| 1. | Explain the barriers that cause mental-health professionals from all disciplines to overlook or avoid dealing with the problems of substance-use disorders (SUDs) in clinical practice. |
| 2. | Explain the repercussions of failures to identify, treat, and/ or properly refer patients with substance-use problems for the clinician in psychotherapy practice. |
| 3. | Explain why well-intentioned psychotherapists often do not assess the nature and extent of a patient's involvement with drugs or alcohol. |
| 4. | Describe the prevalent stereotypes psychotherapists hold about persons with substance-use problems. |
| 5. | Explain how addiction is seen by experts as a substance-induced "brain disease". |
| 6. | List the basic differences in the tenets of psychotherapy and the 12-step models in the treatment of substance-use problems. |
| 7. | Explain the reasons why all psychotherapists should know how to assess and intervene effectively with substance-use problems. |
| 8. | List the therapeutic skills and functions that psychotherapists possess which are effective in the treatment of SUDs. |
| 9. | List some of the advantages of office-based treatment of substance-use problems. |
| 10. | List the types of patients that can benefit from office-based treatment of SUDs. |
| 11. | Describe the factors that come into play in initiating and sustaining problems with substance use. |
| 12. | Describe the typical continuum of substance use. |
| 13. | Explain the variations in the developmental patterns of substance-use problems. |
| 14. | Describe the interaction of substance-use problems with other mental-health problems. |
| 15. | Recite the DSM-IV definitions of substance abuse and substance dependence in terms of the qualitative nature of the person's involvement with psychoactive substances. |
| 16. | Describe NIAAA categories of "Low Risk" and "At-Risk" alcohol drinking. |
| 17. | Explain the importance of familiarity with various psychoactive substances for the appropriate clinical assessment, the correct diagnosis of the patient's condition, and the correct course of treatment for the patient. |
| 18. | Describe the basic concepts of substance administration route; substance half-life; substance tolerance, cross-tolerance, and physical dependence. |
| 19. | Demonstrate familiarity with typical effects and side effects of all the major psychoactive substances listed in chapter 3 of the book. |
| 20. | Describe the main theoretical orientations comprising the integrated approach for the treatment of substance-use problems in office practice. |
| 21. | Explain the primary treatment goals of the integrated approach to substance-use problems in office practice. |
| 22. | Explain the centrality of the therapeutic relationship to the treatment of substance-use problems in office practice. |
| 23. | Describe the phases of treatment of substance-use problems in office practice. |
| 24. | Discuss the five stages of change in the Stages-of-Change (SOC) model. |
| 25. | Explain the clinical value of the Stages-of-Change (SOC) model to the treatment of substance-use problems in office practice. |
| 26. | Describe the motivational interviewing techniques recommended to use in the treatment of a patient with substance-use problems in office practice and their benefits. |
| 27. | Explain the most useful tenets of the disease model to the therapeutic endeavor of the patient with substance-use problems. |
| 28. | Explain the clinical utility of the self-medication model in the treatment of substance-use problems. |
| 29. | Explain the reasons self-help programs are encouraged and recommended in the treatment of patients with substance-use problems in office practice. |
| 30. | List the common therapeutic dilemmas in the treatment of substance-use problems in office practice and describe some of the ways to avoid them. |
| 31. | Describe the recommended stance regarding the treatment of concurrent psychiatric and substance-use disorders in clinical practice. |
| 32. | Describe the dilemma of assessment of concurrent substance-use disorder and psychiatric illness and adopt assessment recommendations involving detailed history taking and observation over a longer period of time before reaching diagnosis. |
| 33. | Explain the goals of treatment of patients presenting with concurrent substance-use disorder and psychiatric illness in office practice. |
| 34. | Discuss other elements such as self-help groups and psychotherapy in the treatment of a patient with concurrent substance-use disorder and psychiatric illness in office practice. |
| 35. | Discuss the risk of suicide in patients with concurrent substance-use disorder and psychiatric illness and how to deal with it. |
| 36. | Describe the categories of medicines used in the treatment of substance-use disorders. |
| 37. | Explain the necessity of medicines in the treatment of substance-use disorders. |
| 38. | Explain the rationale for the use of opioid agonist medicines in the treatment of substance-use disorders. |
| 39. | Discuss the distinction between physical dependence and the addiction syndrome and the ramifications for opioid agonist maintenance treatment. |
| 40. | Discuss the primary functions of the assessment of substance-use problems in clinical practice. |
| 41. | Develop an appropriate assessment strategy to generate accurate information about the patient's substance use problems without alienating the patient in the process. |
| 42. | Adopt appropriate assessment tools for the assessment of substance-use problems in office practice. |
| 43. | Develop an appropriate strategy for dealing with coerced and mandated patients with substance- use problems in office practice. |
| 44. | Describe the strategy for assessment of a substance-use profile of the patient, involving the types of substances used, route of drug administration, amount and frequency of use, settings and circumstances of use, ability to control use, pattern of self-m |
| 45. | Explain the types of substances for which medically managed withdrawal is necessary because abrupt cessation following chronic use can be health threatening or even fatal. |
| 46. | Describe the strategy for assessment of psychosocial consequences to patients with psychoactive substance-use problems in office practice. |
| 47. | Discuss other aspects of the assessment process for substance-use problems: Family history of substance abuse, role of family members in current use, substance-related developmental history, other addictive and compulsive behaviors, and prior treatment an |
| 48. | Describe the recommended manner by which feed-back should be offered to a patient with psychoactive substance-use problems at the end of the assessment process. |
| 49. | Describe the strategies for assessing the patient's readiness for change of psychoactive substance-use behaviors at the end of the assessment process. |
| 50. | Explain how the process of developing an individually tailored treatment plan for the psychoactive substance-using patient is accomplished. |
| 51. | Identify the risk factors requiring immediate attention in the formulation of a treatment plan for the patient with psychoactive substance-use problems. |
| 52. | Describe the ways in which treatment modality, prioritizing treatment goals, and choosing between moderation or abstinence goals are achieved. |
| 53. | Describe the appropriate clinical strategies to be employed at various stages of change (i.e., pre-contemplation, contemplation, preparation, action, maintenance, recurrence). |
| 54. | Explain the rationale and timing for involvement of significant others in the treatment of a patient with psychoactive substance-use problem. |
| 55. | Describe the techniques utilized to obtain moderation and harm reduction in patients with substance-use problems in office practice. |
| 56. | Describe cessation techniques utilized to obtain abstinence in patient with substance-use problems in office practice. |
| 57. | Explain the benefits of starting with short-term goals and maintaining frequent contact in early stages of treatment of substance-use problems in office practice. |
| 58. | Describe the clinical use of urine-drug-testing in treatment of patients with substance use problems in office practice. |
| 59. | Describe the management of withdrawal of a patient with substance-use problems in office practice and the role of the psychotherapist. |
| 60. | Describe the benefits of establishing structure and external controls for the patient with substance-use problems in office practice. |
| 61. | Explain the conditioning pattern of substance-use and the manner in which substance-use triggers are managed in the treatment of patients with substance-use disorders in office practice. |
| 62. | Explain the clinical responses to patient's cravings and urges to use substances in the treatment of substance-use disorders in office practice. |
| 63. | Explain the substance relapse phenomenon and explain the relapse process as it applies to the treatment of patients with substance-use disorders in office practice. |
| 64. | Describe the appropriate relapse-prevention strategies for treatment of patients with substance- use disorders in office practice. |
| 65. | Describe the common issues likely to be addressed in ongoing psychotherapy in later-stage recovery of patients with substance-use disorders in office practice and the common goals for this treatment. |
| 66. | Discuss the role of group therapy in the treatment of patients with substance-use disorders in office practice. |
| 67. | Explain the interface of group therapy with individual therapy and discuss group-management issues pertinent to the treatment of patients with substance-use disorders in office practice. |
| 68. | Explain the rationale for participation in self-help programs in various stages of recovery in the treatment of patients with substance-use disorders in office practice. |
| PART I. BASIC ISSUES AND PERSPECTIVES | ||
| 1 | Introduction | |
| 2 | Nature, Course, and Diagnosis of Substance Use Disorders | |
| 3 | Pharmacology and Overview of Psychoactive Substances | |
| 4 | Ingredients of the Integrated Approach: Doing What Works | |
| 5 | Considerations in Addressing Concurrent Psychiatric and Substance Use Disorders | |
| 6 | The Role of Medications | |
| PART II. CLINICAL STRATEGIES AND TECHNIQUES | ||
| 7 | Assessment | |
| 8 | Individualized Goal Setting and Treatment Planning: Meeting Patients “Where They Are” | |
| 9 | Taking Action | |
| 10 | Preventing Relapse | |
| 11 | Psychotherapy in Ongoing and Later-Stage Recovery | |
| 12 | Group Therapy | |
| Appendices | ||
| 1 | Self-Administered Patient Questionnaire | |
| 2 | 10 Tips for Cutting Down on Your Drinking | |
| 3 | Inventory of “Triggers” for Alcohol and Drug Use | |
| 4 | Substance Abuse Websites | |
| References | ||
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If you have a loved one that needs help with a substance abuse problem then it is the best thing to get them into a drug detox program as soon as possible. All addictions are very dangerous including prescription drug addiction, which is becoming very common today. |
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