Treating Alcohol and Drug Problems in Psychotherapy Practice: Doing What Works / Edition 1

by Arnold M. Washton PhD, Joan E. Zweben PhD

Overview

Written specifically for the office-based psychotherapist, this practical guide describes how to detect, assess, diagnose, and treat clients presenting with a range of alcohol and drug problems. Detailed is an integrated, flexible psychotherapeutic approach that emphasizes building a strong therapeutic relationship, engaging clients "where they are," and addressing substance use within the larger context of clients' lives. The authors describe in very pragmatic terms how to use a combination of motivational, cognitive-behavioral, 12-step, and psychodynamic techniques with clients in different stages of change. Techniques are brought to life with numerous case vignettes, and appendices include reproducible forms and handouts.

About the Author:
Arnold M. Washton, PhD, is Executive Director of Recovery Options, a private practice in New York City and Princeton, New Jersey, and serves as Clinical Director of The Retreat at Princeton

About the Author:
Joan E. Zweben, PhD, is Health Sciences Clinical Professor of Psychiatry at the University of California, San Francisco, and is also the founder and Executive Director of the 14th Street Clinic (1979-2007) and the East Bay Community Recovery Project (1989-present), in Oakland, California

Product Details

ISBN-13:	9781593859800
Publisher:	Guilford Publications, Inc.
Publication date:	06/23/2008
Edition description:	First Edition
Pages:	312
Product dimensions:	5.90(w) x 8.80(h) x 1.00(d)

About the Author

Arnold M. Washton, PhD, is a psychologist in private practice in New York and New Jersey, specializing in the treatment of substance use and other behavioral health problems since 1975. Dr. Washton has served as Clinical Professor of Psychiatry at New York University School of Medicine, as director of several nationally recognized addiction treatment and research programs, and as consultant to professional sports teams, government agencies, media organizations, and major corporations. He has served on the Substance Abuse Advisory Committee of the U.S. Food and Drug Administration and has given expert testimony before special committees of the U.S. Senate and House of Representatives on drug abuse trends in the United States. The author of several books and numerous journal articles on addiction and its treatment, Dr. Washton has devoted most of his career to developing individualized approaches to treating addiction that incorporate the principles and practice of client-centered psychotherapy. His website is www.thewashtongroup.com.
 
Joan E. Zweben, PhD, is an addiction psychologist who began treating co-occurring psychiatric and addictive disorders, and training treatment practitioners, in the 1970s. She has a broad-based background in mental health, alcoholism, and drug dependence, and has experience with both residential and outpatient modalities. Dr. Zweben has a long-standing commitment to building treatment resources through networking activities, and to addressing stigma in its many forms. She is the founder and retired executive director of two treatment programs providing integrated services for people with co-occurring disorders: The 14th Street Clinic (opioid treatment) and East Bay Community Recovery Project (now part of Lifelong Medical Care), both in Oakland, California. Active as a teacher and consultant, Dr. Zweben is Clinical Professor of Psychiatry at the University of California, San Francisco, based at the San Francisco VA Medical Center. Her publications include four books, over 90 articles or book chapters, and 15 monographs on treating addiction.
 

Table of Contents

Part I Basic Issues and Perspectives

Chapter 1 Why Treat Alcohol and Drug Problems in Psychotherapy Practice? 3

Chapter 2 Clinical Course, Definition, and Diagnosis of Substance Use Disorders 12

Chapter 3 Pharmacology of Psychoactive Substances 28

Chapter 4 Addressing Concurrent Psychiatric and Substance Use Disorders 58

Chapter 5 Ingredients of the Integrated Approach: Doing What Works 72

Chapter 6 The Place of Evidence-Based Principles and Interventions 91

Chapter 7 The Role of Medication 96

Part II Clinical Strategies and Techniques

Chapter 8 Clinical Assessment 111

Chapter 9 Treatment Planning: Meeting Patients Where They Are 139

Chapter 10 Abstinence Strategies 164

Chapter 11 Maintaining Positive Gains 181

Chapter 12 Moderation and Harm Reduction Strategies for Alcohol Problems 206

Chapter 13 Psychotherapy in Ongoing and Later Stage Recovery 229

Chapter 14 Facilitating Participation in Mutual-Help Programs 239

Appendix 1 New Patient Questionnaire 251

Appendix 2 Inventory of "Triggers" for Alcohol and Drug Use 256

Appendix 3 Preparing to Go Off Antabuse 257

References 259

Index 277

Interviews

Mental health practitioners, including clinical psychologists, clinical social workers, psychiatrists, counselors, family therapists, and nurses. Also of interest to substance abuse treatment specialists. Will serve as a text in advanced undergraduate- and graduate-level courses on substance abuse and addiction. Also useful as a supplemental text in psychotherapy courses.

Editorial Reviews

"Many people interested in clinical work with alcoholics and addicts will benefit from making this a centerpiece of their library."

Families in Society

"This book offers clear and specific practice suggestions for working with individuals with substance use disorders ranging from managing bill collection to tips for managing relapse triggers. It provides a basic foundation for understanding substance use disorders and will help the interested clinician to build skill for working with individuals who have substance use disorders. Although the book is aimed at office-based mental health practitioners, it would be a helpful resource for any mental health or substance use treatment practitioner as well as graduate students. Its emphasis on utilizing an integrated approach to meet individuals where they are is particularly salient for social workers....The authors have done a tremendous job synthesizing practice wisdom and research-based knowledge on working with individuals with substance use disorders into a clear and concise resource that clinicians can use in their day-to-day practice."

Journal of Social Work Practice in the Addictions

"This text provides a sophisticated snapshot of substance-abuse treatment today, extending the provision of substance-abuse services by private practitioners."

PsycCRITIQUES

"The second edition takes what was already a pragmatic clinical text and offers key updates related to client-centered care, harm reduction, and evidence-based adjunctive pharmacotherapies. This is a book written by therapists for therapists. It provides the perfect combination of clinical wisdom and science-based recommendations."—Molly Magill, LICSW, PhD, Department of Behavioral and Social Sciences, Brown University School of Public Health

"As a trainer of mental health practitioners, I highly recommend this book. Washton and Zweben offer a foundational approach to individualized treatment that is engaging and humane and that meets people 'where they are' with nonstigmatizing language and a harm reduction mindset. Readers will understand how office-based treatments are an effective and accessible piece of the SUDs treatment continuum. For the novice or seasoned clinician, this book offers a menu of options for integrative care that will immediately inform clinical work with complex, co-occurring challenges, particularly those associated with the opioid epidemic."—Mark S. Woodford, PhD, Department of Counselor Education, The College of New Jersey

"A remarkably practical and down-to-earth guide for working with SUDs, which vex even the most experienced clinicians. Washton and Zweben bypass the politics and rhetoric and instead focus on what really matters: doing what works! This book is a true gem for practitioners wanting to know what to do in session that actually helps their clients address this challenging issue."—Diane R. Gehart, PhD, Professor and Program Coordinator, Marriage and Family Therapy, California State University, Northridge

"I have assigned this book as the primary text for a master's-level Substance Use Disorders course and a postgraduate certificate program for master's- and doctoral-level students. I could not find another text that was as practical and realistic about the dilemmas of working with clients with SUDs. The second edition retains all the strengths of the first—such as optimism about the possibility of recovery, centrality of the therapeutic relationship, detailed clinical guidance, value placed on a range of treatments—while incorporating important new material. The authors' approach to relapse prevention contains a rich understanding of what pulls people back into using drugs and ways to interrupt this cycle."—Maryann Amodeo, PhD, MSW, LICSW, Professor Emerita and Former Co-Director, Center for Addictions Research and Services, School of Social Work, Boston University

From the Publisher

"Intended for health care professionals from all disciplines, this book is written in a style that is non-technical and easy to absorb....I felt this book to be particularly useful and appropriate for learners beginning training in addiction counselling. It covers all the major themes, theories, and practices, and the issues discussed remain current and relevant."

Journal of Mental Health