Chemical Dependency Counseling 7/e

Robert R. Perkinson is the clinical director of Keystone Treatment Center in Canton, South Dakota. He is a licensed psychologist; licensed marriage & family therapist; internationally certified alcohol and drug counselor; South Dakota certified chemical dependency counselor, Level III; and a nationally certified gambling counselor and supervisor. His specialty areas focus on treating alcoholics, addicts, and pathological gamblers. He is the author of Chemical Dependency Counseling: A Practical Guide (2nd ed.) (2003a), which is the leading treatment manual in the world for chemical dependency counselors. With Dr. Arthur E. Jongsma Jr. (2001) he is the coauthor of The Addiction Treatment Planner, which is the best-selling treatment planner and computer software program for mental health and addiction professionals. He has also written The Alcoholism and Drug Abuse Patient Workbook (2003c) and the Gambling Addiction Patient Workbook (2003b). These workbooks have all of the exercises patients need to enter a stable recovery. His book entitled Treating Alcoholism: How to Help Your Clients Enter Recovery (2004) trains professionals how to treat patients with alcohol problems. He is the author of the book God Talks to You (2000) and the meditation tape A Communication from God (2008) by cdbaby, which help addicts make their first conscious contact with a Higher Power of their own understanding. He is a composer and has completed his second CD, Peace Will Come, music that helps addicts learn the essentials of a spiritual journey. With Dr. Jean LaCour (2004), he wrote the Faith-Based Addiction Curriculum to teach professionals of faith how to treat addiction. Dr. Perkinson is an international motivational speaker and regular contributor to numerous professional journals. He is the webmaster of several web pages, including www.robertperkinson.com, www.alcoholismtreatment.org, and www.godtalkstoyou.com, where he gets over 2.6 million hits a year and answers questions on addiction for free. His biographies can be found in Who's Who in America, Who's Who in Medicine and Healthcare, Who's Who in Science and Engineering, and Who's Who in the World.

Preface Acknowledgments Chapter 1: First Contact Treatment Works The Motivational Interview How to Assess Motivation Chapter 2: First Hours of Treatment The First Hours How to Greet Clients Beginning the Therapeutic Alliance Dealing With Early Denial How to Check for Organic Brain Dysfunction The Initial Assessment How to Conduct a Crisis Intervention American Society of Addiction Medicine Patient Placement Criteria Diagnostic and Statistical Manual How to Determine the Level of Care Needed Criteria for Outpatient Treatment (Adults) Criteria for Outpatient Treatment (Adolescents) Criteria for Inpatient Treatment (Adolescents) The Client's Reaction to Intoxication What to Do with an Intoxicated Client How Clients React in Detoxification The AMA Threat How to Develop and Use the AMA Team How to Use the In-House Intervention How to Respond to Clients Who Leave AMA Chapter 3: Biopsychosocial Interview The Biopsychosocial Interview How to Conduct the Interview A Sample Biopsychosocial Interview The Problem List Chapter 4: Treatment Plan How to Build a Treatment Plan The Diagnostic Summary Goals and Objectives How to Develop Goals How to Develop Objectives How to Develop Interventions How to Evaluate the Effectiveness of Treatment How to Select Goals, Objectives, and Interventions Treatment Plan Review Documentation How to Write Progress Notes Formal Treatment Plan Review Chapter 5: Individual Treatment The Therapeutic Alliance How to Develop a Therapeutic Alliance How to Be Reinforcing How to Use Empathy Transference and Countertransference Examples of Empathic Statements How to Be Confrontive Behavior Therapy When a Client Breaks a Rule Why We Concentrate on Behavior Therapy Cognitive Therapy Interpersonal Therapy How to Choose the Therapeutic Modality Chapter 6: Group Therapy Benefits of the Group Process Preparation for the Group The Agenda Group The Honesty Group How to End Each Group The Euphoric Recall Group The Reading Group The Relapse Prevention Group Spirituality Group Childhood Group Men's Group/Women's Group Community Group Personal Inventory Group Skills Training Group Problem-Solving Skills Group Chapter 7: Drugs of Abuse Drugs of Abuse Alcohol Alcohol-Induced Organic Mental Disorders Opioids Hallucinogens Cannabis Inhalants Nicotine Club Drugs Polysubstance Treatment Outcome Chapter 8: Recovery Skills The Chemical Use History Honesty Love, Trust, and Commitment Feelings Relationship Skills Addictive Relationships Communication Skills Self-Discipline Impulse Control Relapse Prevention Stress Management Chapter 9: Steps The Committee Step One Step Two Step Three Step Four Step Five Step Six Step Seven Step Eight Step Nine Step Ten Step Eleven Step Twelve Chapter 10: Lectures The Disease Concept Defense Mechanisms The Great Lie Normal Development Physical Addiction and Recovery Alcoholics Anonymous Meetings Feelings Chapter 11: Special Problems The Psychiatric/Psychological Assessment How to Develop the Treatment Plan The Depressed Client The Angry Client Personality Antisocial Personality The Borderline Client The Narcissistic Client The Anxious Client Post-Traumatic Stress Disorder Panic Attacks The Psychotic Client Acquired Immune Deficiency Syndrome The Client with Low Intellectual Functioning The Client Who Cannot Read The Elderly Client The Client with Early Childhood Trauma Love in the Treatment Center The Pathological Gambler Chapter 12: Adolescent Treatment The Normal Adolescent Puberty Ages 13 to 16 Ages 16 to 19 The Adolescent Chemical Dependency Counselor The Point System The Primary Elements in Adolescent Treatment The Rules Communication Skills Honesty Exercise Fun in Sobriety The Reinforcers Spirituality Group Therapy Peer Pressure Continuing Education Continuing Care The Parents Support Group The Behavioral Contract Phases of Adolescent Treatment Chapter 13: The Family Program The First Family Contact How to Handle the Early "Against Medical Advice" Risk Common Family Problems How to Treat Family Members The Family Program Schedule How to Work with the Family in Group The Conjoint Session Chapter 14: The Clinical Staff The Physician/Addictionologist The Psychologist/Psychiatrist The Social Worker/Mental Health Counselor The Nurse The Clinical Director The Clinical Supervisor The Chemical Dependency Counselor The Rehabilitation Technician or Aide The Recreational Therapist Clinical Staffing Team Building Commitment to Coworkers Boundaries Staff-Client Problems What to Do When a Client Does Not Like a Counselor What to Do When a Client Complains About a Rule The Work Environment Chapter 15: Discharge Summary and Continuing Care Outpatient Discharge Criteria Inpatient Discharge Criteria How to Develop a Discharge Summary The Discharge Summary Saying Good-Bye Chapter 16: The Good Counselor Good Counselors Are Caring Good Counselors Love Their Work Good Counselors Do Not Become Overly Involved Good Counselors Do Not Lie Good Counselors Are Gentle Good Counselors Like Themselves Good Counselors Are Supersensitive Good Counselors Have a Sixth Sense Good Counselors Do Not Become Overly Emotional Good Counselors Are Active Listeners Good Counselors Do Not Talk Too Much Good Counselors Maintain Boundaries Good Counselors Are Client-Centered Good Counselors Have Effective Relationship Skills Good Counselors Have a Sound Code of Ethics Appendix 1: Short Michigan Alcoholism Screening Test (SMAST) Appendix 2: AUDIT Questionnaire Appendix 3: The CRAFFT INTERVIEW (version 2.1) Appendix 4: Biopsychosocial Assessment Appendix 5: Rethinking Drinking Appendix 6: Alcohol Withdrawal Scale Appendix 7: Clinical Opiate Withdrawal Scale (COWS) Appendix 8: DSM-5-TR Psychoactive Substance Use Disorder Appendix 9: Daily Craving Record Appendix 10: Sample Biopsychosocial Interview Appendix 11: Hamilton Depression Rating Scale Appendix 12: Step One Appendix 13: Personal Recovery Plan Appendix 14: Feelings Appendix 15: Chemical Use History Appendix 16: Relapse Prevention Appendix 17: Codependency Appendix 18: Anger Management Appendix 19: Stress Management Appendix 20: Relationship Skills Appendix 21: Honesty Appendix 22: Love, Trust, and Commitment Appendix 23: Barriers in Thinking Appendix 24: Self-Discipline Appendix 25: Communication Skills Appendix 26: Drug Categories for Substances of Abuse Appendix 27: Heroin Appendix 28: National Cancer Institute Guide to Quitting Smoking Appendix 29: Drug Abuse Screening Test Appendix 30: Impulse Control Appendix 31: Addictive Relationships Appendix 32: Alcohol Abstinence Self-Efficacy Scale Appendix 33: Step Two Appendix 34: Step Three Appendix 35: Step Four Appendix 36: Step Five Appendix 37: Psychotherapeutic Medications Appendix 38: Narcissism Appendix 39: Hamilton Anxiety Rating Scale Appendix 40: Post-traumatic Stress Disorder (PTSD) Checklist Civilian Version Appendix 41: Post-traumatic Stress Disorder (PTSD) Checklist Military Version Appendix 42: Gambling History Appendix 43: Pressure Relief Group Meeting and Budget Form Appendix 44: Honesty for Gamblers Appendix 45: Step One for Gamblers Appendix 46: Step Two for Gamblers Appendix 47: Step Three for Gamblers Appendix 48: Step Four for Gamblers Appendix 49: Step Five for Gamblers Appendix 50: Relapse Prevention for Gamblers Appendix 51: Adolescent Unit Level System Appendix 52: Adolescent Unit Point System Appendix 53: Peer Pressure Appendix 54: The Behavioral Contract Appendix 55: Family Questionnaire Appendix 56: Sample Discharge Summary Appendix 57: NAADAC Code of Ethics 2025 Appendix 58: Fagerstroem Test for Cigarette Dependence Appendix 59: Diagnostic/Integrated Summary Appendix 60: Mental Health Screening Appendix 61: Adult Nurses Intake Appendix 62: Adolescent Nurses Intake Appendix 63: Adult Inpatient Program Schedule Appendix 64: Adolescent Inpatient Program Schedule Appendix 65: Gambling Inpatient Program Schedule Appendix 66: Adult Outpatient Program Schedule Appendix 67: Adolescent Outpatient Program Schedule Appendix 68: Gambling Outpatient Program Schedule Appendix 69: Day Treatment Schedule Program Appendix 70: Strengths, Needs, Abilities, and Preferences Appendix 71: Finding Your Ace Score About the Author References

In Chemical Dependency Counseling, Dr. Perkinson has given the addictions counseling profession an exceptional foundational text. Students and experienced professionals will find resources that are clinically sound and practice relevant. CDC continues to be welcomed in my classroom and "heavily borrowed" by my colleagues. -- Don P. Osborn The addiction field has long needed a comprehensive set of exercises counselors can use to guide patients through good treatment. The books developed by Dr. Perkinson take the patient from the beginning of treatment to the end. They are written in such a manner that Dr. Perkinson is your mentor and is conversing with you, sharing with you his vast area of expertise and knowledge about recovery. These patient exercises meet the highest standards demanded by accrediting bodies. -- Dr. Bob Carr I have been working with compulsive gamblers and their family members for 12 years and find this work extremely rewarding and challenging. I have been utilizing Dr. Perkinson's books for 10 years and have found them to be some of the most useful tools in helping addicts and gamblers identify the many ways that addiction has impacted their lives. Our clients benefit from the straightforward approach and the clear instructions of how to begin incorporating a 12-step recovery program into their lives. I highly recommend Dr. Perkinson's books. -- Lisa Vig I have been in the chemical dependency field for over 30 years. I have worked as a counselor, clinical supervisor, and executive director in a number of treatment centers. These are the best exercises for alcoholics, drug addicts, and problem gamblers that I have ever seen. I have used them for years, and patients find them easy to understand. The material covers everything an addict needs to know to enter a stable recovery. I highly recommend this book and patient handbooks. Staff and patients love them, and they make the counselor's job easy. The book makes the job easy as all you will need to help your patient is in one place. -- Bob Bogue Dr. Perkinson does an excellent job of bringing together and individualizing 12-step treatment for addicts and gamblers, including identifying character defects and relapse prevention. Comments from patients include, "It has opened my eyes to my gambling and behaviors associated with it" and "I feel it is easy to work and very self-explanatory." -- Ron Scherr An excellent reference for introducing new chemical/substance dependency practitioners to the structure of treatment programs. The expanded version of the original text is loaded with useful tools for treatment professionals and others in related disciplines. -- Gerald Schneck Truly the nuts and bolts of alcohol and drug treatment. The information provided is superbly researched and put in a language that is eminently readable by anyone, including an entry-level counselor. -- Nancy Waite O'Brien