Substance Use Disorder Treatment For People With Co Occurring Disorders Treatment Improvement Protocol Tip 42 Updated March 2020

This Treatment Improvement Protocol (TIP) update is intended to provide addiction counselors and other providers, supervisors, and administrators with the latest science in the screening, assessment, diagnosis, and management of co-occurring disorders (CODs). For purposes of this TIP, CODs refer to co-occurring substance use disorders (SUDs) and mental disorders. Clients with CODs have one or more disorders relating to the use of alcohol or other substances with misuse potential as well as one or more mental disorders. A diagnosis of CODs occurs when at least one disorder of each type can be established independent of the other and is not simply a cluster of symptoms resulting from the one disorder. Many may think of the typical person with CODs as having a serious mental illness (SMI) combined with a severe SUD, such as schizophrenia combined with alcohol use disorder (AUD).

This book includes a compilation of papers published in 2020 and 2021 focused on dual disorders, which are found in significant and growing numbers in both substance addiction and mental health clinics. These contributions assume a broad perspective ranging from exposure to genetic and neurobiological elements to factors such as personality and quality of life. In all cases, these papers aimed to be transferred to and to benefit clinical practice.

This TIP, Substance Abuse Treatment for Persons With Co-Occurring Disorders, revises TIP 9, Assessment and Treatment of Patients With Coexisting Mental Illness and Alcohol and Other Drug Abuse. The revised TIP provides information about new developments in the rapidly growing field of co-occurring substance use and mental disorders and captures the state-ofthe- art in the treatment of people with co-occurring disorders. The TIP focuses on what the substance abuse treatment clinician needs to know and provides that information in an accessible manner. The TIP synthesizes knowledge and grounds it in the practical realities of clinical cases and real situations so the reader will come away with increased knowledge, encouragement, and resourcefulness in working with clients with co-occurring disorders.

To practice psychotherapy in a correctional setting is to encounter a range of cultural issues reflecting the various ethnic, class, gender, and physical subgroups of the prison population--as well as to navigate the culture of the prison, staff, and justice system that underpins the patients' circumstances. Drawing on the authors' extensive professional experience, Psychotherapy in Corrections offers mental health professionals a comprehensive look at the most common situations they are likely to face and provides practical advice on dealing with them. Diagnostically oriented chapters cover core issues that include self-harm and substance use disorders, as well as mood and personality disorders. Specific supportive therapy techniques for addressing these issues, as well as special situations--including the experience of women in prison, behaviors that can disrupt care, and efforts to reduce recidivism--are illustrated by clinical vignettes. In tackling the social and developmental conditions that lead individuals to interact with the correctional system, Psychotherapy in Corrections also acknowledges the effects of the COVID-19 pandemic and the movement for social justice in society. Anyone who conducts psychotherapy in a prison setting will benefit from an approach centered on treating the human in front of them, regardless of the setting or their crime.

This handbook reflects the reality facing mental health and substance abuse professionals in their daily practices, focusing on how to effectively manage caseloads that include individuals with vastly differing levels of functioning.

Preceded by Psychiatric-mental health nursing / [edited by] Jeffrey S. Jones, Joyce J. Fitzpatrick, Vickie L. Rogers. Second edition. [2017].

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.