Counseling Addicted Families: An Integrated Assessment and Treatment Model

341 Pages·2019·25.212 MB·English

by  Gerald A. Juhnke, W. Bryce Hagedorn

Counseling Addicted

Families
Counseling Addicted Families, Second Edition, is an up-t o- date treatment manual that
fosters lasting change for families dealing with addiction and addictive disorders.
Focused around the clinically esteemed Sequential Family Addictions Model, the book
guides counselors through the principles of how to “progressively sequence” a client
family during their change process, and explores how family counseling theories and
interventions can be applied in treatment settings. This second edition aligns with the
DSM- 5 Substance Use Disorder criteria and terminology and includes new sections
on neuroscience and cutting- edge drug detection assessment methods.
Both experienced and entry-l evel counselors will appreciate how the Model improves
their clinical skills and knowledge to address the idiosyncratic needs of each indi-
vidual family system and create healthy systemic change.
Gerald A. Juhnke, Ed.D., is a Licensed Professional Counselor and certified as a
Master Addictions Counselor through the National Board for Certified Counselors.
Dr. Juhnke was the founding director of the Counseling Doctoral Program at
The University of Texas, San Antonio. He is a past president of the International
Association of Addictions and Offender Counselors, past Editor-I n- Chief of the
Journal of Addictions & Offender Counseling, and a Fellow of the American Counseling
Association.
W. Bryce Hagedorn, Ph.D., is a Fellow of the American Counseling Association and
currently serves as a professor and program director of Counselor Education at the
University of Central Florida. In addition to his work at the university, Dr. Hagedorn
is a Licensed Mental Health Counselor, a National Certified Counselor and a Master
Addictions Counselor through the National Board for Certified Counselors, and a
Qualified Clinical Supervisor for the state of Florida. Dr. Hagedorn is the past presi-
dent of the Association for Spiritual, Ethical, and Religious Issues in Counseling.
This book is an essential resource for counselors and other helping
professionals who work with clients addressing issues related to
substance abuse and addiction. The current revision provides the most
up- to- date information regarding diagnosis and intervention strategies.
Highly recommended!
Brian S. Canfield, Ed.D. LPC, LMFT, licensed psychologist;
Master Addiction Counselor; Fellow and past president,
the American Counseling Association
This important second edition contains valuable evidence-b ased tools
that counselors and addiction specialists will find extremely helpful in
any clinical setting. Counselors have long known the major significance
of caring for the whole family and this new edition addresses important
needs with practical family interventions and key counseling tools that
guide families toward achieving recovery. Juhnke and Hagedorn provide
our field with answers to the myriad challenges of successfully treating
the devastating family health complications arising from addiction.
Laura Veach, PhD, LPC, LCAS, CCS, program director,
Addiction Research and Clinical Health M.S. Degree,
Bowman Gray Biomedical Campus, Wake Forest
Graduate School of Arts & Sciences
Counseling Addicted

Families
A Sequential Assessment
and Treatment Model
Second edition
GERALD A. JUHNKE AND W. BRYCE HAGEDORN
Second edition published 2020
by Routledge
52 Vanderbilt Avenue, New York, NY 10017
and by Routledge
2 Park Square, Milton Park, Abingdon, Oxon, OX14 4RN
Routledge is an imprint of the Taylor & Francis Group, an informa business
© 2020 Taylor & Francis
The right of Gerald A. Juhnke and W. Bryce Hagedorn to be identified
as authors of this work has been asserted by them in accordance with
sections 77 and 78 of the Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this book may be reprinted or reproduced or
utilised in any form or by any electronic, mechanical, or other means, now
known or hereafter invented, including photocopying and recording, or in
any information storage or retrieval system, without permission in writing
from the publishers.
Trademark notice: Product or corporate names may be trademarks or
registered trademarks, and are used only for identification and explanation
without intent to infringe.
First edition published by Routledge 2006
Library of Congress Cataloging- in- Publication Data
A catalog record has been requested for this book
ISBN: 978- 1- 138- 77974- 7 (hbk)
ISBN: 978- 1- 138- 77975- 4 (pbk)
ISBN: 978- 1- 315- 77107- 6 (ebk)
Typeset in Dante and Avenir
by Newgen Publishing UK
Contents

Preface ix
1 What Is Addiction? 1
Learning Objectives 1
Introduction 1
Addiction— A Working Definition 2
Addiction and Neuroscience 15
Including the Family: Stories of Impacted Families 19
Conclusion 29
Skill Builder 29
Skill Builder Responses 32
2 Helping Clients and Families Understand
Addictions: Etiological Theories and Models 39
Learning Objectives 39
Introduction 39
Theory, Theory, Theory … Why Can’t We Just Wing It? 41
Moving from Moral to Multifaceted—A Discussion of Addiction
Theories 45
Conclusion 89
Skill Builder 92
Skill Builder Responses 93
vi Contents
3 Key Family Counseling Constructs and Assessment Strategies 103
Learning Objectives 103
Introduction 103
What Is Family Counseling? 105
Common Family Counseling Terms and Constructs 106
The Clinical Family Addictions Assessment 113
Drug Detection Testing and Specialty Assessment Instruments 136
Conclusion 150
Skill Builder 150
Skill Builder Responses 152
4 The Sequential Family Addictions Model: Setting the Stage
for a New Approach to Working with Addicted Families 156
Learning Objectives 156
Introduction 156
Let’s Talk about Change 159
The Sequential Family Addictions Model: An Overview 167
Conclusion 169
Skill Builder 170
Skill Builder Responses 171
5 The Sequential Family Addictions Model: Motivational
Interviewing and Solution Focused Family Therapy 174
Learning Objectives 174
Introduction 174
Stage One: Motivational Interviewing 175
Stage Two: Solution- Focused Family Therapy 192
Conclusion 204
Skill Builder 205
Skill Builder Responses 207
6 The Sequential Family Addictions Model: Structural Family
Counseling and Cognitive Behavioral Family Therapy 210
Learning Objectives 210
Introduction 210
Stage Three: Structural Family Counseling 211
Stage Four: Cognitive- Behavioral Family Therapy 226
Conclusion 240
Skill Builder 240
Skill Builder Responses 242
Contents vii
7 The Sequential Family Addictions Model: Extended Family
Systems, Modified Intergenerational Family- of- Origin
Therapy and Object Relations Family Therapy 246
Learning Objectives 246
Introduction 247
Why These Theories Work in Action, Maintenance, and Relapse 247
Stage Five: Extended Family Systems Counseling 249
Stage Six: Modified Intergenerational Family- of- Origin Therapy 261
Stage Seven: Psychodynamic Object Relations Family Therapy 270
Conclusion 277
Skill Builder 278
Skill Builder Responses 279
8 Special Topics in Counseling Addicted Families: Counseling
Non- Addicted Family Members, Social Justice, Suicide
Assessment, and Forgiveness 283
Learning Objectives 283
Introduction 284
Counseling Non- Addicted Family Members 284
Social Justice 292
Suicide Assessment 296
Forgiveness 309
Conclusion 316
Skill Builder 317
Skill Builder Responses 319
Index 324

Preface

Welcome to this second edition of a widely successful family addictions book.
You are joining hundreds of experienced and beginning counselors who have
successfully utilized this book to increase their family addictions counseling
knowledge and skills. The book has been updated based upon former reader’s
ideas and input. Some of these changes include updates to more closely align
with the DSM- 5 Substance Use Disorder criteria, updates related to drug
detection testing and language, and clinical vignette updates based upon the
preponderance of substance using clients and families we have counseled.
These updates make the book even easier to comprehend.
Our intent in authoring this book is to provide readers with a practical,
clinically based family addictions model that works. Since the early 1990s
we have trained our master’s and doctoral students in the Sequential Family
Addictions Model. They have successfully utilized the model and have noted
its utility with their addicted family clients. Based upon self-r eport of master’s
students, experienced doctoral students, clinical supervisees, and readers like
you, the model is relatively simple to follow and— most important— effective.
Its practical applications provide both brief and long- term treatment options
that match individual family needs no matter the family’s position on the
addictions continuum.
Moreover, the book was written to be used in two distinct ways. First as a
treatment manual, the book provides more experienced counselors a means to
increase their current clinical knowledge and augment their clinical acumen.
For example, less experienced counselors seeking greater understanding of
addictions and desiring effective family substance use interventions will find