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Motivational Enhancement Therapy

Lesson One: Introduction

   Obstacles to Motivation

   Negative vs. Positive Motivation

   Common Myths

   Basic Principles

   The Four Processes of MI

   Four Basic Tools: OARS


Lesson Two: Engaging Your Clients

   Open Questions

   Reflective Listening



   Exploring Values and Goals

   Exploring Discrepancy


Lesson Three: The Focusing Process

   Using OARS

   Offering Information



Lesson Four: Evoking Your Client’s Motivation to Change


   Change Talk

   Sustain Talk


   Other Strategies to Evoke Change Talk

   Responding to Change Talk

   Responding to Sustain Talk

   Warning Signs

   Building Hope/Addressing Low Confidence

   Counseling with Neutrality

   Tipping the Decisional Balance


Lesson Five: The Planning Stage

   Signs of Readiness

   Developing the Change Plan

   OARS During the Planning Stage

   Exploring and Setting Goals

   Non-abstinence Goals for Substance Abusers

   Reinforcing Commitment to Change

   The Importance of Self-Efficacy

   Negotiating a Change Plan

   Initiating the Change Plan

   Stabilizing Change

Lesson Six: Practice


   Open Questions

   Change Talk Jeopardy 

Integrating Vocational Rehabilitation and Substance Abuse Treatment Services

Lesson One: Clinical Issues Related to Integration of Vocational Services

Incorporating Vocational Services

Addressing Vocational Goals and Employment Needs

Competency Areas for Employment

Identifying Employment Goals

Lesson Two: Resources, Challenges, and Screening Protocols

Employment as a Goal

Challenges to Employing Clients in Treatment

Vocational Needs

Availability of Vocational Services

Medicaid and Managed Care Programs

Vocational Programming and Resources

Vocational Rehabilitation Counseling


Lesson Three: Assessment and Ongoing VR Services

Functional Assessment

Categories of Functional Limitations

Six-Realm Classification System

Setting and Achieving Goals

Prevocational and Ongoing Services

Lesson Four: Training, Education, and Employment Services

School-To-Work Transition Programs

On-The-Job Training

Apprenticeship Programs

Technical Schools and Colleges

Community Sponsored Adult Education

Colleges and Universities

Job-Seeking Skills and Training

Job Development and Placement Approaches

Supported Work Programs

Lesson Five: Job Retention and Advancement

Overview of Resources

State Employment Services Commissions

State Vocational Rehabilitation Agencies

Seeking and Securing Funds for Vocational Services

Resources for Veterans

Community Level Providers

Community Based Rehabilitation Centers

Mental Health Agencies

Lesson Six: Additional Considerations

Finding and Maintaining Employment

Coping with Medical and Psychological Challenges

Treatment Approaches for Women Who Abuse Alcohol & Other Drugs

Lesson One: Introduction


Health Impact

Psychological Effects


Lesson Two: Women’s Treatment

Methods and Models

Effective Treatment for Women

Case Management

Special Issues for Women in Treatment

Issues of Sexuality

Women, Violence, and Substance Abuse


Dual Disorders

Lesson Three: Outreach and Identification of Women in Need

Barriers to Outreach and Treatment

Helping Women Overcome Their Fears

Barriers Unique to Special Populations of Women

Ethnic and Racial Populations

Other Sub-Groups

Lesson Four: Comprehensive Treatment

The Intake Interview

Orientation to Treatment

Comprehensive Assessment

Treatment Planning

Lesson Five: Strategies for Providing Comprehensive Treatment


Relationships and Special Populations

Addressing Spiritual Needs


Continuing Care

Lesson Six: Special Populations and Case Studies

Age Groups

Women in the Criminal Justice System

Women with Disabilities

Cultural Knowledge

Case Studies

Treating Adolescents with Substance Use Disorders

Lesson One: Introduction

Consequences of Adolescent Substance Use

Treatment Needs of Adolescents

Risk Behaviors of Adolescents

Tailoring Treatment to Adolescent Populations

Lesson Two: Assessment and Placement

Factors Affecting Placement

Risk and Protective Factors

The Continuum of Treatment

Placement Guidelines

Outpatient Treatment

Residential Treatment

Continuing Care

Lesson Three: Program Considerations

Staff Skills Development

Program Components

Treatment Planning


Program Evaluation

Lesson Four: Three Widely Available Approaches

Twelve Step Programs

Therapeutic Communities

Family Therapy

Lesson Five: Adolescents with Special Treatment Needs

Working with the Juvenile Justice System

Diversion Programs

Homeless Adolescents

Sexual Orientation

Coexisting Disorders

Lesson Six: Legal and Ethical Issues


Consent Forms

Reporting Child Abuse or Neglect

Court-Ordered Disclosure

Medical Emergencies

Solutions for the Treatment-Resistant Client

Lesson One:

The Myth of Treatment Readiness

Inspiring Hope in “Hopeless” Clients

Hope-Inspiring Reflections

Lesson Two:

Using Scaling Techniques

Case Study


Exploring Exceptions

Case Study

Lesson Three:

The Concept of “Denial”

Classic Definition

Alternative Definition

Respecting Preferred Views

Case Study

Turning Client Complaints Into Treatment Goals

Lesson Four:

Externalizing Problems

Consciousness Raising

Developing Discrepancy

Mystery Questions

Case Study

Using Decisional Balance Sheets

Case Study

Lesson Five:

Reaching Mandated Clients

Differentiating Yourself from the Referral Source

Questions for Mandated Clients and Referring Parties


Case Study

Lesson Six:

Practical Considerations

Ethical Considerations

Summary and Conclusions

Improving Outcomes for Dually Diagnosed Clients

Lesson One: Introduction

Relationships Between Substance Abuse and Psychiatric Problems


Differences Between the Mental Health and Addiction Treatment Systems

The Medical System

Lesson Two: Case Management

The Role of Abstinence

Sequential, Simultaneous, or Integrated Treatment?

Treatment Engagement, Continuity, and Comprehensiveness

Phases of Treatment

Individual Case Management

Lesson Three: Mood Disorders

Depressive Disorders

Symptoms of Depression

Treatment Considerations

Bi-Polar Disorders


Treatment Considerations

Levels of Care

Lesson Four: Anxiety Disorders

Generalized Anxiety Disorder

Panic Disorders


Obsessive-Compulsive Disorder

Post Traumatic Stress Disorder

Lesson Five: Personality Disorders

Antisocial Personalities

Borderline Personalities

Paranoid Personalities

Schizoid Personalities

Schizotypal Personalities

Histrionic Personalities

Narcissistic Personalities

Avoidant Personalities

Dependent Personalities

Obsessive-Compulsive Personalities

Lesson Six: Challenges and Linkages

Policy and Planning Challenges

Data Collection and Need Assessment Challenges

Program Development Challenges

Screening, Assessment, and Referral Challenges

Case Management Challenges

Staffing Challenges

Social Service System Linkage Challenges

Health Care System Linkage Challenges

Criminal Justice System Linkage Challenges

Meeting the Challenges

Improving Outcomes for Mandated Clients

Lesson One:

From the Instructor


Lesson Two:

Reflective Listening

Simple Reflections



Differentiating Yourself for the Mandating Party

Lesson Three:

“How” and “What” Questions

Reflective Listening Revisited

Embellished Reflections

“Columbo” Questions

Lesson Four:

Turning Promises Into Treatment Tasks

Exploring Exceptions

Lesson Five:



Lesson Six:

Achieving Goals vs. Solving Problems

Discussing Goals

Agreeing on a Goal

Finding Competence

“Owning” Competence

Expanding Competence

The Stages and Processes of Change

Lesson One: Introduction

Overview of Stages

Benefits of Model

Lessons Two and Three: The Precontemplation Stage

Characteristics of Precontemplators

Goals for Precontemplators

Achieving Goals

Helpful Techniques for Discouraged Precontemplators

Sharing Counseling Notes

Focusing on the Future

Helpful Techniques for Other Precontemplators

“Columbo” Questions

Other Techniques

Developing a “Yes” Set

Lesson Four: The Contemplation Stage

Characteristics of Contemplators

Goals for Contemplators

Helpful Techniques for Contemplation

Case Study

Lesson Five: The Preparation Stage

Characteristics of Those on the Preparation Stage

Goals for Preparation

Helpful Techniques for Preparation

Asking “How” and “What” Instead of “Why”

Mapping the Problem

Pattern Interruption

Exploring Exceptions

Lesson Six: The Action and Maintenance Stages

Characteristics of Those on the Action Stage

Characteristics of Those on the Maintenance Stage

Case Study in Maintenance


Summary of Stages and “Dos” and “Don’ts” for Each Stage

Comprehensive Case Management for Substance Abuse Treatment

Lesson One: Introduction

Interagency Case Management

Importance with Substance Abuse Clients

Models of Case Management

Brokerage Models

Strengths-based Models

PACT Model

Clinical/Rehabilitation Approach

Lesson Two: Core Competencies and Principles of Case Management

Case Management Principles

Core Competencies

Lesson Three: Community Linkages

Forging the Linkages

Identifying Potential Partners

The Agency Environment

Potential Conflicts

Lesson Four: Case Management and the Substance Abuse Treatment Continuum

Outreach and Pre-Treatment

Primary Treatment


Lesson Five: Case Management for Clients with Special Needs

General Rules

Clients with HIV Infection and AIDS

MICA Clients

Homeless Clients



Criminal Justice Clients

Clients with Physical Disabilities

Gay, Lesbian, Transgendered, and Bisexual Clients

Rural Clients

Lesson Six: Evaluation and Quality Assurance

Brief Overview of Research

Evaluating Case Management Programs

Selecting Measurements

Court-Ordered Disclosure

Client Satisfaction

Measuring Client Outcomes

Data Helpful to Case Managers

Data Helpful to Clients and Family Members

The Ethics of Substance Abuse Treatment

Lesson One: Introduction

The Major Areas of Disagreement

Preventing Litigation

Substance Abuse Client Rights

Case Studies

Lesson Two: The Client/Counselor Relationship

Non-Discrimination and Respectful Treatment

Fees for Service


Disclosure and Informed Consent

Dual Relationships and Conflicts of Interest


Evaluation and Assessment

Treatment Planning and Documentation

Other Considerations

Client empowerment

Cultural sensitivity


Self-Assessment Checklist

Lesson Three: Professional Relationships and Professional Responsibilities

Ethical Conduct Toward Other Professionals

Relationships With Employers

Responsibilities to the Counseling Profession




Professional Relationships


For Counselors Who Are Educators or Trainers

For Supervisors and Administrators

Self-Assessment Checklist for Supervisors

Responsibility to Society

Other Concerns

Lesson Four: Resolving Ethical Issues

Seven Steps for Ethical Decision-Making

Five Guidelines for Making Ethical Decisions

Lessons Five and Six: Specific Relevant Codes and Ethics Resources

Ethical Standards from NAADAC

The ACA Code of Ethics

The NASW Code of Ethics

Clinical Supervisor Codes

Prevention Codes

Criminal Justice System Codes

Family-Involved Substance Abuse Treatment

Lesson One: Introduction

The Impact of Substance Abuse on Families

The Goals of Family Therapy

Families with Children

Families without Children

Blended Families

Clients with Grown Children

Adolescents in Traditional Families

Lesson Two: A Comparison of the Two Approaches to Treatment

Regulation, Licensure, and Certification

Barriers to Treatment

Screening and Assessment

The Identified Client

The Presenting Problem

Process vs. Content

Family Interventions

Counselor Self-Disclosure


Lesson Three: Models of Family Therapy

Basic Concepts

Specific Models of Family-Involved Substance Abuse Treatment

Lesson Four: Family-Involved Substance Abuse Treatment—An Integrated Model

The Benefits of an Integrated Model

Limitations of an Integrated Model

Three Levels of Family-Involved Substance Abuse Treatment

Brief Overview of Several Specific Integrated Models

How to Decide Which Model to Use

Lesson Five: Special Populations




Older Adults




American Indians

Sexual Orientation

Physical and Cognitive Disabilities

Rural Populations

Lesson Six: Practical Considerations for Implementation

Family-Friendly Case Management

Levels of Family Recovery

Confidentiality Law Compliance

Lesson One: Introduction

42 CFR Part 2


Penalties for Non-Compliance

Lesson Two: Permitted Disclosures Under 42 CFR Part 2

Medical Emergencies


Administrative Disclosures


Audits and Evaluations


“Duty to Warn”

Under Age Clients

Common Violations

Lesson Three: HIPAA

Covered Transactions

Protected Information

Permitted Disclosures

Necessary Safeguards

Counseling Notes


Client Rights

Lesson Four: How to Communicate, Store Data, and Handle Requests for Protected Information

Telephone and Mail Correspondence

Computer Files, Faxes, and E-Mails

Telephone Calls and Visits to Clients

Reporting Crimes

Subpoenas, Search Warrants, and Arrest Warrants

Court Ordered Disclosures

Underage Clients

Employee Assistance Programs

Getting Payment for Treatment

Marriage and Family Treatment

Fundraising and Publicity

When Consent Is Revoked

Lesson Five: Mandated Reporting

Child Abuse and Neglect

Developing a Program Policy on Mandated Reporting

Limiting Damage to the Therapeutic Relationship

Lesson Six: Compliance Checklists and Sample Forms

Medication and Substance Abuse Treatment

Lesson One:

   Introduction to Psychotherapeutic Medications

   Definitions: Episode, remission, recurrence, recovery, relapse; acute, continuation, and   

   maintenance phases

   Helping clients understand what to expect from medication

   How to be most helpful to the prescribing physician

   Dealing with Depression

   Medication Policies


Lesson Two: “Stepwise” Treatment for Addiction and Co-occurring Disorders

   Factors influencing addiction and other disorders

   Finding a balance between helpful and detrimental pharmacological effects

   Psychoactive mediations

Physicians’ Offices

   Reinforcement Potential

   Stepwise treatment principles

   Conversations with clients

   Outpatient Programs

   Non-pharmacologic, non-psychoactive, and psychoactive approaches


Lesson Three: Common Medications for Co-Occurring Disorders

   Generic vs. brand


   Anti-manic meds

   Anti-depressant meds

   Anti-anxiety meds

   Narcotic and opioid analgesics

   Anti-parkinsonian medications



Lesson Four: Introduction to Addiction Treatment Meds

   Benefits of OUD medication treatment

   Most commonly used medication treatments

   How OUD medications work

   Potential side effects

   Considerations for pregnant women

   Matching service and diagnosis


Lesson Five: The Opioid Use Disorder Medications

   Assessing which clients are best suited

   Integrating Care





   Take-Home doses


Sources Consulted

Improving Outcomes for Clients with HIV/AIDS

Lesson One: Introduction


Progression of the Disease

Early Stage
Middle Stage
Final Stage

Lesson Two: Primary and Secondary Prevention

Sexual Practices Assessment

Risk Reduction Counseling

Sexual Practices
Syringe Sharing
Prenatal and Perinatal Prevention

Infection Control Issues

Lesson Three: Mental Health Treatment Issues

Assessment and Diagnosis

Treatment Goals

Common Mental Health Disorders in HIV Clients

Cognitive Impairment and Adherence to Treatment

Pharmacological Treatment for Psychiatric Disorders

Side Effects of Medications


Methadone Maintenance Therapy

Counseling Tools

Individual Counseling
Group Therapy
Family Therapy
Support Groups

Lesson Four: Substance Abuse Treatment Issues

Obstacles to Integrated Care

Suggestions for Integrating Treatment

Dealing with Continued Substance Abuse

Referral and Coordination of Linkages

Lesson Five: Case Management

Definition and Goal


Home-Based Services

Suggestions on Finding

Lesson Six: Staff Training Issues


Avoiding Burnout

Developing and Maintaining Competence

Teaching Self-Advocacy

Lesson One: Introduction

The Case for Teaching Self-Advocacy
Course Goals
Principles of Recovery

Lesson Two: Using the Life Wheel to Teach Self-Advocacy

Food and Clothing
Employment, Education, and Training
Physical and Emotional Health
Income Maintenance

Lesson Three: Power and Assertiveness

Personal Power and Authority
Developing Assertiveness Skills

Lesson Four: The Therapeutic Relationship

Establishing a Partnership
Stages of Change Model
Transparency and the D-I-E Model
Case Study

Lesson Five: WRAPs and Wraparound Planning

Designing a Wellness Recovery Action Plan (WRAP)
Case Study

Lesson Six: Teaching Self-Advocacy in Groups

Group Rules
Techniques that Promote Self-Advocacy in Group Therapy

Cognitive Behavioral Therapy

  Lesson One: Introduction

        Evidence Base

        History of CBT

        How CBT Works

        Case Study

     Lesson Two: Types of CBT

        Dialectical Behavior Therapy

        Cognitive Analytic Therapy

        Schema Therapy

        Mindfulness Based Cognitive Therapy    

     Lesson Three: Universal CBT Methods

        Problem Inventories

         Negative Automatic Thought Inventories

        Case Studies

        D-I-E-D-E-P Method

        Thought Stopping and Substitution

     Lesson Four: Practical Examples of CBT in Action

        CBT for Chemical Dependence Problems

        Daily Thought Records

        Dealing with Cravings

        Dealing with Triggers

        Exposure Therapy for Anxiety Disorders

        Extinction and Exposure

        Inventory for Phobias

        Extinction and Exposure Plan

        D-I-E-D-E-P Method

        Homework and Record Keeping

        Worry Appointments

     Lesson Five: CBT Techniques and the Therapeutic Relationship


        Progress Assessments

        When Symptoms Increase

        Building the Therapeutic Alliance

        For Clients Who Want To Look Into Their Pasts

        For Clients Who Don’t Want To Look Into Their Pasts

        For Clients Who Say They Want CBT But Then Reject the Methods


Group Leadership Skills

Lesson One: Introduction

Types of Groups
Guidelines for Successful Group Leadership
Co-leading Groups
Building Motivation

Lesson Two: Personal Qualities Conducive to Successful Group Leadership

Active Listening
A non-judgmental stance

Lesson Three: Group Leadership Skills and Styles

Psycho-educational groups
Skills development groups
Cognitive-behavioral groups
Support groups
Interpersonal process groups
Relapse prevention groups
Expressive groups
Solution-focused groups

Lesson Four: Therapeutic Techniques

Psycho-educational groups
Skills development groups
Cognitive-behavioral groups
Support groups
Interpersonal process groups
Relapse prevention groups
Expressive groups
Solution-focused groups

Lesson Five: Addressing Common Problems and Avoiding Common Mistakes

Overheated emotions
Avoiding a leader-centered group
Handling boundary violations
Violations of abstinence
Physical boundary violations
Transference and counter-transference
Handling overly talkative clients
Handling clients who participate minimally
Handling conflicts in group
Managing groups within groups
Administrative discharges

Lesson Six: Integrating Care

Co-occurring disorders
Integrating the 12 Steps
Integrating group and individual counseling
Summary—twelve ways to be a better group leader

Addresing Suicide Risk in Substance Abuse Clients

Lesson One: Introduction

Evidence Base


Recommendations for Substance Abuse Counselors

Lesson Two: Taking the Most Helpful Approach

Ten Guidelines

Taking a Suicide Attitude Inventory

Positive Attitudes and Behaviors

Types of Suicidal Thoughts and Behaviors

Warning Signs

I-S-P-A-T-H-W-A-R-M (Ideation, Substance Abuse, Purposelessness, Anxiety, Trapped,

Hopelessness, Withdrawal, Anger, Recklessness, Mood Changes)

Risk Factors

Protective Factors

Reasons for Suicide Attempts

Lessons Three and Four: How to Respond—G-A-T-E

Gathering Information

Accessing Supervision

Taking Responsible Action

Extending the Action

Safety Cards

Commitment To Treatment Agreements

Lesson Five: Core Competencies

Knowledge Required

Skills Required

Attitudes Required

Lesson Six: Legal and Ethical Issues

Failure in Assessment

Failure in Treatment

Failure to Safeguard


Maintaining Safety

Confidentiality Issues

Ethical Issues

Informed Consent

Admission, Transfer, and Termination

Implementing Evidence Based Practices


Lesson One: Introduction 

   The Case for Implementing EBPs


   Diffusion of Innovation Theories

   Transtheoretical Models

   Implementation Models

   Principles of Implementing Change

 Lesson Two: Pre-planning

   Matching Your Program with Appropriate EBPs

   Gauging Your Readiness to Change

   Checking Your Program for Warning Signs

 Lesson Three: Planning

   Selecting the Change Team

   Defining Your Destination

   Eliminating Obstacles to Change

   Getting All Staff On Board

   Mapping the Implementation Plan

 Lesson Four: Implementation

   Communicating Your Plan’s Relevance

   Overcoming Obstacles in the Implementation Phase

 Lesson Five: Evaluation

   What to Measure

   Selecting the Evaluation Team

   Outside Evaluators

   Estimating Cost

   Planning the Evaluation

   Collecting Data

   Analyzing Data


 Lesson Six: Sustainability

   Monitoring Progress and Making Adjustments

   Maintenance Phase

   Extension Phase

   Adaption Phase

Integrating Tobacco Use Interventions Into Chemical Dependence Services

Lesson One: Introduction


   Screening and Assessment

   Carbon Monoxide Monitors

   Stages of Change Model


Lesson Two: Evidence-Based Practices--Medications


   Other Medications


Lesson Three: Evidence-Based Practices—Motivational Interviewing

   Spirit and Guiding Principles of MI

   Dealing with “Resistance” by Using O-A-R-S

   Identifying and Eliciting Change Talk

   Using Scaling Questions

   The Five “Rs”

   Providing Information

   Motivational Groups


Lesson Four: Evidence-Based Practices—CBT and RPT

   Cognitive Behavioral Therapy

   Relapse Prevention Therapy

   Psycho-educational Groups


Lesson Five: Treatment Planning


   Treatment Plan Principles

   Diagnosing Tobacco Use Disorders

   Problem Statements, Goal Statements, and Objectives


Lesson Six: Special Considerations for Co-occurring Disorders

   Tobacco Use and Mental Health

   Tobacco Use and Special Populations

   Brief Summary

Clinical SupervisionClinical Supervision

Lesson One: Introduction

Central Principles of Clinical Supervision

Suggestions for New Supervisors

Handling Challenging Situations

Models of Supervision

Lesson Two: Key Issues in Supervision

Counselor Development

Supervisor Development

Ethical and Legal Issues

Dual Relationships and Boundaries

Informed Consent


Cultural and Contextual Factors

Sample Forms

Lesson Three: Monitoring Performance

Individual Development Plans (IDPs)

Evaluations of Counselors

Addressing Burnout and Compassion Fatigue


Methods of Observation

Supervision vs. Therapy


Balancing Clinical and Administrative Supervision

Time Management

Structuring Initial Sessions

Lesson Four: Methods and Techniques of Clinical Supervision

Verbal Reports

Written File Reviews

Case Consultation and Case Management

Direct Observation



One-way Windows

Co-facilitation and Modeling


Lesson Five: Administrative Supervision



Legal and Ethical Issues

The Stages of Treatment

Lesson One: Introduction
   Stages of Change
   Stages of Treatment
Lesson Two: Treatment Planning
   Stage-Informed Planning for Each Stage
   Group vs. Individual Treatment
   The Therapeutic Alliance
   The Therapeutic Frame
Lesson Three: Research-Based Approaches
   Motivational Interviewing
   Cognitive-Behavioral Therapy
   Relapse Prevention/12 Step Facilitation
Lesson Four: Persuasion Groups
   Addressing Disruptive Behavior
Lesson Five: Active Treatment/Relapse Prevention Groups

Trauma-Informed Care

Lesson One: Introduction




   DSM V Diagnosis

   Risk Factors

   Acute Stress Disorder

   Adjustment Disorders

Lesson Two: Trauma’s Effects on the Brain

   Survival Brain

   Intellectual Brain



   Healing Strategies

Lesson Three: Gender Differences, Sexual Abuse, and Traumatic Grief

   Gender Differences

   Coping with Traumatic Memories

   Traumatic Grief

   Differentiating PTSD and Traumatic Grief

   Factors that Complicate the Grieving Process

   Anticipatory Grief

Lesson Four: Violent Events, Coping Styles, and Resilience

   Homicide, Suicide, and Murder


   Survivors’ Needs

   Coping Styles

   Coping Strategies and the Search for Meaning

   Resilience and Post-Traumatic Growth

Lesson Five: Trauma-Informed Counseling Techniques

   General Guidelines


   Self-soothing, Self-care, and Self-efficacy


   Educational Interventions

   Role Playing

   Exposure Therapy



   Interpersonal Therapy

   Cognitive Therapy

   Group Therapy


   Art Therapy

   Dos and Don’ts

Lesson Six: Counselor Wellness

   Role Modeling

   Preventing Burnout

   What Programs Can Do to Support Counselor Wellness

Improving Cultural Competence

Lesson One: Introduction
   The case for improving cultural competence
   Cultural identity
   Common characteristics of culture
   Definitions of race
   Definitions of ethnicity
Lesson Two: Important Factors in Race, Ethnicity, and Cultural Identity
   Language and communication
   Geographic location
   Worldview, values, and traditions
   Family and kinship
   Gender roles
   Socio-economic status and education
   Immigration and migration
   Acculturation and Cultural Identification
   Assimilation, segmented assimilation, biculturalism, and enculturation
   Heritage and history
   Perspectives on health, illness, and healing
   Religion and spirituality
Lesson Three: Core Competencies for Clinical Staff
   Trust and power
   Knowledge of other cultural groups
   Culturally responsive attitudes and behaviors
   Values and biases
   Personal space
   Culturally specific meanings of touch
   Culturally based experiences of power and powerlessness
   Communication styles
   Goals for culturally informed counseling
Lesson Four: Organizational Cultural Competence
   Awareness and commitment
   Defined values and principles
   Creating a cultural awareness committee
   Ongoing training
   Clinical supervision
Lesson Five: Drug Cultures and the Cultures of Recovery
   Cultures specific to certain drugs
   Cultures specific to sexual preference
   The relationship between mainstream and drug cultures
   Online drug cultures
   Drug cultures in assessment and engagement
   Finding alternatives to drug cultures
   Developing a culture of recovery
   Course summary


Detoxification and Substance Abuse Treatment

Lesson One: Introduction

    Basics of detox services

   Three essential components

   Settings, Levels of Care, and Patient Placement


Lesson Two: The Most Common Detox Settings

   Physicians’ Offices

   Outpatient Programs

   Freestanding Urgent Care Centers and ERs

   Freestanding Substance Abuse Treatment or Mental Health Facilities

   Intensive Outpatient and Partial Hospitalization Programs

   Acute Care Inpatient Settings

   Other Placement Considerations


Lesson Three: Psychosocial and Biomedical Issues

   Conducting the Initial Evaluation

   Addressing Immediate Medical Concerns

   Addressing Immediate Mental Health Needs

   Dealing with Anger, Aggression, and Violence

   General Guidelines for Addressing Nutritional Concerns

   Considerations for Adolescents

   Gender-Specific Concerns

   Considerations for Chronic Relapsers

   Educating Patients on the Withdrawal Process


Lesson Four: Alcohol Detox

   Initial Screening

   Blood Alcohol Content

   Blood Alcohol Levels

   Urine Drug Screens

   Withdrawal Signs and Symptoms

   Managing Withdrawal Without Medication

   Managing Withdrawal With Medications

   What To Do In The Event Of A Seizure


Lesson Five: Detox From Other Substances


   Benzodiazepines and Other Sedative-Hypnotics

   Detox From Stimulants

   Inhalants and Solvents


   Marijuana and Hashish

   Anabolic Steroids

   Club Drugs


   Gamma-hydroxybutyrate (GHB)


   Ketamine and PCP

   Management of Polydrug Abuse

Avoiding Boundary Violations

Outline for Avoiding Boundary Violations Part One: Confidentiality

  1. Introduction to Confidentiality Law
  1. 42 CFR Part 2
  2. HIPAA


  1. Specific Requirements of 42 CFR Part 2 and HIPAA
  1. Client Rights
  2. Permitted Disclosures
  3. Covered Transactions
  4. Informal Consent
  5. Medical Emergencies
  6. Reporting of Crimes
  7. Subpoenas, Search Warrants, and Arrest Warrants
  8. Court Ordered Disclosures
  9. Administrative Disclosures
  10. “Duty to Warn”
  11. Underage Clients
  12. Deceased Clients
  13. Counseling Notes
  14. Using Clients for Fund-raising or Marketing
  15. Necessary Safeguards
  16. Telephone and Mail Correspondence
  17. Computer Files, Faxes, and E-mails
  18. How Long To Keep Records
  19. Telephone Calls and Visits to Clients
  20. Marriage and Family Treatment
  21. When Consent is Revoked
  22. Penalties for Non-Compliance
  23. Ten Most Common Confidentiality Law   Boundary Violations


  1. Mandated Reporting and Recent Clarifications from SAMHSA
  1. Client Abuse and Neglect
  2. Limiting Damage to the Therapeutic Relationship
  3. Nine SAMHSA Clarifications to 42 CFR Part 2


  1. Homework Assignments, Evaluation, Sources Consulted



Course Outline for “Avoiding Boundary Violations Part Two: Counselor Ethics”

  1. Introduction to Counselor Ethics
  1. The major areas of disagreement
  2. Preventing litigation
  3. Primum non nocere
  4. The Counselor/Client Relationship
  1. Non-discrimination, respectful treatment, and competence
  2. Disclosure and informed consent
  3. Dual relationships and conflicts of interest
  4. Evaluation, Assessment, and Treatment Planning
  5. The rules of self-disclosure
  1. Your responsibilities in Dealing with Other Professionals
  2. For Counselors Who are Educators or Trainers
  3. For Supervisors and Administrators
  4. Self-assessment for Supervisors


  1. New Ethical Dilemmas in the Digital Age
  1. Electronic Communication
  2. Social Media
  3. “Googling”


  1. Resolving Ethical Issues
  1. Seven Steps for Ethical Decision-Making
  2. Guidelines for Making Ethical Decisions
  3. Food for Thought: A Case Study


  1. Homework Assignments, Course Evaluation, Sources Consulted

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