of the essentials.

GERI MILLER, PHD, Diplomate in Counseling Psychology, ABPP, is a Professor in the Department of Human Development and Psychological Counseling at Appalachian State University. She is a Licensed Psychologist, a Licensed Professional Counselor, a Licensed Clinical Addictions Specialist, and a Substance Abuse Professional Practice Board Certified Clinical Supervisor in North Carolina. She has also received a Certificate of Proficiency in the Treatment of Alcohol and other Psychoactive Substance Use Disorders from the American Psychological Association College of Professional Psychology. Dr. Miller has worked in the mental health counseling profession since 1976 and in the addiction counseling profession since 1979. She has conducted research related to mental health counseling and addiction counseling. She has also presented extensively to mental health counselors and addiction counselors.

Preface xi

Acknowledgments xv

CHAPTER 1

INTRODUCTION 1

Personal Reflections 1

Addiction Counseling Influences 3

Models of Addiction 6

CHAPTER 2

THEORIES OF COUNSELING APPLIED TO ADDICTION TREATMENT 13

Personal Reflections 13

Development of a Theoretical Framework for Addiction Counseling 14

Dangers in Developing a Theoretical Framework and Recommendations 16

General Counseling Theories Applied to Addiction Treatment 19

CHAPTER 3

ASSESSMENT AND DIAGNOSIS OF ADDICTION 31

Personal Reflections 31

Interviews 33

Behavioral Observations 40

Physiological Instruments 41

Psychometric Instruments 41

Diagnosis 52

Stages of Change 53

CHAPTER 4

CO-OCCURRING DISORDERS AND BEHAVIORAL ADDICTIONS 58

Personal Reflections 58

Co-Occurring Disorders 59

Collaboration Between the Mental Health and Substance Abuse Fields 60

Assessment 63

Treatment 67

Behavioral Addictions 80

CHAPTER 5

THE CORE TREATMENT PROCESS FOR ADDICTIONS 91

Personal Reflections 91

Philosophical Approaches 92

Crisis Intervention 97

Individual Therapy 103

Group Therapy 110

Family Therapy 123

CHAPTER 6

TREATMENT-RELATED ISSUES AND COUNSELING APPROACHES 138

Personal Reflections 138

Sexual Issues 139

HIV/AIDS 149

Intimate Partner Violence 158

Homelessness 169

Specific Counseling Approaches 173

CHAPTER 7

RELAPSE PREVENTION 196

Personal Reflections 196

Counselor Approaches 197

Relapse-Prevention Models 201

Counseling Techniques 209

Case Studies of Special Populations 217

Co-Occurring Disorders 220

CHAPTER 8

SELF-HELP GROUPS 226

Personal Reflections 226

Suggestions for Counselors 227

12-Step Groups 229

12-Step Alternative Groups 238

Matching Self-Help Groups to Meet Client Needs 247

Special Issues 253

Appendix 8A: Stories of Recovery 260

Appendix 8B: Emotional Sobriety 261

CHAPTER 9

ELABORATION ON SPECIFIC THERAPIES AND TECHNIQUES RELEVANT TO ADDICTION COUNSELING 266

Personal Reflections 266

Client Resilience 267

Positive Psychology 270

Stages-of-Change Model 273

Motivational Interviewing 278

Brief Therapy 284

Evidence-Based Practices (EBPs) 290

CHAPTER 10

CULTURALLY SENSITIVE ADDICTION COUNSELING 301

Personal Reflections 301

Defining Multicultural 303

Social-Environmental Aspects 305

Breakdown of Communication 308

Multicultural Competence/Multicultural Orientation 309

Dialogue 311

General Counseling Suggestions 314

Assessment, Treatment, and Aftercare Issues 314

Overall Substance Use/Abuse Exploration Multicultural Exercises 370

CHAPTER 11

CHRONIC PAIN ASSESSMENT AND TREATMENT 379

Personal Reflections 379

Definition of Pain 382

Issues of Living Sober with Chronic Pain 383

Assessment and Treatment 385

CHAPTER 12

INCORPORATING SPIRITUALITY INTO ADDICTION COUNSELING 398

Personal Reflections 398

The History of Incorporating Spirituality into Addiction Counseling 399

Incorporation Barriers and Bridges 401

Spiritual Identity Development 406

Counseling Resources and Techniques 408

CHAPTER 13

PERSONAL AND PROFESSIONAL DEVELOPMENT OF THE COUNSELOR 417

Personal Reflections 417

Ethical Issues 419

Testifying in Court 428

Working in Difficult Systems 432

Working with Addicts 436

Self-Care 442

CHAPTER 14

OBTAINING ADDICTION PROFESSIONAL CREDENTIALS 453

Personal Reflections 453

Self-Care on the Journey 455

Supervision 458

Credentialing 460

Appendix 14A: Sample Supervision Documentation 467

References 469

Author Index 523

Subject Index 535

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