TIP 39 Substance Abuse Treatment And Family Therapy PDF
Preview TIP 39 Substance Abuse Treatment And Family Therapy
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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