Introduction to Chemical Dependency Counseling / Edition 1

by Jerome D. Levin, Joseph Culkin, Richard S. Perrotto

Overview

This book is a basic resource of knowledge about alcoholism and drug addiction. The authors cover the scientific and clinical aspects of chemical dependency in a balanced way with case vignettes to illustrate clinical issues.

The book is suitable for a number of student needs. Students preparing for the Certified Alcoholism and Substance Abuse Counselor (CASAC) examination will find topics discussed that are drawn from the certification examination requirements. The text can stand as a main source for college-level courses in addictions or chemical dependancy in the mental health health programs, and can be used as a college or stand-alone introduction to chemical dependancy and counseling. Psychologists, social workers, clergy, and other professional counselors who wish to supplement their knowledge about chemical dependancy will find this text serves as a valuable reference.

After an introduction to the general problems of substance abuse counseling, the authors delineate the different types of drugs and their effects, organize the relevant information used in the assessment and diagnosis of addictions, integrate knowledge of human development with causes of dependancy and addiction, and explore the impact of addiction on health and the family. They then focus on the principles of chemical abuse counseling, including treatment planning, the different schools of counseling, how to understand and manage relapse, and special populations. They conclude with ethical considerations involved in treating chemical abusers.

The authors believe that chemical dependency counseling is the only profession that treats substance abuse as a primary disorder and disease with its own causes, course, progression and complication. Chemical dependency counseling must deal with and absorb a complex and intriguing web of fact and theory drawn from sciences, medicine, and other fields. But the practical side of chemical dependency counseling remains an art and a science. This book offers a whole set of specific techniques

Product Details

ISBN-13:	9780765702890
Publisher:	Aronson, Jason Inc.
Publication date:	03/01/2002
Series:	Library of Substance Abuse Treatment
Edition description:	New Edition
Pages:	391
Product dimensions:	7.26(w) x 10.20(h) x 1.17(d)

About the Author

Jerome D. Levin, Ph.D., is director of the Alcoholism and Substance Abuse Counselor Training Program at the New School University in Manhattan, where he also serves both on the humanities department faculty, and as co-director of the joint masters program in psychology and substance abuse treatment. Joseph Culkin, Ph.D., is professor of psychology in the Department of Social Sciences of Queensborough Community College/The City University of New York. Richard S. Perrotto, Ph.D., is professor of psychology in the Department of Social Sciences at Queensborough Community College/The City University of New York, where he has taught since 1978.

Table of Contents

	Preface	xiii
1	Introduction to Chemical Dependency Counseling	1
1-1	The Scope of Chemical Dependency Counseling	2
	What Is Chemical Dependency Counseling?	2
	Chemical Dependency Counseling and Other Health Professions	5
1-2	History of Chemical Dependency Counseling	7
	Early Figures and Movements	8
	Alcoholics Anonymous and the Twelve-Step Movement	9
	The Peer Counseling Movement and Professionalization	12
	Employee Assistance Programs	13
	Therapeutic Communities	14
1-3	Professional Counseling and Chemical Dependency	15
	Education and Certification	15
	Employment Opportunities	16
2	Psychoactive Drugs	19
2-1	Psychoactive Drugs and the Nervous System	20
	Electrical and Chemical Events in Neurons	21
	How Psychoactive Drugs Affect Neurons and the Synapse	21
	Types of Neurotransmitters	22
2-2	Depressants	23
	Alcohol	23
	Barbiturates And Other Sedative-Hypnotics	25
	Benzodiazepines	25
	Mechanisms of Action	26
2-3	Opioids	26
	Morphine and Other Prescription Opioids	26
	Heroin	26
	Methadone	27
	Mechanisms of Action	28
2-4	Stimulants	28
	Cocaine	28
	Amphetamines	29
	Mechanisms of Action	30
2-5	Hallucinogens	30
	Lysergic Acid Diethylamide	31
	Phencyclidine	31
	Mechanisms of Action	32
2-6	Cannabinoids	32
	Marijuana and Hashish	32
	Mechanisms of Action	33
2-7	Inhalants	34
	Types of Inhalants	34
	Psychoactive Effects and Mechanisms of Action	34
3	The Assessment of Chemical Dependency	37
3-1	The Clinical Interview	38
	Underreporting of Drug Use	38
	Types of Interviews	38
	Interview Strategies	39
3-2	Substance Abuse Assessment Instruments	42
	Screening Instruments	42
	Structured Interview Schedules	44
	Assessment of Motivation for Change	46
3-3	Psychological Testing	47
	Characteristics of Psychological Tests	47
	Self-Report Inventories	48
	Projective Tests	49
	Intelligence and Neuropsychological Tests	50
3-4	Laboratory Analysis	51
	History and Rationale of Drug Testing	51
	Drugs Tested and Characteristics of Drug-Testing Methods	52
	Types of Biological Specimens Analyzed	53
4	Diagnosis and Types of Chemical Dependency	57
4-1	The Scope of Psychoactive Drug Use	58
	Epidemiology of Psychoactive Drug Use	58
	The National Household Survey	58
	The Monitoring the Future Study	59
4-2	The Diagnosis of Substance-Related Disorders	61
	Substance-Related Disorders and the DSM-IV	61
	Substance Abuse	62
	Substance Dependence	64
	Substance Withdrawal	66
4-3	The Course of Substance Abuse and Dependence	68
	General Trends	68
	The Course of Alcohol and Drug Dependence	69
4-4	Types of Alcoholism	70
	Early Views of Alcoholism Types	70
	The Type 1-Type 2 Model	71
	A Biopsychosocial Model	72
	The Type A-Type B Model	73
	Alcoholism Types: An Integration	73
5	Development and Chemical Dependency	77
5-1	Principles of Human Development	78
	The Developmental Perspective	78
	Developmental Models and Chemical Dependency	81
5-2	Developmental Research	83
	Retrospective Research	83
	The Longitudinal Method	83
	Vulnerability, Risk, and Protection	83
5-3	Drug Use Across the Life Span	87
	Childhood	87
	Adolescence	89
	Adulthood	92
6	Causes of Chemical Dependency	97
6-1	Biology of Chemical Dependency	98
	The Disease Model of Chemical Dependency	98
	Hereditary Influences	99
	Neurophysiology of Addiction	101
6-2	Personality and Chemical Dependency	103
	Psychodynamic Views	103
	Personality Traits	104
6-3	Learning and Chemical Dependency	106
	Classical Conditioning	107
	Operant Conditioning	107
6-4	Cognitive Influences on Chemical Dependency	109
	Social Learning and Social Cognitive Theory	109
	Expectancy Theory	111
6-5	Motivation and Emotion	112
	Tension and Stress Reduction	112
6-6	Sociocultural Influences	114
	The Family	114
	Social Factors	116
7	Chemical Dependency and Physical Health	121
7-1	General Health Risks	122
	Complications Due to Route of Administration	122
	Overdose and Withdrawal	123
7-2	Cardiovascular Disorders	124
	The Heart and Cardiovascular Function	124
	Alcohol and the Cardiovascular System	124
	Cocaine and the Cardiovascular System	126
7-3	Neurological Disorders	126
	Alcohol and Neurological Damage	126
	Cocaine and Neurological Damage	127
7-4	Liver, Gastrointestinal, and Pancreatic Disorders	128
	Liver Disease	128
	Gastrointestinal Disorders	129
	Pancreatic Disorders	130
7-5	Immune System Disorders	130
	The Immune System	130
	AIDS and HIV Infection	131
	Drug Use and AIDS	131
	Sexual Behavior and AIDS	132
	Drug Use, HIV/AIDS, and Tuberculosis	134
7-6	Prenatal Exposure to Drugs	135
	Mechanisms of Prenatal Exposure	135
	Alcohol	136
	Cocaine and Opioids	136
8	Chemical Dependency and Mental Health	139
8-1	What is Mental Health?	140
	Concepts of Mental Health	140
	Drug Use and Mental Disorders	142
8-2	Cognitive and Perceptual Disorders	144
	Delirium	144
	Dementia and Amnesia	145
	Flashbacks	146
8-3	Anxiety Disorders	146
	Types of Anxiety Disorders	146
	Substance Use and Anxiety Disorders	148
8-4	Mood Disorders	149
	Types of Mood Disorders	149
	Substance Use and Mood Disorders	150
8-5	Psychotic Disorders	152
	Schizophrenia	152
	Substance Use and Psychotic Disorders	153
8-6	Personality Disorders	154
	Types of Personality Disorders	154
	Substance Use and Personality Disorders	156
8-7	Impulse Control and Eating Disorders	158
	Impulse Control Disorders	158
	Eating Disorders	159
9	Chemical Dependency and the Family	163
9-1	Substance Abuse as a Family Disease?	164
	Homeostasis	165
	General Systems Theory	166
	The Addicted Family	167
9-2	Major Family Therapy Approaches	169
	Strategic Family Therapy	169
	Structural Family Therapy	172
	Experiential Family Therapy	173
	Intergenerational Systems Therapy	175
	Behavioral Family Therapy	177
	Psychodynamic Family Therapy	177
9-3	Family Counseling Illustrated: The Baker Family	179
	Meeting the Baker Family: Initial Session	179
	Asking Questions and Sorting Issues	182
	Strategic Approach with the Bakers	184
	Structural Approach with the Bakers	185
	Experiential Approach with the Bakers	187
	Intergenerational Systems Approach with the Bakers	188
	Behavioral Approach with the Bakers	192
	Psychodynamic Approach with the Bakers	193
	Substance Abuse Approach with the Bakers	196
10	Chemical Dependency and Society	201
10-1	Social History of Drugs	202
	The Ancient World	202
	The Early Modern World	203
	Eighteenth- and Nineteenth-Century America	204
	The Twentieth Century	205
10-2	The Sociocultural Context of Drug Use	205
	Drugs and Culture	205
	Sociological Perspective on Drug Problems	207
10-3	Economic Impact of Chemical Dependency on Society	208
	The Cost-of-Illness Method	209
	The External Social Cost Model	210
	Educational Attainment	211
10-4	Aggression, Crime, and Chemical Dependency	211
	Aggression, Violence, and Drugs	211
	Chemical Dependency and Crime	212
10-5	Societal Response to Chemical Dependency	213
	Legal and Political Responses	213
	Educational Responses	214
	Health Profession Responses	214
11	Principles of Chemical Dependency Counseling	219
11-1	The Disease Model in Chemical Dependency Counseling	219
	The Course of Chemical Dependency	220
	Phases in Chemical Dependency Treatment	221
11-2	The Professional Counselor's Role and Tasks	223
	Who Is the Chemical Dependency Counselor?	223
	Basic Tasks of Chemical Dependency Counselors	225
11-3	The Counselor's Responsibilities	228
	Therapeutic Responsibilities	229
	Ethical Responsibilities	231
	Professional Development	232
12	Planning, Selecting, and Implementing Treatment	235
12-1	Treatment Goals and General Principles of Treatment	236
	Treatment Goals and Planning Treatment	236
	General Principles of Effective Treatment	237
	Motivation: Treatment Compliance and Involvement	239
12-2	Treatment Settings	240
	Factors That Determine the Choice of Setting	240
	Types of Treatment Settings	241
	Treatment Setting and Effectiveness	243
12-3	Detoxification	244
	General Principles	244
	Medications for Detoxification	244
	Outpatient and Inpatient Detoxification	245
12-4	Pharmacotherapy	246
	Rationale for Pharmacotherapy	246
	Drugs to Decrease the Reinforcing Effects of Abused Substances	246
	Drugs That Discourage the Use of Abused Substances	247
	Agonist Substitution Drugs	248
	Medications to Treat Comorbid Mental Disorders	249
12-5	Self-Help Groups and Psychosocial Treatments	250
	Self-Help Groups	250
	Individual, Group, and Family Therapies	251
	An Evaluation of Individual, Group, and Family Therapies	252
12-6	Manual-Guided and Other Treatment Modalities	253
	Treatments to Enhance Motivation	253
	Cognitive-Behavioral Coping Skills Therapy	254
	Twelve Step Facilitation Therapy	255
	Matching Treatments to Patient Needs	255
13	Counseling Schools and Techniques	261
13-1	Schools of Counseling	262
	Behavioral Counseling	263
	Client-Centered Counseling	264
	Cognitive Counseling	264
	Existential Counseling	265
	Gestalt Counseling	267
	Psychodynamic Counseling	268
	Substance Abuse-Specific Counseling	271
	Counseling Schools and Counseling Techniques	273
13-2	Relationship-Focused Techniques	273
	Establishing Rapport	274
	Active Listening	274
	Confrontation	275
13-3	Emotion-Focused Techniques	276
	Reflection	276
	Affect Labeling	276
	Relaxation Training	277
13-4	Cognition-Focused Techniques	278
	Education	279
	Interpretation	281
	Exploration and Clarification	283
	Making Drink/Drug Signals Conscious	283
13-5	Behavior-Focused Techniques	284
	Direct Guidance	284
	Modeling	What People are Saying About This Dan Gilhooley Drs. Levin, Culkin, and Perrotto are to be commended for writing a clear, straightforward introduction to the very complex, multidisciplinary field of chemical dependency counseling. This book is broad and comprehensive in scope, combing the findings of current scientific research with an evolutionary view of significant theories relating to addiction. The design of the book is 'learner-centered,' making it an excellent choice for college-level introductory courses on the topic. Student learning is targeted in each chapter by an initial statement of learning objectives, while chapters conclude with a summary of the central ideas covered. The text makes frequent and effective use of citations, and the extensive bibliography of current and historically significant work in the field will stimulate student research. This introductory text is so comprehensive that it will become a valued resource to be used again and again by students as they move through the various courses comprising their curriculum. From the B&N Reads Blog Page 1 of Related Subjects Psychology Clinical Psychology Psychological Disorders Counseling - General & Miscellaneous Substance Use & Abuse Psychopathology Dual diagnosis Psychology Clinical Psychology Psychological Disorders Counseling - General & Miscellaneous Substance Use & Abuse Psychopathology Dual diagnosis Editorial Reviews This book is an extremely comprehensive textbook on abstinence-oriented chemical dependency treatment that will serve as a wonderful introduction to the field for students and as a reference for the more experienced mental health clinician. The authors present material on all the important topics in the field of chemical dependency counseling, and discuss cutting edge work on the motivational stages of change, motivational enhancement therapy for clients not prepared to attempt abstinence, and the importance of matching the intervention to the client's motivational state. Not only is this book impressive in its ability to convey the information that clinicians need for working in this challenging area, it is equally able to transmit the authors' excitement and love for the work and their appreciation of its complexity and intellectual and emotional challenges. Andrew Tartarsky PhD As the practice of substance abuse counseling becomes increasingly professionalized with a scientifically grounded base, there is a need for a textbook of high quality. This current text provides a sophisticated presentation of the science and practice of treatment, complemented by the wisdom of clinical experience. Those who study it will be well prepared to embark on their work in clinical care, and those in practice can keep it on hand as a valued reference. Marc Galanter Drs. Levin, Culkin, and Perrotto are to be commended for writing a clear, straightforward introduction to the very complex, multidisciplinary field of chemical dependency counseling. This book is broad and comprehensive in scope, combing the findings of current scientific research with an evolutionary view of significant theories relating to addiction. The design of the book is 'learner-centered,' making it an excellent choice for college-level introductory courses on the topic. Student learning is targeted in each chapter by an initial statement of learning objectives, while chapters conclude with a summary of the central ideas covered. The text makes frequent and effective use of citations, and the extensive bibliography of current and historically significant work in the field will stimulate student research. This introductory text is so comprehensive that it will become a valued resource to be used again and again by students as they move through the various courses comprising their curriculum. Dan Gilhooley This book is an extremely comprehensive textbook on abstinence-oriented chemical dependency treatment that will serve as a wonderful introduction to the field for students and as a reference for the more experienced mental health clinician. The authors present material on all the important topics in the field of chemical dependency counseling, and discuss cutting edge work on the motivational stages of change, motivational enhancement therapy for clients not prepared to attempt abstinence, and the importance of matching the intervention to the client's motivational state. Not only is this book impressive in its ability to convey the information that clinicians need for working in this challenging area, it is equally able to transmit the authors' excitement and love for the work and their appreciation of its complexity and intellectual and emotional challenges. 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