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TIP 39 Substance Abuse Treatment And Family Therapy PDF

260 Pages·2012·2.56 MB·English
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Substance Abuse Treatment And Family Therapy A Treatment Improvement Protocol TIP 39 Substance Abuse Treatment And Family Therapy A Treatment  Improvement  Protocol TIP 39 U.S.  DEPARTMENT  OF  HEALTH  AND  HUMAN  SERVICES Substance  Abuse  and  Mental  Health  Services  Administration Center  for  Substance  Abuse  Treatment 1  Choke  Cherry  Road Rockville,  MD  20857 Acknowledgments Electronic Access and Printed Copies This publication was produced under the Knowledge Application Program (KAP) This publication may be ordered from or Contract, number 270-99-7072 with the downloaded from SAMHSA’s Publications Substance Abuse and Mental Health Services Ordering Web page at Administration (SAMHSA), U.S. Department http://store.samhsa.gov. Or, please call of Health and Human Services (HHS). Karl SAMHSA at 1-877-SAMHSA-7 (1-877-726- D. White, Ed.D., and Andrea Kopstein, 4727) (English and Español). Ph.D., M.P.H., served as the Center for Substance Abuse Treatment (CSAT) Government Project Officers. Christina Recommended Citation Currier served as the CSAT TIPs Task Center for Substance Abuse Treatment. Leader. Substance Abuse Treatment and Family Therapy. Treatment Improvement Protocol Disclaimer (TIP) Series, No. 39. HHS Publication No. (SMA) 15-4219. Rockville, MD: Substance The opinions expressed herein are the views Abuse and Mental Health Services of the consensus panel members and do not Administration, 2004. necessarily reflect the official position of SAMHSA or HHS. No official support of or endorsement by SAMHSA or HHS for these Originating Office opinions or for the instruments or resources Quality Improvement and Workforce described are intended or should be inferred. Development Branch, Division of Services The guidelines presented should not be con- Improvement, Center for Substance Abuse sidered substitutes for individualized client Treatment, Substance Abuse and Mental care and treatment decisions. Health Services Administration, 1 Choke Cherry Road, Rockville, MD 20857. Public Domain Notice All materials appearing in this volume except HHS Publication No. (SMA) 15-4219 those taken directly from copyrighted sources Printed 2004 are in the public domain and may be repro- Revised 2005, 2006, 2008, 2009, 2010, 2012, duced or copied without permission from 2014, and 2015 SAMHSA or the authors. Citation of the source is appreciated. However, this publica- tion may not be reproduced or distributed for a fee without the specific, written authorization of the Office of Communications, SAMHSA, HHS. ii Contents Contents What Is a TIP?............................................................................................................vii  Consensus Panel...........................................................................................................ix KAP Expert Panel and Federal Government Participants ....................................................xi Foreword ..................................................................................................................xiii Executive Summary .....................................................................................................xv  Chapter 1—Substance Abuse Treatment and Family Therapy................................................1 Overview......................................................................................................................1 Introduction .................................................................................................................1 What Is a Family? ..........................................................................................................2 What Is Family Therapy?.................................................................................................4 Family Therapy in Substance Abuse Treatment .....................................................................8 Goals of This TIP .........................................................................................................18 Chapter 2—Impact of Substance Abuse on Families ..........................................................21 Overview ....................................................................................................................21 Introduction ................................................................................................................21 Families With a Member Who Abuses Substances .................................................................23 Other Treatment Issues ..................................................................................................28 Chapter 3—Approaches to Therapy................................................................................31 Overview ....................................................................................................................31 Differences in Theory and Practice ...................................................................................31 Family Therapy for Substance Abuse Counselors .................................................................49 Substance Abuse Treatment for Family Therapists................................................................64 Chapter 4—Integrated Models for Treating Family Members...............................................73 Overview ....................................................................................................................73 Integrated Substance Abuse Treatment and Family Therapy ...................................................73 Integrated Models for Substance Abuse Treatment................................................................85 Matching Therapeutic Techniques to Levels of Recovery.......................................................105 Chapter 5—Specific Populations ..................................................................................109 Overview...................................................................................................................109 Introduction ..............................................................................................................109 Age ..........................................................................................................................110 Women .....................................................................................................................114 Race and Ethnicity ......................................................................................................116 Sexual Orientation.......................................................................................................130 People With Physical or Cognitive Disabilities....................................................................131 People With Co­Occurring Substance Abuse and Mental Disorders .........................................136 Rural Populations .......................................................................................................138 Other Contextual Factors ..............................................................................................141 iii Chapter 6—Policy and Program Issues .........................................................................147 Overview...................................................................................................................147 Primary Policy Concerns ..............................................................................................147 Program Planning Models .............................................................................................149 Other Program Considerations .......................................................................................160 Directions for Future Research.......................................................................................161 Appendix A: Bibliography ...........................................................................................165 Appendix B: Glossary.................................................................................................191 Appendix C: Guidelines for Assessing Violence................................................................195 Appendix D: Resources ..............................................................................................199 Appendix E: Resource Panel .......................................................................................203 Appendix F: Cultural Competency and Diversity Network Participants................................205 Appendix G: Field Reviewers.......................................................................................207 Appendix H: Acknowledgments....................................................................................209 Index ......................................................................................................................211 CSAT TIPs and Publications........................................................................................231 iv Contents Figures  3­1 Overview of Key Elements for Inclusion in Assessment ......................................................39 3­2 Basic Symbols Used in Genograms ...............................................................................42 3­3 Eugene O’Neill Genogram ..........................................................................................43 3­4 Individual, Family, and Environmental Systems ..............................................................56 4­1 Facets of Program Integration.....................................................................................74 4­2 Levels of Counselor Involvement With Families ...............................................................80 4­3 Techniques To Help Families Attain Sobriety ................................................................103 4­4 Techniques To Help Families Adjust to Sobriety.............................................................104 4­5 Techniques To Help Families in Long­Term Maintenance .................................................106 Contents v What Is a TIP? Treatment Improvement Protocols (TIPs) are developed by the Substance Abuse and Mental Health Services Administration (SAMHSA) within the U.S. Department of Health and Human Services (HHS). Each TIP involves the development of topic-specific best-practice guidelines for the prevention and treatment of substance use and mental disorders. TIPs draw on the experience and knowledge of clinical, research, and administrative experts of various forms of treatment and prevention. TIPs are distributed to facilities and individuals across the country. Published TIPs can be accessed via the Internet at http://store.samhsa.gov. Although each consensus-based TIP strives to include an evidence base for the practices it recommends, SAMHSA recognizes that behavioral health is continually evolving, and research frequently lags behind the innovations pioneered in the field. A major goal of each TIP is to convey "front-line" information quickly but responsibly. If research supports a particular approach, citations are provided. When no citation is provid- ed, the information is based on the collective clinical knowledge and experience of the consensus panel. vii viii Consensus  Panel Note:  The  information  given  indicates  each  participant's  affiliation  during  the  time  the  panel was  convened  and  may  no  longer  reflect  the  individual's  current  affiliation. Chair Daniel  Santisteban,  Ph.D.  Research  Associate  Professor  Edward  Kaufman,  M.D.  University  of  Miami  Editor  in  Chief  School  of  Medicine  American  Journal  of  Drug  and  Alcohol  Abuse  Miami,  Florida Dana  Point,  California Carol  Shapiro,  M.S.W.  Executive  Director  Co­Chair Family  Justice  Center  Marianne  R.  M.  Yoshioka,  M.S.W.,  Ph.D.  New  York,  New  York Associate  Professor  Columbia  University Panelists  School  of  Social  Work  New  York,  New  York Fred  U.  Andes,  D.S.W.,  M.S.W.,  M.P.A.,  LCSW  Assistant  Professor  of  Sociology  Workgroup  Leaders New  Jersey  City  University  Mary  M.  Gillespie,  Psy.D.,  CASAC  Jersey  City,  New  Jersey Professor  Hudson  Valley  Community  College  Paul  Curtin,  M.A.,  CAC,  NCAC  II  Saratoga  Springs,  New  York President  Alcohol  Services,  Inc.  Gloria  Grijalva­Gonzales  Syracuse,  New  York Certified  Sr.  Substance  Abuse  Case  Manager/Counselor  Jo­Ann  Krestan,  M.A.,  MFT,  LADC  San  Joaquin  County  –  Office  of  Substance  Family  Therapist/Writer  Abuse Private  Practice  Allies  Project  Surry,  Maine Stockton,  California Eric  E.  McCollum,  Ph.D.,  LCSW,  LMFT  I. Andrew Hamid, Ph.D., M.S.W., MFT, CSW  Professor  and  Clinical  Director  Professor  Virginia  Tech  Falls  Church  Columbia  University  Marriage  and  Family  Therapy  Program  School  of  Social  Work  Falls  Church,  Virginia New  York,  New  York Margaret  McMahon,  M.T.S.,  M.S.,  M.S.W. David  Rosenthal,  Ph.D.  Clinician Executive  Director Licensed  Certified  Social  Worker  Lower  East  Side  Harm  Reduction  Center Private  Practice  New  York,  New  York Washington,  DC ix

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Substance Abuse Treatment. And Family Therapy. A Treatment. Improvement. Protocol. TIP. 39. U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. Substance Abuse and Mental Health Services Administration. Center for Substance Abuse Treatment. 1 Choke Cherry Road. Rockville, MD 20857
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Most books are stored in the elastic cloud where traffic is expensive. For this reason, we have a limit on daily download.