Integrated Treatment for Co-Occurring Disorders E-Book

Jack Klott

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch
• Veröffentlichungsjahr: 2013

Seitenzahl: 354

Beschreibung

The definitive guide to identify, assess, and create individualized treatment plans for high-risk clients who suffer from challenging co-occurring disorders "Treat the person and not the diagnosis. Respect that all behaviors are purposeful. Remain mindful that nobody changes behaviors without motivation. These essential guiding principles are the framework of this book. They will be repeated quite often as we examine the challenging population of men and women with co-occurring disorders." --From Integrated Treatment for Co-Occurring Disorders Annual studies reveal that 70 percent of men and women who died by suicide were diagnosed with a mental illness or personality disorder and used drugs to gain temporary relief from the symptoms. Until now, very little has been written about how to identify, assess, and treat this population. Integrated Treatment for Co-Occurring Disorders: Treating People, Not Behaviors addresses that need. Respectful of the client and filled with practical advice, this book: * Examines the guiding principles for treating clients with co-occurring disorders * Details the methods of formulating an evidence-based individualized treatment plan for the self-medicating mentally ill * Explores how to assess this population for suicide risk and vulnerability * Focuses on the person and not a behaviorally defined diagnostic category * Reflects state-of-the-art knowledge for the treatment of co-occurring disorders * Illustrates how Motivational Enhancement Therapy can be an effective treatment strategy With numerous clinical case studies to illustrate key points and reinforce learning, Integrated Treatment for Co-Occurring Disorders encourages a flexible, person-centered treatment approach that focuses on the individual rather than the diagnosis.

Leseprobe

Contents

Acknowledgments

Chapter One: Introduction

Purposeful Behavior

Reasons for Seeking Therapy

Chapter Two: Definition for Co-Occurring Disorders

Predisposing Factors

Chapter Three: The Core Task of Therapy

The Varied Presentations of Resistance

Acceptance of Resistance

The Engagement Session

Chapter Four: The Therapy Alliance

The Story of George

Chapter Five: Case Conceptualization for Co-Occurring Disorders

Identify Developmental, Precipitating, and Maintaining Factors that Contribute to Maladaptive Behaviors

Identify Individual Developmental Protective Features and Strengths

Identify Short-Term and Long-Term Goals

Case Conceptualization From a Model for Co-Occurring Disorders

Chapter Six: Suicide Risk Assessment for Co-Occurring Disorders

Psychological Vulnerabilities

Suicidal Populations

Who is at Risk?

Chapter Seven: Putting It All Together—Integrated Treatment

Respect Their Complexity

Mindfulness Skills

Stress Tolerance Skills

Emotional Regulation Skills

Empathic Regard

Interpersonal Relationship Effectiveness

Appendix A: Co-Occurring Disorders as Factors Associated With Aggressive Behavior

Appendix B: Co-Occurring Disorders as Factors Associated With Suicidal Behavior

References

About the Author

Author Index

Subject Index

Cover Image: © Jaap Hart/iStockphoto

Cover Design: Andrew Liefer

Copyright © 2013 by John Wiley & Sons, Inc. All rights reserved.

Published by John Wiley & Sons, Inc., Hoboken, New Jersey.

Published simultaneously in Canada.

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Library of Congress Cataloging-in-Publication Data:

Klott, Jack.

Integrated treatment for co-occurring disorders : treating people, not behaviors / Jack Klott.

1 online resource.

Includes bibliographical references and index. Description based on print version record and CIP data provided by publisher; resource not viewed.

978-1-118-20566-2 (print)

978-1-118-41938-0 (ebook)

978-1-118-42103-1 (ebook)

978-1-118-63961-0 (ebook)

1. Dual diagnosis—Patients–Rehabilitation. I. Title.

RC564.68

616.89’14—dc23

2012044415

For My Father

Acknowledgments

Thanks and feelings of gratitude to my Wiley editors, Marquita Flemming and Sherry Wasserman. Thank you for the support and kind words during this project. I am indebted to Ken Minkoff, MD, and Donald Meichenbaum, PhD, for their insights on co-occurring disorders, and to my wife, Rebecca Klott, PhD, for her continued guidance, support, and encouragement.

Chapter One

Introduction

An Examination of the Guiding Principles for Treating Co-Occurring Disorders

I would like to begin this book with a story. The story is about one of the more important events—and lessons—in my 45-year career as an addiction counselor. At the time, I had been in the profession for 10 years. Most of my efforts with clients resulted in extreme frustration. My practice was marked by noncompliance, relapse, recidivism, confrontation, and, basically, poor outcomes. My clients were getting nothing from me, and I was becoming a poster child for burnout. Perhaps some of you have been to this place. I remember dreaming about working in a flower shop or, my favorite escape fantasy, in a bookstore. During this time I placed the blame for my inadequate results on the clients. After all, I would proclaim to myself, I am appropriately applying the skills that I was taught in my graduate program that would enable these people to surrender the plague of drugs and alcohol from their lives. The problem, therefore, could not possibly be with me. The problem was with the clients and the fact that they were “just not ready.” I am sure that many of you have heard the old mantra in drug counseling that “addicts have to hit rock bottom” before they see their behaviors as problematic. I would do my best to point out to them that their use of drugs and/or alcohol was destroying both themselves and those around them. They would not listen. I would educate them about the effects of drugs and alcohol on their brains and other body functions. They would not listen. I would resort, at times, to emotional blackmail. They would leave counseling. I was not a good counselor.

It was at this point that I was invited to participate in a two-week seminar sponsored by the Veteran’s Administration. The seminar was designed to acquaint us with a new treatment strategy for addiction disorders—Motivational Enhancement Therapy. This strategy, which is discussed at length in Chapter 5, had some glowing research outcomes. I was excited. I knew I could benefit from anything that would help change what I was doing. This training resulted in the watershed event of my career, but it began as a very humbling experience.

Three days into this training, I was gently confronted by one of the presenters regarding my attitude toward the skills being taught. These skills appeared, in my humble estimate, to be enabling. I was also presenting myself as being confused. This was a very appropriate observation because I was, indeed, confused. I was being presented with material that went against most of what I was taught regarding the treatment of addiction disorders. My “slap-face” methods were being attacked, and being put on the defensive did not sit well with me. At any rate, this wonderful gentleman comes to me and says: “Jack, your problem is that you are an addiction counselor.” I responded that this was a marvelous observation. He looked at me and respectfully replied: “Jack, hopefully, what you will learn from us is that we don’t treat addictions; we treat people with addictions.” He was telling me that I was locked into my professional definition. I am sure that those reading this book are very aware and sensitive to this frame of treating people and not behaviors. We don’t treat addicts. We don’t treat alcoholics. We treat people with addiction disorders. We do not define our clients by their DSM diagnosis! These are conditions our clients have, and these conditions do not define people. All of you are aware of this. Sadly, at this time in my career, I was not. I defined myself as an addictions counselor so, therefore, I treated addictions. This was my problem.