This book shows mental health providers how to assess and treat substance use in medical settings. Clinical health psychologists often encounter patients needing interventions for substance use, yet rarely do practitioners receive specialized training in this area. Psychological Treatment of Medical Patients With Harmful Substance Use is designed for mental health providers in medical settings who need the knowledge and skills to assess and treat conditions relevant to substance use. This book is especially useful for mental health providers who treat adult medical outpatients for whom substance use is not their primary presenting problem. The authors clarify the distinction between nonharmful and harmful substance use, describe the signs and symptoms of substance use disorders, epidemiology, current models denoting biological and socio-cultural causes, and contributing factors (with an emphasis on cardiac, cancer, women's health, and primary care settings). They offer best-practice assessment strategies, and psychological, self-help and pharmacological treatments. Chapters also describe assessment and intervention for conditions that are often comorbid with substance use, including depression, anxiety, and sleep dysregulation, as well as treatment for family members who are dealing with a loved one's harmful substance use, relapse prevention and continuing care.

Estimates indicate that as many as 1 in 4 Americans will experience a mental health problem or will misuse alcohol or drugs in their lifetimes. These disorders are among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. Improving the lives of people with mental health and substance abuse disorders has been a priority in the United States for more than 50 years. The Community Mental Health Act of 1963 is considered a major turning point in America's efforts to improve behavioral healthcare. It ushered in an era of optimism and hope and laid the groundwork for the consumer movement and new models of recovery. The consumer movement gave voice to people with mental and substance use disorders and brought their perspectives and experience into national discussions about mental health. However over the same 50-year period, positive change in American public attitudes and beliefs about mental and substance use disorders has lagged behind these advances. Stigma is a complex social phenomenon based on a relationship between an attribute and a stereotype that assigns undesirable labels, qualities, and behaviors to a person with that attribute. Labeled individuals are then socially devalued, which leads to inequality and discrimination. This report contributes to national efforts to understand and change attitudes, beliefs and behaviors that can lead to stigma and discrimination. Changing stigma in a lasting way will require coordinated efforts, which are based on the best possible evidence, supported at the national level with multiyear funding, and planned and implemented by an effective coalition of representative stakeholders. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change explores stigma and discrimination faced by individuals with mental or substance use disorders and recommends effective strategies for reducing stigma and encouraging people to seek treatment and other supportive services. It offers a set of conclusions and recommendations about successful stigma change strategies and the research needed to inform and evaluate these efforts in the United States.

Disorders of anxiety and substance use are, for some reason, rarely treated in an integrated fashion by professionals. This timely volume addresses this glaring omission with dispatches from the frontlines of research and treatment. Thirty-four international experts offer findings, theories, and intervention strategies for this common form of dual disorder, across a range of substances and of anxiety disorders, to give the reader comprehensive knowledge in a practical format.

All across the United States, individuals, families, communities, and health care systems are struggling to cope with substance use, misuse, and substance use disorders. Substance misuse and substance use disorders have devastating effects, disrupt the future plans of too many young people, and all too often, end lives prematurely and tragically. Substance misuse is a major public health challenge and a priority for our nation to address. The effects of substance use are cumulative and costly for our society, placing burdens on workplaces, the health care system, families, states, and communities. The Report discusses opportunities to bring substance use disorder treatment and mainstream health care systems into alignment so that they can address a person's overall health, rather than a substance misuse or a physical health condition alone or in isolation. It also provides suggestions and recommendations for action that everyone-individuals, families, community leaders, law enforcement, health care professionals, policymakers, and researchers-can take to prevent substance misuse and reduce its consequences.

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.

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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

Each year, more than 33 million Americans receive health care for mental or substance-use conditions, or both. Together, mental and substance-use illnesses are the leading cause of death and disability for women, the highest for men ages 15-44, and the second highest for all men. Effective treatments exist, but services are frequently fragmented and, as with general health care, there are barriers that prevent many from receiving these treatments as designed or at all. The consequences of this are seriousâ€"for these individuals and their families; their employers and the workforce; for the nation's economy; as well as the education, welfare, and justice systems. Improving the Quality of Health Care for Mental and Substance-Use Conditions examines the distinctive characteristics of health care for mental and substance-use conditions, including payment, benefit coverage, and regulatory issues, as well as health care organization and delivery issues. This new volume in the Quality Chasm series puts forth an agenda for improving the quality of this care based on this analysis. Patients and their families, primary health care providers, specialty mental health and substance-use treatment providers, health care organizations, health plans, purchasers of group health care, and all involved in health care for mental and substanceâ€"use conditions will benefit from this guide to achieving better care.

The most innovative leaders in progressive addiction treatment in the US offer a groundbreaking, science-based guide to helping loved ones overcome addiction problems and compulsive behaviors. The most innovative leaders in progressive addiction treatment in the US offer a groundbreaking, science-based guide to helping loved ones overcome addiction problems and compulsive behaviors. Beyond Addiction eschews the theatrics of interventions and tough love to show family and friends how they can use kindness, positive reinforcement, and motivational and behavioral strategies to help their loved ones change. Drawing on forty collective years of research and decades of clinical experience, the authors present the best practical advice science has to offer. Delivered with warmth, optimism, and humor, Beyond Addiction defines a new, empowered role for friends and family and a paradigm shift for the field. Learn how to tap the transformative power of relationships for positive change, guided by exercises and examples. Practice what really works in therapy and in everyday life, and discover many different treatment options along with tips for navigating the system. And have hope: this guide is designed not only to help someone change, but to help someone want to change.

A substance use problem exists when one experiences any type of difficulty related to using alcohol, tobacco, or other drugs including illicit street drugs or prescribed drugs such as painkillers or tranquilizers. The difficulty can be in any area of life; medical or physical, psychological, family, interpersonal, social, academic, occupational, legal, financial, or spiritual. This expanded new edition of the successful Graywind Publications title provides the reader with practical information and skills to help them understand and change a drug or alcohol problem. Designed to be used in conjunction with therapy or counseling, it focuses on special issues involved in stopping substance use and in changing behaviors or aspects of one's lifestyle that keep the substance use problem active. The information presented is derived from a wealth of research studies, and discusses the most effective recovery strategies from the examination of cognitive-behavoral treatment. TreatmentsThatWorkTM represents the gold standard of behavioral healthcare interventions! · All programs have been rigorously tested in clinical trials and are backed by years of research · A prestigious scientific advisory board, led by series Editor-In-Chief David H. Barlow, reviews and evaluates each intervention to ensure that it meets the highest standard of evidence so you can be confident that you are using the most effective treatment available to date · Our books are reliable and effective and make it easy for you to provide your clients with the best care available · Our corresponding workbooks contain psychoeducational information, forms and worksheets, and homework assignments to keep clients engaged and motivated · A companion website (www.oup.com/us/ttw) offers downloadable clinical tools and helpful resources · Continuing Education (CE) Credits are now available on select titles in collaboration with PsychoEducational Resources, Inc. (PER)