Every day, huge numbers of people use drugs or alcohol for recreation, medication, celebration, stress management, social lubrication, or escape. The abuse of psychoactive chemicals touches individual lives in countless ways, and clients frequently hint in therapy sessions at problems related to substance misuse. But historically, substance abuse treatment has been regarded as a separate specialty, for which students and trainees often prepare along tracks different from those leading to licensing or certification as psychotherapists. Few non-specialists feel completely competent and willing to grapple closely with the issues these clients present, in spite of the fact that such problems are quite frequent among client populations. In this book, Cynthia Glidden-Tracey lays out an integrated, holistic, and effective approach to clients' inevitably intertwined problems, which encourages all practitioners to develop skills for detecting, assessing, and addressing substance use whenever concerns about it emerge in the course of therapy. She describes the frequent co-occurrence of substance misuse and other mental health problems, reviews therapy models and current professional questions, and empowers practitioners with the latest scientific knowledge about the causes and effective treatment of addictions. Throughout, her points are grounded in rich clinical examples.

Every day, huge numbers of people use drugs or alcohol for recreation, medication, celebration, stress management, social lubrication, or escape. The abuse of psychoactive chemicals touches individual lives in countless ways, and clients frequently hint in therapy sessions at problems related to substance misuse. But historically, substance abuse treatment has been regarded as a separate specialty, for which students and trainees often prepare along tracks different from those leading to licensing or certification as psychotherapists. Few non-specialists feel completely competent and willing to grapple closely with the issues these clients present, in spite of the fact that such problems are quite frequent among client populations. In this book, Cynthia Glidden-Tracey lays out an integrated, holistic, and effective approach to clients' inevitably intertwined problems, which encourages all practitioners to develop skills for detecting, assessing, and addressing substance use whenever concerns about it emerge in the course of therapy. She describes the frequent co-occurrence of substance misuse and other mental health problems, reviews therapy models and current professional questions, and empowers practitioners with the latest scientific knowledge about the causes and effective treatment of addictions. Throughout, her points are grounded in rich clinical examples.

This eminently practical guide presents an empirically supported approach for treating people with substance abuse problems and their spouses or domestic partners. Behavioral couples therapy (BCT) explicitly focuses on both substance use and relationship issues, and is readily compatible with 12-step approaches. In a convenient large-size format, the book provides all the materials needed to introduce BCT; implement a recovery contract to support abstinence; work with clients to increase positive activities, improve communication, and reduce relapse risks; and deal with special treatment challenges. Appendices include a session-by-session treatment manual and 70 reproducible checklists, forms, and client education posters.

An accessible guide to providing effective support to substance users. The book uses transactional analysis to provide models for understanding substance use, assessing clients, intervention and treatment. Counseling techniques such as motivational interviewing and relapse process work are included, and case studies feature throughout.

This ground-breaking volume provides readers with both an overview of harm reduction therapy and a series of ten case studies, treated by different therapists, that vividly illustrate this treatment approach with a wide variety of clients. Harm reduction is a framework for helping drug and alcohol users who cannot or will not stop completely—the majority of users—reduce the harmful consequences of use. Harm reduction accepts that abstinence may be the best outcome for many but relaxes the emphasis on abstinence as the only acceptable goal and criterion of success. Instead, smaller incremental changes in the direction of reduced harmfulness of drug use are accepted. This book will show how these simple changes in emphasis and expectation have dramatic implications for improving the effectiveness of psychotherapy in many ways. From the Foreword by Alan Marlatt, Ph.D.: “This ground-breaking volume provides readers with both an overview of harm reduction therapy and a series of ten case studies, treated by different therapists, that vividly illustrate this treatment approach with a wide variety of clients. In his introduction, Andrew Tatarsky describes harm reduction as a new paradigm for treating drug and alcohol problems. Some would say that harm reduction embraces a paradigm shift in addiction treatment, as it has moved the field beyond the traditional abstinence-only focus typically associated with the disease model and the ideology of the twelve-step approach. Others may conclude that the move toward harm reduction represents an integration of what Dr. Tatarsky describes as the “basic principles of good clinical practice” into the treatment of addictive behaviors. “Changing addiction behavior is often a complex and complicated process for both client and therapist. What seems to work best is the development of a strong therapeutic alliance, the right fit between the client and treatment provider. The role of the harm reduction therapist is closer to that of a guide, someone who can provide support an