This report is based on a rethinking of the concept of motivation, which is redefined here as purposeful, intentional, & positive -- directed toward the person's best interests. This report shows how substance abuse treat. staff can influence change by developing a therapeutic relationship that respects & builds on the client's autonomy & makes the treat. clinician a partner in the change process. Describes motivational interventions that can be used at all stages of the change process, from pre-contemplation & preparation to action & maintenance, & informs readers of the research, results, tools, & assessment instruments related to enhancing motivation.

America had a radically different relationship with drugs a century ago. Drug prohibitions were few, and while alcohol was considered a menace, the public regularly consumed substances that are widely demonized today. Heroin was marketed by Bayer Pharmaceuticals, and marijuana was available as a tincture of cannabis sold by Parke Davis and Company. Exploring how this rather benign relationship with psychoactive drugs was transformed into one of confusion and chaos, The Cult of Pharmacology tells the dramatic story of how, as one legal drug after another fell from grace, new pharmaceutical substances took their place. Whether Valium or OxyContin at the pharmacy, cocaine or meth purchased on the street, or alcohol and tobacco from the corner store, drugs and drug use proliferated in twentieth-century America despite an escalating war on “drugs.” Richard DeGrandpre, a past fellow of the National Institute on Drug Abuse and author of the best-selling book Ritalin Nation, delivers a remarkably original interpretation of drugs by examining the seductive but ill-fated belief that they are chemically predestined to be either good or evil. He argues that the determination to treat the medically sanctioned use of drugs such as Miltown or Seconal separately from the illicit use of substances like heroin or ecstasy has blinded America to how drugs are transformed by the manner in which a culture deals with them. Bringing forth a wealth of scientific research showing the powerful influence of social and psychological factors on how the brain is affected by drugs, DeGrandpre demonstrates that psychoactive substances are not angels or demons irrespective of why, how, or by whom they are used. The Cult of Pharmacology is a bold and necessary new account of America’s complex relationship with drugs.

No matter how committed two people are to being together, why can't they get away from feeling something is missing? In this important and transformative guide, three experienced practitioners identify the widespread dysfunctional dynamic they call "irrelationship," a psychological defense system two people create together to protect themselves from the fear and anxiety of real intimacy in a relationship. Drawing on their wide clinical and life experience, the authors examine behavioral "song-and-dance routines" repeatedly performed by couples affected by irrelationship. Readers will find a valuable framework for understanding their challenges with action-oriented tools to help them navigate their way to fulfilling relationships. Mark B. Borg, Jr., PhD, is a community psychologist and psychoanalyst, and a supervisor of psychotherapy at the William Alanson White Institute. Grant H. Brenner, MD, is a board-certified psychiatrist in private practice, specializing in treating mood and anxiety disorders and the complex problems that may arise in adulthood from childhood trauma and loss. Daniel Berry, RN, MHA, has practiced as a Registered Nurse in New York City since 1987 and has worked for almost two decades in community-based programs.

All across the United States, individuals, families, communities, and health care systems are struggling to cope with substance use, misuse, and substance use disorders. Substance misuse and substance use disorders have devastating effects, disrupt the future plans of too many young people, and all too often, end lives prematurely and tragically. Substance misuse is a major public health challenge and a priority for our nation to address. The effects of substance use are cumulative and costly for our society, placing burdens on workplaces, the health care system, families, states, and communities. The Report discusses opportunities to bring substance use disorder treatment and mainstream health care systems into alignment so that they can address a person's overall health, rather than a substance misuse or a physical health condition alone or in isolation. It also provides suggestions and recommendations for action that everyone-individuals, families, community leaders, law enforcement, health care professionals, policymakers, and researchers-can take to prevent substance misuse and reduce its consequences.

Estimates indicate that as many as 1 in 4 Americans will experience a mental health problem or will misuse alcohol or drugs in their lifetimes. These disorders are among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. Improving the lives of people with mental health and substance abuse disorders has been a priority in the United States for more than 50 years. The Community Mental Health Act of 1963 is considered a major turning point in America's efforts to improve behavioral healthcare. It ushered in an era of optimism and hope and laid the groundwork for the consumer movement and new models of recovery. The consumer movement gave voice to people with mental and substance use disorders and brought their perspectives and experience into national discussions about mental health. However over the same 50-year period, positive change in American public attitudes and beliefs about mental and substance use disorders has lagged behind these advances. Stigma is a complex social phenomenon based on a relationship between an attribute and a stereotype that assigns undesirable labels, qualities, and behaviors to a person with that attribute. Labeled individuals are then socially devalued, which leads to inequality and discrimination. This report contributes to national efforts to understand and change attitudes, beliefs and behaviors that can lead to stigma and discrimination. Changing stigma in a lasting way will require coordinated efforts, which are based on the best possible evidence, supported at the national level with multiyear funding, and planned and implemented by an effective coalition of representative stakeholders. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change explores stigma and discrimination faced by individuals with mental or substance use disorders and recommends effective strategies for reducing stigma and encouraging people to seek treatment and other supportive services. It offers a set of conclusions and recommendations about successful stigma change strategies and the research needed to inform and evaluate these efforts in the United States.

2020 Award Winner for the Independent Press Award in the category of Addiction & Recovery. A new model of addiction that incorporates neurobiology, social relationships, and ecological systems. Understanding addiction is no longer just about understanding neurons or genes, broken brain functioning, learning, or faulty choices. Oliver J. Morgan provides a fresh take on addiction and recovery by presenting a more inclusive framework than traditional understanding. Cutting- edge work in attachment, interpersonal neurobiology, and trauma is integrated with ecological- systems thinking to provide a consilient and comprehensive picture of addiction. Humans are born into connection and require nourishing relationships for healthy living. Adversities, however, bring fragmentation and create the conditions for ill health. They create vulnerabilities. In order to cope, individuals can turn to alternatives, “substitute relationships” that ease the pain of disconnection. These can become addictions. Addiction, Attachment, Trauma, and Recovery presents a model, a method, and a mandate. This new focus calls for change in the established ways we think and behave about addiction and recovery. It reorients understanding and clinical practice for mental health and addiction counselors, psychologists, and social workers, as well as for addicts and those who love them.