Treatment Improvement Protocols (TIPs) are developed by the Substance Abuse and Mental Health Services Administration (SAMHSA) within the U.S. Department of Health and HumanServices (HHS). Each TIP involves the development of topic-specific best practice guidelines for the prevention and treatment of substance use and mental disorders. TIPs draw on the experience and knowledge of clinical, research, and administrative experts of various forms of treatment andprevention. TIPs are distributed to facilities and individuals across the country. Published TIPs can be accessed via the Internet at http: //store.samhsa.gov. Although each consensus-based TIP strives to include an evidence base for the practices it recommends, SAMHSA recognizes that behavioral health is continually evolving, and research frequently lags behind the innovations pioneered in the field. A major goal of each TIP is to convey "front-line" information quickly but responsibly. If research supports a particular approach, citations are provided.

Motivation is key to substance use behavior change. Counselors can support clients' movement toward positive changes in their substance use by identifying and enhancing motivation that already exists. Motivational approaches are based on the principles of person-centered counseling. Counselors' use of empathy, not authority and power, is key to enhancing clients' motivation to change. Clients are experts in their own recovery from SUDs. Counselors should engage them in collaborative partnerships. Ambivalence about change is normal. Resistance to change is an expression of ambivalence about change, not a client trait or characteristic. Confrontational approaches increase client resistance and discord in the counseling relationship. Motivational approaches explore ambivalence in a nonjudgmental and compassionate way.

Exposure to potentially traumatic events puts individuals at risk for developing a variety of psychological disorders; the complexities involved in treating them are numerous and have serious repercussions. How should diagnostic criteria be defined? How can we help a client who does not present with traditional PTSD symptoms? The mechanisms of human behavior need to be understood and treatment needs to be tested before we can move beyond traditional diagnostic criteria in designing and implementing treatment. No better guide than Retraumatization exists to fulfill these goals. The editors and contributors, all highly regarded experts, accomplish six objectives, to: define retraumatization outline the controversies related to it provide an overview of theoretical models present data related to the frequency of occurrence of different forms of trauma detail the most reliable strategies for assessment to provide an overview of treatments. Contained within is the most current information on prevention and treatment approaches for specific populations. All chapters are uniformly structured and address epidemiological data, clinical descriptions, assessment, diagnosis and prognosis, and prevention. It is an indispensible resource that expands readers’ knowledge and skills, and will encourage dialogue in a field that has many unanswered questions.

Interpersonal trauma is ubiquitous and its impact on health has long been understood. Recently, however, the critical importance of this issue has been magnified in the public eye. A burgeoning literature has demonstrated the impact of traumatic experiences on mental and physical health, and many potential interventions have been proposed. This volume serves as a detailed, practical guide to trauma-informed care. Chapters provide guidance to both healthcare providers and organizations on strategies for adopting, implementing and sustaining principles of trauma-informed care. The first section maps out the scope of the problem and defines specific types of interpersonal trauma. The authors then turn to discussion of adaptations to care for special populations, including sexual and gender minority persons, immigrants, male survivors and Veterans as these groups often require more nuanced approaches. Caring for trauma-exposed patients can place a strain on clinicians, and approaches for fostering resilience and promoting wellness among staff are presented next. Finally, the book covers concrete trauma-informed clinical strategies in adult and pediatric primary care, and women’s health/maternity care settings. Using a case-based approach, the expert authors provide real-world front line examples of the impact trauma-informed clinical approaches have on patients’ quality of life, sense of comfort, and trust. Case examples are discussed along with evidence based approaches that demonstrate improved health outcomes. Written by experts in the field, Trauma-Informed Healthcare Approaches is the definitive resource for improving quality care for patients who have experienced trauma.

This manual presents the first empirically studied, integrative treatment approach developed specifically for co-occurring PTSD and substance abuse. For persons with this prevalent and difficult-to-treat dual diagnosis, the most urgent clinical need is to establish safety--to work toward discontinuing substance use, letting go of dangerous relationships, and gaining control over such extreme symptoms as dissociation and self-harm. The manual is divided into 25 specific units or topics, addressing a range of different cognitive, behavioral, and interpersonal domains. Each topic provides highly practical tools and techniques to engage patients in treatment; teach "safe coping skills" that apply to both disorders; and restore ideals that have been lost, including respect, care, protection, and healing. Structured yet flexible, topics can be conducted in any order and in a range of different formats and settings. The volume is designed for maximum ease of use with a large-size format and helpful reproducible therapist sheets and handouts, which purchasers can also download and print at the companion webpage. See also the author's self-help guide Finding Your Best Self, Revised Edition: Recovery from Addiction, Trauma, or Both, an ideal client recommendation.

Mental health practitioners are becoming increasingly aware that they are encountering a very large number of men and women who are survivors of sexual and physical abuse. This volume identifies the essential elements necessary for a system to begin to integrate an understanding about trauma into its core service programs. The fundamental elements of a trauma-informed system are identified and the necessary supports for bringing about system change are highlighted. The basic philosophy of trauma-informed practice is then examined across several specific service components: assessment and screening, inpatient treatment, residential services, addictions programming, and case management. Modifications necessary to transform a current system into a trauma-informed system are discussed in great detail as well as the changing roles of consumers and providers.This is the 89th issue of the quarterly journal New Directions for Mental Health Services.

For the last thirty years, the nation's mental health and social service systems have been under relentless assault, with dramatically rising costs and the fragmentation of service delivery rendering them incapable of ensuring the safety, security, and recovery of their clients. The resulting organizational trauma both mirrors and magnifies the trauma-related problems their clients seek relief from. Just as the lives of people exposed to chronic trauma and abuse become organized around the traumatic experience, so too have our social service systems become organized around the recurrent stress of trying to do more under greater pressure: they become crisis-oriented, authoritarian, disempowered, and demoralized, often living in the present moment, haunted by the past, and unable to plan for the future. Complex interactions among traumatized clients, stressed staff, pressured organizations, and a social and economic climate that is often hostile to recovery efforts recreate the very experiences that have proven so toxic to clients in the first place. Healing is possible for these clients if they enter helping, protective environments, yet toxic stress has destroyed the sanctuary that our systems are designed to provide. This thoughtful, impassioned critique of business as usual begins to outline a vision for transforming our mental health and social service systems. Linking trauma theory to organizational function, Destroying Sanctuary provides a framework for creating truly trauma-informed services. The organizational change method that has become known as the Sanctuary Model lays the groundwork for establishing safe havens for individual and organizational recovery. The goals are practical: improve clinical outcomes, increase staff satisfaction and health, increase leadership competence, and develop a technology for creating and sustaining healthier systems. Only in this way can our mental health and social service systems become empowered to make a more effective contribution to the overall health of the nation. Destroying Sanctuary is a stirring call for reform and recovery, required reading for anyone concerned with removing the formidable barriers to mental health and social services, from clinicians and administrators to consumer advocates.

This book highlights the field of youth mental health and why it is a specialty distinct from both child and adolescent and adult mental health. Youth Mental Health: Approaches to Emerging Mental Ill-Health in Young People examines issues such as mental health literacy, e-Health, family, psychological, vocational and pharmacological interventions. The authors also discuss issues that are particularly pertinent to young people, such as suicidality, substance abuse, gender identity and sexuality, attention deficit disorder and eating disorders. Taking a preventative focus, this book presents evidence for youth mental health as an important and growing field, makes the case for the reform of existing service structures to better serve this group and outlines the latest specialised approaches to treatment. Drawing on the knowledge and expertise of leading thinkers in youth mental health, this book is instrumental for mental health professionals who wish to design new specialised mental health systems for young people.

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