Acknowledgments
Preface
Introduction: Understanding addiction
Addiction
AOD addictions
Case study: Multiple risk factors: Terry
Case study: Minimal risk factors: Fred
Behavioural addictions
Case study: Gambling addiction: Lyn
Case study: Sex addiction: Grant
Case study: Internet addiction: Dean
Case study: Food addiction: Dawn
Stages of change
Case study: Stages of change
Conclusion
Useful resources
PART 1 CONTENT
Part Introduction
Chapter 1 The therapeutic alliance
What is meant by ‘therapeutic alliance’?
Counsellor factors
Dealing with ruptures
In summary
Useful references
Chapter 2 Assessment and follow-up
Assessment interview
Raising sensitive topics in the assessment interview
Screening instruments and questionnaires
Feedback to clients
The client’s file
Follow-up
Useful resources
Chapter 3 Suicide and self-harm
Suicide
Self-harm
Chronic suicidality
Case study: Suicidality: Sally
Useful resources
Chapter 4 Motivational interviewing
Using motivational interviewing
Benefits or ‘good things’
Costs or ‘less good things’
Highlighting discrepancy
The decision
Case study: Motivational interviewing: Joe
Useful resources
Chapter 5 Case formulation, goal setting, and treatment planning
Case formulation
Case study: Case formulation: Sonny
Goal setting
Case study: Goal setting: Sonny
Treatment plans
Case study: Treatment plan: Sonny
Treatment matching
Case management
Referral
Case study: Referral: Tania
Useful resources
Chapter 6 Harm reduction
Conceptualising harms
Information needed by clinicians and clients
Negotiated safety
Case study: Negotiated safety: Sarah
Useful resources
Chapter 7 Relapse prevention and management
Rationale
Enhancing commitment
Coming off autopilot and increasing mindfulness
Identifying high-risk situations
Developing coping responses
Case study: Problem solving: Sam
Preparation for a lapse
Relapse management
Food-related addictions
Case study: Relapse prevention: Georgie
Useful references
Chapter 8 Emotion management skills: distress reduction
Distress reduction skills
Grounding
Breathing
Self-soothing
Focusing awareness on the surface of the body
Creating a safe place
Progressive muscle relaxation
Case study: Distress reduction: Monique
Useful resources
Chapter 9 Emotion management skills: general affect regulation
Understanding emotions
Identifying and discriminating emotions
Identifying and countering thoughts
Increase experiences of positive emotion
Resist tension-reducing behaviours
Case study: General affect regulation: Monique
Useful resources
Chapter 10 Emotion management skills: mindfulness
Formal mindfulness activities
Informal mindfulness activities
Case study: Mindfulness: Monique
Useful resources
Chapter 11 Developing strengths
Assumptions of a strengths-based approach
Strengths-oriented questions
Practical skill development
Conclusion
Useful references
Chapter 12 Cognitive restructuring
Overview
Unhelpful thinking styles
Identifying core beliefs
Challenging thoughts and beliefs
Formal and informal cognitive restructuring
Case study: Cognitive restructuring: Gina
Useful resources
Chapter 13 Effective communication: assertion and anger management
Assertion
Case study: Assertion: Jenny
Anger management
Case study 13.1: Anger management: Patrick
Useful resources
Chapter 14 Basic self-care: nutrition, sleep, and exercise
Nutrition
Sleep
Exercise
Useful resources
Chapter 15 Grief and loss
Grief
Grief counselling
Useful grief counselling techniques
Additional considerations
When a client dies
Case study: Grief: Grace
Useful resources
Chapter 16 Working with coerced clients
Confidentiality
Conflicts of interest
Client resistance
Harm reduction
Making counselling a positive experience
Case study: Coerced client: Brent
Chapter 17 Working with young people
Accommodating adolescent attitudes and behaviours
Assist with negotiating developmental tasks
Confidentiality
Assertive case management
Flexibility
Including the family
Child protection issues
Clients in exploitative relationships
Linking clients with mainstream activities
Case study: Working with young people: Bill
Useful resources
Chapter 18 Pharmacotherapies for AOD relapse prevention
Alcohol pharmacotherapies
Case study: Alcohol pharmacotherapy: Len
Opioid pharmacotherapies
Case study: Opioid pharmacotherapy 1: Phil
Case study: Opioid pharmacotherapy 2: Clare
Benzodiazepines
Psychostimulants: amphetamines and cocaine
Cannabis
Nicotine
Useful resources
Chapter 19 Clinical supervision
What is clinical supervision?
Ingredients of effective supervision
Multiple points of focus in supervision
Case study: Supervision: novice: Jane
Case study: Supervision: apprentice: Kellie
Case study: Supervision: journeyman: Aaron
Case study: Supervision: master craftsman: Gerard
Working with countertransference in supervision
Group or individual supervision
Useful resources
PART 2 PROCESS
Part Introduction
Chapter 20 Developmental needs
Relational templates
Developmental needs and experiences
Therapeutic implications
Conclusion
Case study: Enmeshment: Annie
Case study: Neglect, chaos, and sexual abuse: Don
Useful resources
Chapter 21 Coping with unmet developmental needs
Blocking unmet needs with internal strategies
Rising above unmet needs with interpersonal strategies
Why avoiding unmet needs is doomed to failure
Therapeutic implications
Case study: Internal blocking strategies: Simon
Case study: Interpersonal strategies: moving towards and moving away: Simon
Case study: Interpersonal strategies: moving against others: Haley
Useful resources
Chapter 22 Transference and countertransference
Content and process
Transference
Countertransference
Conclusion
Case study: Transference: Sue
Case study: Countertransference: the counsellor
Useful resources
Chapter 23 How to ‘do’ process work
Process comments
Moving the focus to the counselling relationship
Responding to clients’ experience of counsellors
Responding to client behaviours that cause replays of the past
How much process work is needed?
Reluctance to explore the process dimension
Conclusion
Case study: Working with process: Belinda
Case study: Working with process: Renee
Useful resources
Chapter 24 Client ambivalence about counselling
Client ambivalence
Responding to client ambivalence
Conclusion
Case study: Working with client ambivalence: Louisa
Useful resources
Chapter 25 Helping clients to explore themselves
The problem with inadequate exploration
The solution
Avoiding an internal focus
Conclusion
Case study: Inadequate self-exploration: Sheila
Case study: Inadequate self-exploration: Frank
Useful resources
Chapter 26 Identifying core themes
Repetitive relational patterns
Problematic beliefs about self and others
Core emotions
A note on traumatised clients
Conclusion
Case study: Core themes providing structure for counselling: Kathy
Case study: Identifying core themes: Sam
Useful resources
Chapter 27 Termination
Affirming relatedness and separateness
Natural endings
Artificial endings
As clients face the end of the counselling relationship
Client decision to end
Case study: Early termination: David
Case study: Early termination and recontact: Jake
Case study: Natural termination: Wendy
Case study: Natural termination and recontact: Jennifer
Useful resources
Chapter 28 Integrating process with content
PART 3 CO-OCCURRING MENTAL-HEALTH ISSUES
Part Introduction
Chapter 29 Diagnostic issues, psychological integration, and counselling implications
Diagnostic issues
Axis I and Axis II disorders
Degree of psychological integration
Case study: Good psychological integration: Belinda
Case study: Poor psychological integration: Renee
Very poor personality organisation (psychosis)
Case stuffy: Very poor psychological integration: Peter
Medications
Conclusion
Useful resources
Chapter 30 Co-occurring post-trauma syndromes and addictions
Trauma
Acute Stress Disorder (ASD)
Post-traumatic Street Disorder (PTSD)
Complex PTSD
Complex PTSD and Borderline Personality Disorder (PTSD)
Shame in relation to trauma
Immediate crisis response
Treating co-occurring post-trauma syndromes and addictions
Working out where to start
Medication
Case Study: Complex trauma, alcohol, opioids: Simone
Useful resources
Chapter 31 Co-occurring panic disorder and addictions
Panic attacks
Fight or flight response
The role of breathing
Panic disorder
Why do people develop panic disorder?
Treating co-occurring panic disorder and addictions
Medication
Case study: Panic, agoraphobia, alcohol: Tracey
Useful resources
Chapter 32 Co-occurring generalised anxiety disorder and addictions
Generalised anxiety disorder
Treating co-occurring GAD and addiction issues
Focus on the therapeutic alliance and process work
Medication
Case study: GAD, binge eating: Karen
Useful resources
Chapter 33 Co-occurring social anxiety disorder and addictions
SAD/social phobia
Why do people develop social anxiety disorder?
Treating co-occurring social anxiety disorder and addictions
Medication
Case study: Social phobia, gambling: Malcolm
Useful resources
Chapter 34 Co-occurring depression and addictions
Depressive disorders
Why do people develop depression?
Treating co-occurring depression and addictions
Medication
Case study: Depression, methamphetamine: Ben
Useful resources
References
Index |
