Treating Alcohol and Drug Problems in Psychotherapy Practice, Second Edition
Doing What Works
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Providing a framework for treating substance use disorders (SUDs) in office-based psychotherapy, the second edition of this trusted work has been updated throughout and features two entirely new chapters. The authors show how clinicians from any background can leverage the therapeutic skills they already have to address clients' alcohol and drug problems competently and effectively. Vivid case examples demonstrate ways to engage clients at different stages of change; set collaborative treatment goals; address SUDs concurrently with other psychological problems; and interweave motivational, cognitive-behavioral, and other interventions, tailored to each individual's needs. Reproducible forms and handouts can be downloaded and printed in a convenient 8 1/2" x 11" size.
New to This Edition
*Chapter on evidence-based principles and interventions.
*Chapter on moderation-focused alcohol treatment.
*Revised throughout with current data, clinical techniques, and examples.
*Reflects over 15 years of important changes in the field--increased demand for integrated treatment, the ongoing opioid crisis, the growth of harm reduction and medication-assisted treatments, and more.
Table of Contents
I. Basic Issues and Perspectives
1. Why Treat Alcohol and Drug Problems in Psychotherapy Practice?
2. Clinical Course, Definition, and Diagnosis of Substance Use Disorders
3. Pharmacology of Psychoactive Substances
4. Addressing Concurrent Psychiatric and Substance Use Disorders
5. Ingredients of the Integrated Approach: Doing What Works
6. The Place of Evidence-Based Principles and Interventions
7. The Role of Medication
II. Clinical Strategies and Techniques
8. Clinical Assessment
9. Treatment Planning: Meeting Patients Where They Are
10. Abstinence Strategies
11. Maintaining Positive Gains
12. Moderation and Harm Reduction Strategies for Alcohol Problems
13. Psychotherapy in Ongoing and Later Stage Recovery
14. Facilitating Participation in Mutual-Help Programs
Appendix 1: New Patient Questionnaire
Appendix 2: 10 Tips for Cutting Down on Your Drinking
Appendix 3: Inventory of “Triggers” for Alcohol and Drug Use
Appendix 4: Preparing to Go Off Antabuse
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.
"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 non-stigmatizing 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 masters- 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-