Counseling Addicted Families

by ;
Edition: 1st
Format: Hardcover
Pub. Date: 2006-06-19
Publisher(s): Brunner-Routled
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Summary

Although one person's addiction almost inevitably affects his or her family members, a surprising number of treatment models appear to operate under the assumption that an individual's addiction (and potential recovery) occurs in a vacuum. By not paying sufficient attention to preexisting family dynamics-whether dysfunctional, supportive, or somewhere in between-counselors run the risk of not fully understanding the roots of an individual's addictions or the obstacles to his recovery; as a result, counselors may undermine their own treatment efforts both by neglecting any underlying family problems and by failing to capitalize upon a family's potential assistance in an intervention with the addicted individual. In Counseling Addicted Families, Gerald A. Juhnke and William Bryce Hagedorn address this problem head-on. Recognizing that even those treatment providers who understand the importance of the familial context of addiction are often stymied by the variety of family treatment theories and theiroften imperfect fit for cases of addiction, Juhnke and Hagedorn provide a truly integrated model for assessment and treatment. Based upon the authors' combined 23 years of experience in clinical and treatment supervision, the Integrated Family Addictions Model consists of six progressive treatment tiers which organize the relevant family treatment theories into a graduated and coherent sequence, beginning with the briefest and least costly forms of therapy. If one of the lower tiers allows clients to reach their treatment goals, the patient and therapist need not waste time and resources following the full continuum. If, however, their needs are still unmet, they can progress in a logical fashion to more advanced and intensive forms of therapy. The book is divided into three broad topic areas designed to provide counselors and graduate students with essential information both about addictions and about the practical applications of various treatment theories. Part One discusses the prevalence ofaddictions, their negative impact upon families, and the primary existing addiction treatment models, including their limitations and benefits. Part Two outlines methods of assessment for individual cases, and Part Three presents the Integrated Family Addictions Model in detail. Along the way, the authors deal with specific interventions for families dealing with violence and dual diagnosis. The book concludes with a helpful epilogue on professional training, which includes an overview of the major professional addiction and marriage and family counseling organizations, and the ways in which they might benefit individual practices and practitioners.

Author Biography

Gerald A. Juhnke, Ed.D., LPC, NCC, MAC, CCAS, ACS, Professor and Doctoral Program Director, Department of Counseling, Educational Psychology, and Adult & Higher Education, University of Texas at San Antonio W. Bryce Hagedorn, Ph.D., LMHC, NCC, MAC, Assistant Professor and Program Director of Counselor Education, Department of Educational and Psychological Studies, Florida International University

Table of Contents

Preface vii
The Definition and Prevalence of Addiction: Impacts on the Family and the Nation
1(60)
Learning Objectives
1(1)
Introduction
1(1)
Addiction---A Working Definition
2(8)
Helping Clients and Families Understand
2(2)
Clinical Definitions---Can We Agree?
4(1)
Now to Complicate Matters . . .
5(5)
Addiction---Prevalence and Impacts
10(29)
An Accurate Count---Is It Possible?
10(4)
How Much Does It All Cost?
14(1)
Impacts of Chemical Addictions
14(13)
Impacts of Process Addictions
27(12)
The Final Calculations
39(1)
Skill Builder
40(6)
Skill Builder Responses and Answers
46(4)
References
50(11)
Helping Clients and Families Understand Addictions: Etiological Theories and Models
61(80)
Learning Objectives
61(1)
Introduction
61(2)
Theory, Theory, Theory . . . Why Can't We Just Wing It?
63(3)
Moving from Moral to Multifaceted---A Discussion of Addiction Theories
66(2)
Why Don't They Just Stop?---The Moral Model of Addictive Disorders
68(3)
Clinical Case Example
69(2)
Summary and Integration
71(1)
I Can't Help It---I Have a Disease: The Physiological Theory of Addiction
71(16)
The Disease/Medical Model
72(2)
Support for the Physiological Theory: The Impact of Genetics
74(3)
Clinical Case Example
77(7)
Summary and Integration
84(3)
Numbing Out---The Psychological Theory of Addictive Disorders
87(10)
The Influence of Behavioral Theory
88(1)
Hiding the Hurt: The Self-Medication Hypothesis
89(1)
Living the Lifestyle: The Addictive Personality
90(2)
Clinical Case Example
92(2)
Summary and Integration
94(3)
``Where'd You Learn to Drink Like That?''---The Influence of the Environment on Addictive Disorders
97(5)
Sociological Theory
97(3)
Social Learning Theory
100(1)
Summary and Integration
101(1)
Which Came First, the Chicken or the Egg?---The Biopsychosocialspiritual Approach to Addictive Disorders
102(11)
Spirituality and Addiction
103(2)
Clinical Case Example
105(7)
Summary and Integration
112(1)
Conclusions
113(4)
Skill Builder
117(6)
Skill Builder Responses and Answers
123(5)
References
128(13)
Family Addictions Assessment
141(74)
Learning Objectives
141(1)
Introduction
141(2)
The Clinical Family Addictions Assessment Interview
143(25)
Six Clinical Family Addiction Assessment Phases
149(19)
Drug Detection Testing and Specialty Assessment Instruments
168(32)
Drug Detection Testing
169(10)
Specialty Assessment Instruments
179(21)
Therapeutic Feedback
200(4)
Sincere Accomplishment Reviews and Compliments
200(4)
When Perceptions Don't Match
204(1)
Summary
204(1)
Skill Builder
205(5)
Skill Builder Responses
210(2)
References
212(3)
The Sequential Family Addictions Counseling Model
215(86)
Learning Objectives
215(1)
Introduction
215(2)
Why Family Counseling?
217(2)
What Is Family Counseling?
219(1)
Common Family Therapy Terms and Constructs
220(9)
Equifinality
220(1)
Homeostasis
221(2)
Family Roles
223(2)
Family Boundaries
225(1)
Domestic Violence and Addicted Families
226(3)
The Model
229(64)
General Model Overview
229(4)
Stage One: The Change Model and Motivational Interviewing
233(6)
Stage Two: Solution-Focused Therapy
239(8)
Stage Three: Cognitive-Behavioral Family Therapy
247(10)
Stage Four: Structural Family Counseling
257(9)
Stage Five: Extended Family Systems Counseling
266(12)
Stage Six: Modified Intergenerational Family-of-Origin Therapy
278(8)
Summary
286(1)
Stage Seven: Psychodynamic Object Relations Family Therapy
286(7)
Conclusion
293(1)
Skill Builder
294(2)
Skill Builder Responses
296(1)
References
297(4)
Special Topics in Counseling Addicted Families
301(48)
Learning Objectives
301(1)
Introduction
301(1)
Social Justice
302(5)
Stigmatization and Discrimination toward Addicted Families
302(2)
Ignorance Is No Excuse
304(3)
Multicultural Topics
307(4)
Self-Assessment
308(1)
Multicultural Family Addictions Counseling
309(1)
Multicultural Resources
310(1)
Life-Threatening Behaviors
311(23)
Suicide
311(15)
Substance-Related Familial Violence
326(8)
Conclusion
334(1)
Skill Builder
335(5)
Skill Builder Responses
340(5)
References
345(4)
Final Comments 349(2)
Index 351

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