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- About these Reports
- TIP 52. Clinical Supervision and Professional Development of the Substance Abuse
Counselor
- Consensus Panel
- What Is a TIP?
- Foreword
- How This TIP Is Organized
- Part 1, Chapter 1, Clinical Supervision and Professional Development of the Substance Abuse Counselor: Information You Need to Know
- Part 1, Chapter 2, Clinical Supervision and Professional Development of the Substance Abuse Counselor: Clinical Scenarios Showing How to Apply the Information
- Part 2, Chapter 1, Clinical Supervision and Professional Development of the Substance Abuse Counselor: A Guide for Administrators
- Part 2, Chapter 2, Clinical Supervision and Professional Development of the Substance Abuse Counselor: A Guide for Administrators
- Part 3, Section 1, Clinical Substance and Professional Development of the Substance Abuse Counselor: A Review of the Literature
- Part 3, Section 2, Clinical Substance and Professional Development of the Substance Abuse Counselor: Annotated Bibliography
- Part 3, Section 3, Clinical Substance and Professional Development of the Substance Abuse Counselor: Bibliography of Available Literature
- Appendix A: Bibliography
- Appendix B: New York State Office of Alcoholism and Substance Abuse Services Clinical Supervision Vision Statement
- Appendix C: Advisory Meeting Panel
- Appendix D: Stakeholders Meeting Participants
- Appendix E: Field Reviewers
- Appendix F: Acknowledgments
- TIP 51. Substance Abuse Treatment: Addressing the Specific Needs of Women
- Consensus Panel
- Editorial Board
- KAP Expert Panel and Federal Government Participants
- Foreword
- Executive Summary
- Chapter 1: Creating the Context
- Chapter 2: Patterns of Use: From Initiation to Treatment
- Chapter 3: Physiological Effects of Alcohol, Drugs, and Tobacco on Women
- Chapter 4: Screening and Assessment
- Chapter 5: Treatment Engagement, Placement, and Planning
- Chapter 6: Substance Abuse Among Specific Population Groups and Settings
- Chapter 7: Substance Abuse Treatment for Women
- Chapter 8: Recovery Management and Administrative Considerations
- Appendix A: Bibliography
- Appendix B: CSAT’s Comprehensive Substance Abuse Treatment Model for Women and Their Children
- Appendix C: Screening and Assessment Instruments
- Appendix D: Allen Barriers to Treatment Instrument
- Appendix E: DSM-IV-TR Criteria for Posttraumatic Stress Disorder
- Appendix F: Integration Self-Assessment for Providers
- Appendix G: Resource Panel Members
- Appendix H: Cultural Competency and Diversity Network Participants
- Appendix I: Field Reviewers
- Appendix J: Acknowledgments
- TIP 50. Addressing Suicidal Thoughts and Behaviors in Substance Abuse Treatment
- Consensus Panel
- What Is a TIP?
- Foreword
- How This TIP Is Organized
- Part 1, Chapter 1, Addressing Suicidal Thoughts and Behaviors in Substance Abuse Treatment: Information You Need To Know
- Part 1, Chapter 2, Addressing Suicidal Thoughts and Behaviors in Substance Abuse Treatment: Clinical Vignettes Demonstrating How To Apply the Information
- Part 2, Chapter 1, Addressing Suicidal Thoughts and Behaviors: An Implementation Guide for Administrators
- Part 2, Chapter 2, Addressing Suicidal Thoughts and Behaviors in Substance Abuse Treatment: Building a Suicide Prevention- and Intervention-Capable Agency
- Part 3, Section 1, Addressing Suicidal Thoughts and Behaviors in Substance Abuse Treatment: A Review of the Literature
- Part 3, Section 2, Addressing Suicidal Thoughts and Behaviors in Substance Abuse Treatment: Annotated Bibliography
- Part 3, Section 3, Addressing Suicidal Thoughts and Behaviors in Substance Abuse Treatment: General Bibliography
- Appendix A—Biblography
- Appendix B—Advisory Meeting Panel
- Appendix C—Stakeholders Meeting Participants
- Appendix D—Field Reviewers
- Appendix E—Acknowledgments
- TIP 49. Incorporating Alcohol Pharmacotherapies Into Medical Practice
- Consensus Panel
- Expert Advisory Board
- What Is a TIP?
- Foreword
- Chapter 1—Introduction
- Chapter 2—Acamprosate
- Chapter 3—Disulfiram
- Chapter 4—Oral Naltrexone
- Chapter 5—Extended-Release Injectable Naltrexone
- Chapter 6—Patient Management
- Appendix A—Bibliography
- Appendix B—NIAAA's A Pocket Guide for Alcohol Screening and Brief Intervention
- Appendix C—Excerpts From Quick Guide for Clinicians Based on TIP 45, Detoxification and Substance Abuse Treatment
- Appendix D—Excerpts From Quick Guide for Clinicians Based on TIP 24, A Guide to Substance Abuse Services for Primary Care Clinicians
- Appendix E—Resource Panel
- Appendix F—Field Reviewers
- Appendix G—Acknowledgments
- TIP 48. Managing Depressive Symptoms in Substance Abuse Clients During Early Recovery
- Foreword
- How This TIP Is Organized
- Part 1, Chapter 1, Managing Depressive Symptoms in Substance Abuse Clients During Early Recovery
- Part 1, Chapter 2, Managing Depressive Symptoms in Substance Abuse Clients During Early Recovery
- Part 2, Chapter 1, Managing Depressive Symptoms: An Implementation Guide for Administrators
- Part 2, Chapter 2, Managing Depressive Symptoms: An Implementation Guide for Administrators
- Part 3, Managing Depressive Symptoms: A Review of the Literature, Section 1—A Review of the Literature
- Part 3, Managing Depressive Symptoms: A Review of the Literature, Section 2—Annotated Bibliography
- Part 3, Managing Depressive Symptoms: A Review of the Literature, Section 3—General Bibliography
- Appendix A—Bibliography
- Appendix B—Center for Epidemiologic Studies Depression Scale (CES-D)
- Appendix C—Fidelity Checklists
- Appendix D—DSM-IV-TR Mood Disorders
- Appendix E—Advisory Meeting Panel
- Appendix F—Field Reviewers
- TIP 47. Substance Abuse: Clinical Issues in Intensive Outpatient Treatment
- Consensus Panel
- Foreword
- Executive Summary
- Chapter 1. Introduction
- Chapter 2. Principles of Intensive Outpatient Treatment
- Chapter 3. Intensive Outpatient Treatment and the Continuum of Care
- Chapter 4. Services in Intensive Outpatient Treatment Programs
- Chapter 5. Treatment Entry and Engagement
- Chapter 6. Family-Based Services
- Chapter 7. Clinical Issues, Challenges, and Strategies in Intensive Outpatient Treatment
- Chapter 8. Intensive Outpatient Treatment Approaches
- Chapter 9. Adapting Intensive Outpatient Treatment for Specific Populations
- Chapter 10. Addressing Diverse Populations in Intensive Outpatient Treatment
- Appendix A. Bibliography
- Appendix B. Urine Collection and Testing Procedures and Alternative Methods for Monitoring Drug Use
- Appendix C. Resource Panel
- Appendix D. Cultural Competency and Diversity Network Participants
- Appendix E. Field Reviewers
- TIP 46. Substance Abuse: Administrative Issues in Outpatient Treatment
- Consensus Panel
- KAP Expert Panel and Federal Government Participants
- Foreword
- Executive Summary
- Chapter 1. Introduction
- Chapter 2. Management Issues
- Chapter 3. Managing Human Resources
- Chapter 4. Preparing a Program To Treat Diverse Clients
- Chapter 5. Outpatient Treatment Financing Options and Strategies
- Chapter 6. Performance Improvement and Outcomes Monitoring
- Appendix A—Bibliography
- Appendix B—Resource Panel
- Appendix C—Cultural Competency and Diversity Network Participants
- Appendix D—Field Reviewers
- TIP 45. Detoxification and Substance Abuse Treatment
- Consensus Panel
- KAP Expert Panel and Federal Government Participants
- Consulting Members
- Foreword
- Executive Summary
- 1 Overview, Essential Concepts, and Definitions in Detoxification
- 2 Settings, Levels of Care, and Patient Placement
- 3 An Overview of Psychosocial and Biomedical Issues During Detoxification
- 4 Physical Detoxification Services for Withdrawal From Specific Substances
- 5 Co-Occurring Medical and Psychiatric Conditions
- 6 Financing and Organizational Issues
- Appendix A: Bibliography
- Appendix B: Common Drug Intoxication Signs and Withdrawal Symptoms
- Appendix C: Screening and Assessment Instruments
- Appendix D: Resource Panel
- Appendix E: Field Reviewers
- TIP 44. Substance Abuse Treatment for Adults in the Criminal Justice System
- Consensus Panel
- Foreword
- Executive Summary
- 1 Introduction
- 2 Screening and Assessment
- 3 Triage and Placement in Treatment Services
- 4 Substance Abuse Treatment Planning
- 5 Major Treatment Issues and Approaches
- 6 Adapting Offender Treatment for Specific Populations
- 7 Treatment Issues in Pretrial and Diversion Settings
- 8 Treatment Issues Specific to Jails
- 9 Treatment Issues Specific to Prisons
- 10 Treatment for Offenders Under Community Supervision
- 11 Key Issues Related to Program Development
- Appendix A: Bibliography
- Appendix B: Glossary
- Appendix C: Screening and Assessment Instruments
- Appendix D: Resource Panel
- Appendix E: Cultural Competency and Diversity Network Participants
- Appendix F: Special Consultants
- Appendix G: Field Reviewers
- TIP 43. Medication-Assisted Treatment for Opioid Addiction in Opioid Treatment
Programs
- Consensus Panel
- Editorial Advisory Board
- Consensus Panelists
- KAP Expert Panel and Federal Government Participants
- Foreword
- Executive Summary
- Chapter 1. Introduction
- Chapter 2. History of Medication-Assisted Treatment for Opioid Addiction
- Chapter 3. Pharmacology of Medications Used To Treat Opioid Addiction
- Chapter 4. Initial Screening, Admission Procedures, and Assessment Techniques
- Appendix 4-A. Example of Standard Consent to Opioid Maintenance Treatment
- Chapter 5. Clinical Pharmacotherapy
- Chapter 6. Patient-Treatment Matching: Types of Services and Levels of Care
- Chapter 7. Phases of Treatment
- Chapter 8. Approaches to Providing Comprehensive Care and Maximizing Patient Retention
- Chapter 9. Drug Testing as a Tool
- Chapter 10. Associated Medical Problems in Patients Who Are Opioid Addicted
- Chapter 11. Treatment of Multiple Substance Use
- Chapter 12. Treatment of Co-Occurring Disorders
- Appendix 12-A. Internet Resources for Accessing Psychiatric Instruments
- Chapter 13. Medication-Assisted Treatment for Opioid Addiction During Pregnancy
- Chapter 14. Administrative Considerations
- Appendix A: Bibliography
- Appendix B: Abbreviations and Acronyms
- Appendix C: Glossary
- Appendix D: Ethical Considerations in MAT
- Appendix E: Resource Panel
- Appendix F: Field Reviewers
- TIP 42. Substance Abuse Treatment for Persons With Co-Occurring Disorders
- Consensus Panel
- KAP Expert Panel and Federal Government Participants
- Foreword
- Executive Summary
- 1 Introduction
- 2 Definitions, Terms, and Classification Systems for Co-Occurring Disorders
- 3 Keys to Successful Programming
- 4 Assessment
- 5 Strategies for Working With Clients With Co-Occurring Disorders
- 6 Traditional Settings and Models
- 7 Special Settings and Specific Populations
- 8 A Brief Overview of Specific Mental Disorders and Cross-Cutting Issues
- 9 Substance-Induced Disorders
- Appendix A: Bibliography
- Appendix B: Acronyms
- Appendix C: Glossary of Terms
- Appendix D: Specific Mental Disorders: Additional Guidance for the Counselor
- Appendix E: Emerging Models
- Appendix F: Common Medications for Disorders
- Appendix G: Screening and Assessment Instruments
- Appendix H: Screening Instruments
- Appendix I: Selected Sources of Training
- Appendix J: Dual Recovery Mutual Self-Help Programs and Other Resources for Consumers and Providers
- Appendix K: Confidentiality
- Appendix L: Resource Panel
- Appendix M: Cultural Competency and Diversity Network Participants
- Appendix N: Field Reviewers
- TIP 41. Substance Abuse Treatment: Group Therapy
- Consensus Panel
- KAP Expert Panel and Federal Government Participants
- Foreword
- Executive Summary
- 1 Groups and Substance Abuse Treatment
- 2 Types of Groups Commonly Used in Substance Abuse Treatment
- 3 Criteria for the Placement of Clients in Groups
- 4 Group Development and Phase‐Specific Tasks
- 5 Stages of Treatment
- 6 Group Leadership, Concepts, and Techniques
- 7 Training and Supervision
- Appendix A: Bibliography
- Appendix B: Adult Patient Placement Criteria
- Appendix C: Sample Group Agreement
- Appendix D: Glossary
- Appendix E: Association for Specialists in Group Work Best Practice Guidelines
- Appendix F: Resource Panel
- Appendix G: Cultural Competency and Diversity Network Participants
- Appendix H: Field Reviewers
- TIP 40. Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid
Addiction
- Consensus Panel
- Panelists
- Buprenorphine Expert Panel
- Foreword
- Executive Summary
- 1 Introduction
- 2 Pharmacology
- 3 Patient Assessment
- 4 Treatment Protocols
- 5 Special Populations
- 6 Policies and Procedures
- Appendix A. Bibliography
- Appendix B Assessment and Screening Instruments
- Appendix C DSM‐IV‐TR Material
- Appendix D Consent to Release of Information Under Title 42, Part 2, Code of Federal Regulations
- Appendix E Clinical Toolbox: Chapter 3 Supplemental Information
- Appendix F Federation of State Medical Boards—Model Policy Guidelines for Opioid Addiction Treatment in the Medical Office
- Appendix G Stages of Change
- Appendix H Sample Treatment Agreement/Contract
- Appendix I Glossary
- Appendix J Field Reviewers
- TIP 39. Substance Abuse Treatment and Family Therapy
- Consensus Panel
- KAP Expert Panel and Federal Government Participants
- Foreword
- Executive Summary
- Chapter 1 Substance Abuse Treatment and Family Therapy
- Chapter 2 Impact of Substance Abuse on Families
- Chapter 3 Approaches to Therapy
- Chapter 4 Integrated Models for Treating Family Members
- Chapter 5 Specific Populations
- Chapter 6 Policy and Program Issues
- Appendix A: Bibliography
- Appendix B: Glossary
- Appendix C: Guidelines for Assessing Violence
- Appendix D: Resources
- Appendix E: Resource Panel
- Appendix F: Cultural Competency and Diversity Network Participants
- Appendix G: Field Reviewers
- TIP 38. Integrating Substance Abuse Treatment and Vocational Services
- Editorial Advisory Board
- Consensus Panel
- Foreword
- Executive Summary and Recommendations
- Chapter 1—The Need for Vocational Services
- Chapter 2—Vocational Programming And Resources
- Chapter 3—Clinical Issues Related to Integrating Vocational Services
- Chapter 4—Integrating Onsite Vocational Services
- Chapter 5—Effective Referrals and Collaborations
- Chapter 6 --Funding and Policy Issues
- Chapter 7—Legal Issues
- Chapter 8—Working With the Ex-Offender
- Appendix A -- Bibliography
- Appendix B --Resources: Tools and Instruments
- Appendix C—Published Resource Materials
- Appendix D—Addiction Severity Index
- Appendix E—State Employment Agencies
- Appendix F—Federal Funding Sources
- Appendix G—Sample Individualized Written Rehabilitation Program
- Appendix H—Resource Panel
- Appendix I—Field Reviewers
- Figure 1-1: Challenges to Employment
- Figure 1-2: Strategies for Promoting Employment
- Figure 2-1: Vocational Services Provided to a Residential Treatment Facility
- Figure 2-2: Vocational Information From Initial Screen
- Figure 2-3: Assessment Tools
- Figure 2-4: Prevocational Counseling Activities
- Figure 2-5: Job Search Resources: America's Job Bank on the Internet
- Figure 2-6: Vocational Opportunities of Cherokee, Inc.: Rehabilitation Facility Providing Primarily Onsite Services
- Figure 2-7: The Michigan Drug Addiction and Alcoholism Referral and Monitoring Agency: A Case Management Model
- Figure 2-8: Combating Alcohol and Drugs Through Rehabilitation and Education (CADRE)
- Figure 2-9: The Texas Workforce Commission: Project RIO (Re-Integration of Offenders)
- Figure 2-10: Basic Materials for a Vocational Reference Library
- Figure 3-1: Early-Stage Vocational Issues and Approaches
- Figure 3-2: Answering Questions Related to Substance Use History-A Sample Scenario
- Figure 4-1: Steps for Planning an Integrated Program
- Figure 4-2: Job Clubs
- Figure 4-3: Focus on Client Outcomes: The Future for Substance Abuse Treatment Providers
- Figure 5-1: Data-Matching Software
- Figure 5-2: Steps for Establishing an Authentically Connected Network
- Figure 5-3: Characteristics of Authentically Connected Referral Networks
- Figure 6-1: Agency Self-Assessment Categories
- Figure 7-1: Americans With Disabilities Act and Rehabilitation Act Protections
- Figure 7-2: Services Provided Under the Workforce Investment Act of 1996
- Figure 7-3: Sample Consent Form
- Figure 7-4: Making a Referral to a Vocational or Training Program
- Figure 8-1: A Program That Addresses Women's Issues
- Figure 8-2: Summary of Program Examples
- Figure F-1: Federal Funding Sources
- Figure F-2: Federal Sources of Discretionary, Time-Limited Project Grants
- TIP 37. Substance Abuse Treatment for Persons with HIV/AIDS
- Editorial Advisory Board
- Consensus Panel
- Foreword
- Executive Summary and Recommendations
- Chapter 1-- Introduction to HIV/AIDS
- Chapter 2—Medical Assessment and Treatment
- Chapter 3—Mental Health Treatment
- Chapter 4—Primary and Secondary HIV Prevention
- Chapter 5—Integrating Treatment Services
- Chapter 6—Accessing and Obtaining Needed Services
- Chapter 7—Counseling Clients With HIV And Substance Abuse Disorders
- Chapter 8—Ethical Issues
- Chapter 9—Legal Issues
- Chapter 10—Funding and Policy Considerations
- Appendix A -- Bibliography
- Appendix B—Glossary
- Appendix C—1993 Revised Classification System For HIV Infection and Expanded AIDS Surveillance Case Definition For Adolescents and Adults
- Appendix D --Screening Instruments
- Appendix E—Sample Codes of Ethics
- Appendix F—AIDS-Related Web Sites
- Appendix G—State and Territorial Health Agencies/Offices of AIDS
- Appendix H—Mini Mental State Examination (MMSE)
- Appendix I—Standards of Care: Client Assessment/Treatment Protocol
- Appendix J -- Resource Panel
- Appendix K—Field Reviewers
- TIP 36. Substance Abuse Treatment for Persons with Child Abuse and Neglect Issues
- Editorial Advisory Board
- Consensus Panel
- Foreword
- Executive Summary and Recommendations
- Chapter 1—Working With Child Abuse and Neglect Issues
- Chapter 2—Screening and Assessing Adults For Childhood Abuse and Neglect
- Chapter 3—Comprehensive Treatment for Adult Survivors of Child Abuse and Neglect
- Chapter 4—Therapeutic Issues for Counselors
- Chapter 5—Breaking the Cycle: The Substance-Dependent Client as Parent/Caregiver
- Chapter 6—Legal Responsibilities and Recourse
- Chapter 7—Emerging and Continuing Issues
- Appendix A --Bibliography
- Appendix B --Protecting Clients' Privacy
- Appendix C --Implications of Recent Federal Legislation for Clients in Treatment
- Appendix D—Obtaining Screening and Assessment Tools
- Appendix E --Resources Related to Childhood Trauma Among Adults
- Appendix F --Resource Panelists
- Appendix G—Field Reviewers
- TIP 35. Enhancing Motivation for Change in Substance Abuse Treatment
- Editorial Advisory Board
- Consensus Panel
- Foreword
- Executive Summary and Recommendations
- Chapter 1-- Conceptualizing Motivation And Change
- Chapter 2—Motivation and Intervention
- Chapter 3—Motivational Interviewing as a Counseling Style
- Chapter 4—From Precontemplation to Contemplation: Building Readiness
- Chapter 5—From Contemplation to Preparation: Increasing Commitment
- Chapter 6—From Preparation to Action: Getting Started
- Chapter 7—From Action to Maintenance: Stabilizing Change
- Chapter 8—Measuring Components of Client Motivation
- Chapter 9—Integrating Motivational Approaches Into Treatment Programs
- Chapter 10—Directions for Future Research
- Appendix A -- Bibliography
- Appendix B—Screening and Assessment Instruments
- Appendix C—Ordering Information for Assessment Instruments
- Appendix D—Resource Panel
- Appendix E --Field Reviewers
- TIP 34. Brief Interventions and Brief Therapies for Substance Abuse
- Editorial Advisory Board
- Consensus Panel
- Foreword
- Executive Summary and Recommendations
- Chapter 1—Introduction to Brief Interventions and Therapies
- Chapter 2—Brief Interventions in Substance Abuse Treatment
- Chapter 3—Brief Therapy in Substance Abuse Treatment
- Chapter 4—Brief Cognitive-Behavioral Therapy
- Chapter 5—Brief Strategic/Interactional Therapies
- Chapter 6 --Brief Humanistic and Existential Therapies
- Chapter 7—Brief Psychodynamic Therapy
- Chapter 8—Brief Family Therapy
- Chapter 9—Time-Limited Group Therapy
- Appendices
- TIP 33. Treatment for Stimulant Use Disorders
- Editorial Advisory Board
- Consensus Panel
- Foreword
- Executive Summary and Recommendations
- Chapter 1—Introduction
- Chapter 2—How Stimulants Affect the Brain and Behavior
- Chapter 3—Approaches to Treatment
- Chapter 4—Practical Application of Treatment Strategies
- Chapter 5—Medical Aspects of Stimulant Use Disorders
- Chapter 6—Treatment Issues for Special Groups and Settings
- Appendices
- TIP 32. Treatment of Adolescents with Substance Use Disorders
- Editorial Advisory Board
- Consensus Panel
- Foreword
- Executive Summary and Recommendations
- Chapter 1--Substance Use Among Adolescents
- Chapter 2—Tailoring Treatment to the Adolescent's Problem
- Chapter 3—General Program Characteristics
- Chapter 4—Twelve-Step-Based Programs
- Chapter 5—Therapeutic Communities
- Chapter 6—Family Therapy
- Chapter 7—Youths With Distinctive Treatment Needs
- Chapter 8—Legal and Ethical Issues
- Appendix A -- Bibliography
- Appendix B —Medical Management of Drug Intoxication and Withdrawal
- Appendix C --Field Reviewers
- TIP 31. Screening and Assessing Adolescents for Substance Use Disorders
- Editorial Advisory Board
- Consensus Panel
- Foreword
- Executive Summary and Recommendations
- Chapter 1-- Introduction
- Chapter 2—Preliminary Screening of Adolescents
- Chapter 3—Comprehensive Assessment of Adolescents for Referral and Treatment
- Chapter 4 --Legal Issues in the Screening And Assessment of Adolescents
- Chapter 5—Screening and Assessment of Adolescents in Juvenile Justice Settings
- Appendix A--Bibliography
- Appendix B—Instrument Summaries
- Appendix C --Drug Identification and Testing in The Juvenile Justice System
- Appendix D—Field Reviewers
- TIP 30. Continuity of Offender Treatment for Substance Use Disorders from Institution to
Community
- Editorial Advisory Board
- Consensus Panel
- Foreword
- Executive Summary and Recommendations
- Chapter 1—Introduction
- Chapter 2—Case Management and Accountability
- Chapter 3—Guidelines for Institution and Community Programs
- Chapter 4—Administrative Guidelines
- Chapter 5—Ancillary Services
- Chapter 6—Special Populations
- Appendix A -- Bibliography
- Appendix B—Instruments
- Appendix C — Resource Panel
- Appendix D—Field Reviewers
- Tables and Figures
- TIP 29. Substance Use Disorder Treatment For People With Physical and Cognitive
Disabilities
- Editorial Advisory Board
- Consensus Panel
- Foreword
- Executive Summary and Recommendations
- Chapter1—Overview of Treatment Issues
- Chapter 2—Screening Issues
- Chapter 3—Treatment Planning and Service Delivery
- Chapter 4 --Treatment Planning and the Community: Linkages and Case Management
- Chapter 5—Administrative Tasks
- Appendix A -- Bibliography
- Appendix B—Information Resources
- Appendix C—How To Refer to People With Disabilities
- Appendix D—Alcohol and Drug Programs and The Americans With Disabilities Act
- Appendix E—Resource Panel
- Appendix F—Field Reviewers
- TIP 28. Naltrexone And Alcoholism Treatment 28
- Editorial Advisory Board
- Consensus Panel
- Foreword
- Executive Summary and Recommendations
- Chapter 1 --The Current Situation
- Chapter 2—Pharmacological Management With Naltrexone
- Chapter 3 --Basic Neurobiological and Preclinical Research
- Chapter 4 --Clinical Findings
- Chapter 5 --Clinical Profile
- Appendix A -- Bibliography
- Appendix B--Naltrexone and the Formulary
- Appendix C --Translating Research Into Practice
- Appendix D --Instruments
- Appendix E --Resource Panel
- Appendix F --Field Reviewers
- TIP 27. Comprehensive Case Management for Substance Abuse Treatment
- Editorial Advisory Board
- Consensus Panel
- Foreword
- Executive Summary
- Chapter 1 - Substance Abuse and Case Management: An Introduction
- Chaper 2 - Applying Case Management to Substance Abuse Treatment
- Chapter 3 - Case Management in the Community Context: An Interagency Perspective
- Chapter 4 - Evaluation and Quality Assurance of Case Management Services
- Chapter 5 - Case Management for Clients With Special Needs
- Chapter 6 - Funding Case Management in a Managed Care Environment
- Appendix A - Bibliography
- Appendix B - Practice Dimensions
- Appendix C - Managed Healthcare Organizational Readiness Guide and Checklist: Special Report By James B. Bixler, M.S
- Appendix D - Resource Panel
- Appendix E - Field Reviewers
- Exhibits
- TIP 26. Substance Abuse Among Older Adults
- Editorial Advisory Board
- Consensus Panel
- Foreword
- Executive Summary and Recommendations
- Chapter 1 - Substance Abuse Among Older Adults: An Invisible Epidemic
- Chapter 2 - Alcohol
- Chapter 3 - Use and Abuse of Psychoactive Prescription Drugs and Over-the-Counter Medications
- Chapter 4 - Identification, Screening, and Assessment
- Chapter 5 - Referral and Treatment Approaches
- Chapter 6 - Outcomes and Cost Issues in Alcohol Treatment for Older Adults
- Appendix A - Legal and Ethical Issues
- Appendix B - Tools
- Appendix D - Resource Panel
- Appendix E - Field Reviewers
- Appendix C - Bibliography
- TIP 25. Substance Abuse Treatment and Domestic Violence
- Editorial Advisory Board
- Consensus Panel
- Foreword
- Executive Summary and Recommendations
- Chapter 1—Effects of Domestic Violence on Substance Abuse Treatment
- Chapter 2—Survivors of Domestic Violence: An Overview
- Chapter 3 -- Batterers: An Overview
- Chapter 4—Screening and Referral of Survivors and Batterers in Substance Abuse Treatment Programs
- Chapter 5—Legal Issues
- Chapter 6 -- Linkages: A Coordinated Community Response
- Appendix A -- Bibliography
- Appendix B—Federal Confidentiality Regulations
- Appendix C—Instruments
- Appendix D—Sample Personalized Safety Plan For Domestic Violence Survivors
- Appendix E—Hotlines and Other Resources For Domestic Violence and Related Issues
- Appendix F—Resource Panel
- Appendix G—Field Reviewers
- Tables and Figures
- TIP 24. A Guide to Substance Abuse Services for Primary Care Clinicians
- Editorial Advisory Board
- Consensus Panel
- Foreword
- Executive Summary and Recommendations
- Chapter 1—Substance Abuse and Primary Care
- Chapter 2—Screening for Substance Use Disorders
- Chapter 3—Brief Intervention
- Chapter 4—Assessment
- Chapter 5—Specialized Substance Abuse Treatment Programs
- Chapter 6—Implementation and Recommendation Summary
- Appendix A—Pharmacotherapy
- Appendix B—Legal and Ethical Issues
- Appendix C—Screening and Assessment Instruments
- Appendix D—Substance Abuse Resources for the Primary Care Setting
- Appendix F—Resource Panel
- Appendix G—Field Reviewers
- Tables and Figures*
- Appendix E -- Bibliography
- TIP 23. Treatment Drug Courts: Integrating Substance Abuse Treatment With Legal Case Processing
- Consensus Panel
- Foreword
- Chapter 1—Introduction
- Chapter 2—Key Elements of Treatment Drug Courts
- Chapter 3—Program Planning
- Chapter 4—Designing the Program
- Chapter 5—Implementation
- Chapter 6—Program Evaluation
- Chapter 7—Program Costs and Financing
- Chapter 8—Legal and Ethical Issues
- Appendix A -- Bibliography
- Appendix B—Federal Resource Panel
- Appendix C—Federal Resource Panel
- TIP 22. LAAM in the Treatment of Opiate Addiction
- Consensus Panel
- Foreword
- Chapter 1 - Introduction
- Chapter 2 - Clinical Profile of LAAM
- Chapter 3 - Clinical Application of LAAM Therapy
- Chapter 4 - Treatment Planning
- Chapter 5 - Management and Administrative Issues
- Chapter 6 - Regulatory and Ethical Issues
- Appendix A - Bibliography
- Appendix B - Training Resources
- Appendix C - Federal Resource Panel
- Appendix D - Field Reviewers
- TIP 21. Combining Alcohol and Other Drug Abuse Treatment With Diversion for Juveniles in
the Justice System
- Consensus Panel
- Foreword
- Chapter1—Introduction
- Chapter 2 -- Goals of AOD Treatment-Focused Diversion Programs
- Chapter 3—Collaborating on a Diversion Program
- Chapter 4—Planning Juvenile Diversion to AOD Abuse Treatment
- Chapter 5 -- Program Implementation Issues
- Appendix A -- Bibliography
- Appendix B -- Glossary
- Appendix C—CSAT Juvenile Justice Treatment Planning Chart
- Appendix D—Oregon's Department of Human Services Multiagency Release
- Appendix E—Assessment Instruments for Adolescent Populations
- Appendix F—Desktop Guide to Good Juvenile Probation Practice (Legal Rights of Juvenile Offenders)
- Appendix G - "Multicultural Awareness: Developing Cultural Understanding in the Juvenile Justice System[1]
- Appendix H—Prospectus for a Consensus Development Panel
- Appendix I—Federal Resource Panel
- Appendix J—Field Reviewers
- TIP 20. Matching Treatment to Patient Needs in Opioid Substitution Therapy
- Consensus Panel
- Foreword
- Chapter 1 -- Patient Matching: Historical Perspective and Overview
- Chapter 2—Assessing Patient Needs
- Chapter 3—Phases of Treatment
- Chapter 4—Treatment Elements
- Chapter 5—Self-Monitoring and Evaluation
- Chapter 6 -- Cost-Effectiveness of Opioid Substitution Therapy
- Appendix A -- Bibliography
- Appendix B —Massachusetts Methadone Treatment Criteria
- Appendix C -- Methodological Approaches to Cost-Efficiency and Cost-Effectiveness Analyses
- Appendix D—Federal Resource Panel
- Appendix E—Field Reviewers
- TIP 19. Detoxification From Alcohol and Other Drugs
- Consensus Panel
- Foreword
- Chapter 1—Introduction
- Chapter 2—Detoxification Settings and Patient Matching
- Chapter 3—Clinical Detoxification Protocols
- Chapter 4—Special Populations
- Chapter 5—Improving Quality and Measuring Outcomes of AOD Detoxification Services
- Chapter 6—Costs and Current Payment Mechanisms for AOD Detoxification
- Appendix A -- Bibliography
- Appendix B—Glossary
- Appendix C—Resource List
- Appendix D—Acronyms
- Appendix E - Legal and Ethical Issues for Detoxification Programs
- Appendix F—Federal Resource Panel
- Appendix G—Field Reviewers
- TIP 18. The Tuberculosis Epidemic: Legal and Ethical Issues for Alcohol and Other Drug Treatment Providers
- Consensus Panel
- Foreword
- Chapter 1—Introduction
- Chapter 2—Summary of Recommendations
- Chapter 3—The Facts About Tuberculosis
- Chapter 4—AOD Programs and Public Health: Joining Together to Fight the Spread of TB
- Chapter 5—Providing TB-Related Services to Patients
- Chapter 6—Toward a Safe Workplace
- Appendix A—Bibliography
- Appendix B—Legal Questions and Answers Regarding TB-Related Discrimination in the AOD Setting
- Appendix C—Sample Forms
- Appendix D—Massachusetts Policy for TB Control in Substance Abuse Treatment Centers
- Appendix E—A Massachusetts Pamphlet on HIV and TB
- Appendix F—A Massachusetts Pamphlet on the Connection Between Substance Abuse and Certain Communicable Diseases
- Appendix G—New York State OASAS Administrative Bulletin on TB Control In Drug Treatment Programs
- Appendix H—New York City TB/Methadone Registry Match Procedure
- Appendix I—New York State Division Of Substance Abuse Services Tuberculosis Update
- Appendix J—CDC: Essential Components of a TB Prevention and Control Program; and Screening for TB and TB Infection in High-Risk Populations
- Appendix K—Federal Resource Panel
- Appendix L—Field Reviewers
- TIP 17. Planning for Alcohol and Other Drug Abuse Treatment for Adults in the Criminal Justice
System
- Consensus Panel
- Foreword
- Chapter 1—Introduction
- Chapter 2—The Effectiveness of AOD Treatment in the Criminal Justice System
- Chapter 3—The AOD-Involved Offender
- Chapter 4—The Criminal Justice Continuum
- Chapter 5—The AOD Abuse Treatment System
- Chapter 6—Collaboration Between Systems
- Chapter 7—Coordinated Training
- Chapter 8—Confidentiality Issues 5
- Chapter 9—Evaluation
- Appendix A -- Bibliography
- Appendix B—CSAT Criminal Justice Treatment Planning Chart
- Appendix C—Sample Interagency Agreement
- Appendix D—Federal Resource Panel
- Appendix E—Field Reviewers
- TIP 16. Alcohol and Other Drug Screening of Hospitalized Trauma Patients
- Consensus Panel
- Foreword
- A Note to Readers
- Chapter 1—Introduction
- Chapter 2—Trauma Patients
- Chapter 3 -- Effects of Alcohol and Other Drugs on Trauma Patients
- Chapter 4—Screening and Assessment
- Chapter 5—Cost-Benefit Issues Affecting Implementation of Screening
- Chapter 6—Legal and Ethical Concerns
- Chapter 7—Recordkeeping and Quality Improvement
- Appendix A -- Bibliography
- Appendix B—Glossary of Medical Terms
- Appendix C—Federal Resource Panel
- Appendix D—Field Reviewers
- TIP 15. Treatment for HIV-Infected Alcohol and Other Drug Abusers
- Consensus Panel
- Foreword
- Chapter 1 - The HIV Challenge to AOD Treatment
- Chapter 2—Overview of AOD Treatment Services
- Chapter 3 - Primary Medical Care for HIV-Infected AOD Abuse Patients
- Chapter 4—Mental Health and Counseling Needs of HIV-Infected AOD Abusers
- Chapter 5—Social Services for HIV-Infected AOD Abusers
- Chapter 6—Linkages and Services Integration: Policy and Implementation
- Chapter 7 - Key Legal Issues in HIV/AIDS and AOD Abuse Treatment
- Appendix A -- Bibliography
- Appendix B—Summary of Block Grants: Interim Final Rule (1993)
- Appendix C—Elements of a Needle Exchange Program
- Appendix D—Cultural Proficiency Questionnaire
- Appendix E - Information About the Ryan White Comprehensive AIDS Resources Emergency Act of 1990 (The CARE Act)
- Appendix F—Standards of Care
- Appendix G—National HIV/AIDS Organizations and Hotlines
- Appendix H—Sample Memorandum of Understanding
- Appendix I - Federal Resource Panel
- Appendix J—Field Reviewers
- TIP 12. Combining Substance Abuse Treatment with Intermediate Sanctions for Adults in the
Criminal Justice System
- Consensus Panel
- Foreword
- Chapter 1—Introduction and Purpose
- Chapter 2—An Overview of the Criminal Justice System
- Chapter 3—The AOD Abuse Treatment System
- Chapter 4—Combining AOD Abuse Treatment and Intermediate Sanctions
- Chapter 5—Issues in Combining Treatment and Intermediate Sanctions
- Chapter 6—Planning: Approaches for Developing Policy
- Chapter 7 - Ethical and Legal Issues
- Appendix A -- Bibliography
- Appendix B—Costing Issues
- Appendix C—Cultural Competence
- Appendix D—Federal Resource Panel
- Appendix E—Field Reviewers
- TIP 11. Simple Screening Instruments for Outreach for Alcohol and Other Drug Abuse and
Infectious Diseases
- Consensus Panel
- Foreword
- Chapter 1 - Introduction
- Chapter 2 - Development of the Simple Screening Instrument For AOD Abuse
- Chapter 3 - Development of the Simple Screening Instrument for Infectious Diseases
- Chapter 4 - Training and Implementation
- Chapter 5 - Legal Issues Surrounding Client Confidentiality
- Appendix A - References
- Appendix B - Sample Curriculum for Outreach Workers
- Appendix C - Cultural Competence
- Appendix D - Federal Resource Panel
- Appendix E - Field Reviewers
- TIP 10. Assessment and Treatment Planning for Cocaine-Abusing Methadone-Maintained Patients
- Consensus Panel
- Foreword
- Note From the Chair
- Chapter 1-Overview
- Chapter 2-Statement of the Problem
- Chapter 3-Screening, Admission, and Assessment Techniques
- Chapter 4-Treatment Interventions and Related Issues
- Chapter 5-Legal and Ethical Issues
- Chapter 6-Evaluating Program Performance
- Chapter 7-Consensus Panel Recommendations for Further Research
- Appendix A - Glossary
- Appendix B - Levels of Care
- Appendix C - Acronyms
- Appendix D - TB/PPD Testing - Sample Forms
- Appendix E - Multidrug Abuse Patterns
- Appendix F - Diagnostic Assessment Instruments
- Appendix G - DSM-IV Criteria for Substance-Related Disorders
- Appendix H - Psychiatric Disorders
- Appendix I - Internal Trigger Questionnaire and External Trigger Questionnaire
- Appendix J - Self-Help Groups
- Appendix K - Federal Resource Panel
- Appendix L - Field Reviewers
- References
- TIP 9. Assessment and Treatment of Patients with Coexisting Mental Illness and Alcohol
and Other Drug Abuse
- Consensus Panel
- Foreword
- Chapter 1 --Introduction
- Chapter 2—Dual Disorders: Concepts and Definitions
- Chapter 3 -- Mental Health And Addiction Treatment Systems: Philosophical and Treatment Approach Issues
- Chapter 4—Linkages For Mental Health and AOD Treatment
- Chapter 5—Mood Disorders
- Chapter 6—Anxiety Disorders
- Chapter 7—Personality Disorders
- Chapter 8—Psychotic Disorders
- Chapter 9—Pharmacologic Management
- Appendix A -- Bibliography
- Appendix B—Treatment of Patients With Dual Disorders: Sample Cost Data
- Appendix C—Federal Resource Panel
- Appendix D—Field Reviewers
- TIP 8. Intensive Outpatient Treatment for Alcohol and Other Drug Abuse
- Consensus Panel
- Foreword
- Chapter 1—Introduction
- Chapter 2—Placement Criteria and Expected Treatment Outcomes
- Chapter 3—Components of an Effective IOT Program
- Chapter 4—Staffing Issues and Guidelines
- Chapter 5—The Treatment Needs Of Special Groups
- Chapter 6—Special Fiscal and Administrative Issues
- Chapter 7—Legal Issues for IOT Programs1
- Appendix A -- References
- Appendix B—Sample IOT Program Schedules
- Appendix C—Federal Resource Panel
- Appendix D—Field Reviewers
- TIP 7. Screening and Assessment for Alcohol and Other Drug Abuse Among Adults in the
Criminal Justice System
- Consensus Panel
- Foreword
- Chapter 1—Introduction
- Chapter 2—Criminal Justice and Assessment: An Overview
- Chapter 3—Screening, Assessment, and Readiness for Treatment
- Chapter 4—Treatment Planning And Treatment Progress
- Chapter 5—Special Assessment Issues
- Chapter 6 -- Legal and Ethical Issues
- Appendix A—References and Bibliography
- Appendix B—CSAT Criminal Justice Treatment Planning
- Appendix C—Screening and Assessment Instruments
- Appendix D—Supplementary Instruments Recommended for the Assessment of Life Domains and Problem Areas of Adult Clients
- Appendix E—Federal Resource Panel
- Appendix F—Field Reviewers
- TIP 6. Screening for Infectious Diseases Among Substance Abusers
- Consensus Panel Members
- Foreword
- Definition of the Term "Drug Use"
- Chapter 1 - Introduction
- Chapter 2 - Issues for Counselors
- Chapter 3 - Legal and Ethical Issues
- Chapter 4 - Issues for Treatment Program Administrators: Staff and Community Development and Environmental Safety
- Chapter 5 - The Initial Patient Contact
- Chapter 6 - Summary Statement on Tuberculosis
- Chapter 7 - Tuberculosis
- Chapter 8 - Multidrug-Resistant Tuberculosis
- Chapter 9 - Human Immunodeficiency Virus and the Acquired Immunodeficiency Syndrome
- Chapter 10 - Syphilis
- Chapter 11 - Introduction to Viral Hepatitis
- Chapter 12 - Viral Hepatitis B
- Chapter 13 - Viral Hepatitis C
- Chapter 14 - Viral Hepatitis A
- Chapter 15 - Viral Hepatitis D
- Chapter 16 - Gonorrhea
- Chapter 17 - Chlamydia
- Chapter 18 - Herpes Simplex
- Chapter 19 - Chancroid
- Appendix A - Bibliography
- Appendix B - Federal Resource Panel on Screening for Infectious Diseases Among Substance Abusers
- Appendix C - TIP Field Reviewers
- Appendix D - Resource List
- Appendix E - Program Models and Sample Budgets
- Appendix F - Quality Assurance
- Appendix G - HIV/AIDS Prevention Bulletin
- TIP 5. Improving Treatment for Drug-Exposed Infants
- Consensus Panel
- Chapter 1 - Introduction
- Chapter 2 - Medical Management of The Drug-Exposed Infant
- Chapter 3 - Followup and Aftercare of Drug-Exposed Infants
- Chapter 4 - Psychosocial Services for Drug-Exposed Infants and Their Families
- Chapter 5 - Ethical and Legal Guidelines
- Chapter 6 - Quality Assurance Guidelines
- Appendix A - Resources
- Appendix B - Sample Programs
- Appendix C - Urine toxicology Guidelines
- Appendix D - Description of IDEA
- Appendix E - Family Service Plan
- Appendix F - Medical Glossary
- Appendix G - Cost Factors
- Appendix H - Federal Resource Panel
- Appendix I - Field Reviewers
- References
- TIP 2. Pregnant, Substance-Using Women
- Consensus Panel on Pregnant, Substance-Using Women
- Foreword
- Introduction
- Chapter 1—Alcohol and Other Drug Treatment Guidelines for Pregnant, Substance-Using Women
- Chapter 2—Medical Guidelines for Pregnant, Substance-Using Women
- Chapter 3—Legal and Ethical Guidelines for the Care of Pregnant, Substance-Using Women
- Appendix A—Training Guidelines for Programs
- Appendix B—Assessment Instruments
- Appendix C—Continuum of Care Model Program
- Appendix D—Quality Assurance Monitoring
- Appendix E—Glossary of Terms
- Appendix F—References
- Appendix G—Federal Resource Panel on Pregnant, Substance-Using Women
- Appendix H—Contributors
- Appendix I—Comprehensive Care Flow Charts
NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.
Center for Substance Abuse Treatment. SAMHSA/CSAT Treatment Improvement Protocols. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 1993-.
TIP 42Substance Abuse Treatment for Persons With Co-Occurring Disorders
Acknowledgments
Numerous people contributed to the development of this TIP (see pp. xi, xiii, and appendices L, M, and N). This publication was produced by The CDM Group, Inc. under the Knowledge Application Program (KAP) contract, number 270-99-7072 with the Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (DHHS). Karl D. White, Ed.D., and Andrea Kopstein, Ph.D., M.P.H., served as the Center for Substance Abuse Treatment (CSAT) Government Project Officers. Christina Currier served as the CSAT TIPs Task Leader. Rose M. Urban, M.S.W., J.D., LCSW, CCAC, CSAC, served as the CDM KAP Executive Deputy Project Director. Elizabeth Marsh served as the CDM KAP Deputy Project Director. Shel Weinberg, Ph.D., served as the CDM KAP Senior Research/Applied Psychologist. Other KAP personnel included Raquel Witkin, M.S., Deputy Project Manager; Susan Kimner, Managing Editor; Deborah Steinbach, Senior Editor/Writer; and Erica Flick, Editorial Assistant. In addition, Sandra Clunies, M.S., I.C.A.D.C., served as Content Advisor. Special thanks go to Susan Hills, Ph.D., for serving as Co-Editor on this TIP, and Doug Ziedonis, M.D., for his contribution to chapter 8. Jonathan Max Gilbert, M.A., Margaret K. Hamer, M.P.A., Randi Henderson, B.A., Susan Hills, Ph.D., and David Shapiro, M.S., M.Ed., were writers. Appendix K was prepared by Margaret Brooks, J.D., and SAMHSA staff in consultation with the Office of the General Counsel, the U.S. Department of Health and Human Services, Washington, D.C.
Disclaimer
The opinions expressed herein are the views of the Consensus Panel members and do not necessarily reflect the official position of CSAT, SAMHSA, or DHHS. No official support of or endorsement by CSAT, SAMHSA, or DHHS for these opinions or for particular instruments, software, or resources described in this document are intended or should be inferred. The guidelines in this document should not be considered substitutes for individualized client care and treatment decisions.
Public Domain Notice
All materials appearing in this volume except those taken directly from copyrighted sources are in the public domain and may be reproduced or copied without permission from SAMHSA/CSAT or the authors. Do not reproduce or distribute this publication for a fee without specific, written authorization from SAMHSA's Office of Communications.
Electronic Access and Copies of Publication
Copies may be obtained free of charge from SAMHSA's National Clearinghouse for Alcohol and Drug Information (NCADI), (800) 729-6686 or (301) 468-2600; TDD (for hearing impaired), (800) 487-4889, or electronically through the following Internet World Wide Web site: www.ncadi.samhsa.gov.
Recommended Citation
Center for Substance Abuse Treatment. Substance Abuse Treatment for Persons With Co-Occurring Disorders. Treatment Improvement Protocol (TIP) Series 42. DHHS Publication No. (SMA) 05-3922. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2005.
Originating Office
Practice Improvement Branch, Division of Services Improvement, Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration, 1 Choke Cherry Road, Rockville, MD 20857.
DHHS Publication No. (SMA) 05-3922
Printed 2005
What Is a TIP?
Treatment Improvement Protocols (TIPs), developed by the Center for Substance Abuse Treatment (CSAT), part of the Substance Abuse and Mental Health Services Administration (SAMHSA) within the U.S. Department of Health and Human Services (DHHS), are best-practice guidelines for the treatment of substance use disorders. CSAT draws on the experience and knowledge of clinical, research, and administrative experts to produce the TIPs, which are distributed to a growing number of facilities and individuals across the country. The audience for the TIPs is expanding beyond public and private treatment facilities as alcohol and other drug disorders are increasingly recognized as a major problem.
CSAT's Knowledge Application Program (KAP) Expert Panel, a distinguished group of experts on substance use disorders and professionals in such related fields as primary care, mental health, and social services, works with the State Alcohol and Drug Abuse Directors to generate topics for the TIPs. Topics are based on the field's current needs for information and guidance.
After selecting a topic, CSAT invites staff from pertinent Federal agencies and national organizations to a Resource Panel that recommends specific areas of focus as well as resources that should be considered in developing the content for the TIP. Then recommendations are communicated to a Consensus Panel composed of experts on the topic who have been nominated by their peers. This Panel participates in a series of discussions; the information and recommendations on which they reach consensus form the foundation of the TIP. The members of each Consensus Panel represent substance abuse treatment programs, hospitals, community health centers, counseling programs, criminal justice and child welfare agencies, and private practitioners. A Panel Chair (or Co-Chairs) ensures that the guidelines mirror the results of the group's collaboration.
A large and diverse group of experts closely reviews the draft document. Once the changes recommended by these field reviewers have been incorporated, the TIP is prepared for publication, in print and online. The TIPs can be accessed via the Internet at the URL: www.kap.samhsa.gov. The move to electronic media also means that the TIPs can be updated more easily so that they continue to provide the field with state-of-the-art information.
While each TIP strives to include an evidence base for the practices it recommends, CSAT recognizes that the field of substance abuse treatment is 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. For this reason, recommendations proffered in the TIP are attributed to either Panelists' clinical experience or the literature. If research supports a particular approach, citations are provided.
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-of-the-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.
Contents
KAP Expert Panel and Federal Government Participants
2 Definitions, Terms, and Classification Systems for Co-Occurring Disorders
3 Keys to Successful Programming
5 Strategies for Working With Clients With Co-Occurring Disorders
6 Traditional Settings and Models
7 Special Settings and Specific Populations
8 A Brief Overview of Specific Mental Disorders and Cross-Cutting Issues
Appendix D: Specific Mental Disorders: Additional Guidance for the Counselor
Appendix F: Common Medications for Disorders
Appendix G: Screening and Assessment Instruments
Appendix H: Screening Instruments
Appendix I: Selected Sources of Training
Appendix J: Dual Recovery Mutual Self-Help Programs and Other Resources for Consumers and Providers
Appendix M: Cultural Competency and Diversity Network Participants
- About these Reports
- TIP 52. Clinical Supervision and Professional Development of the Substance Abuse
Counselor
- Consensus Panel
- What Is a TIP?
- Foreword
- How This TIP Is Organized
- Part 1, Chapter 1, Clinical Supervision and Professional Development of the Substance Abuse Counselor: Information You Need to Know
- Part 1, Chapter 2, Clinical Supervision and Professional Development of the Substance Abuse Counselor: Clinical Scenarios Showing How to Apply the Information
- Part 2, Chapter 1, Clinical Supervision and Professional Development of the Substance Abuse Counselor: A Guide for Administrators
- Part 2, Chapter 2, Clinical Supervision and Professional Development of the Substance Abuse Counselor: A Guide for Administrators
- Part 3, Section 1, Clinical Substance and Professional Development of the Substance Abuse Counselor: A Review of the Literature
- Part 3, Section 2, Clinical Substance and Professional Development of the Substance Abuse Counselor: Annotated Bibliography
- Part 3, Section 3, Clinical Substance and Professional Development of the Substance Abuse Counselor: Bibliography of Available Literature
- Appendix A: Bibliography
- Appendix B: New York State Office of Alcoholism and Substance Abuse Services Clinical Supervision Vision Statement
- Appendix C: Advisory Meeting Panel
- Appendix D: Stakeholders Meeting Participants
- Appendix E: Field Reviewers
- Appendix F: Acknowledgments
- TIP 51. Substance Abuse Treatment: Addressing the Specific Needs of Women
- Consensus Panel
- Editorial Board
- KAP Expert Panel and Federal Government Participants
- Foreword
- Executive Summary
- Chapter 1: Creating the Context
- Chapter 2: Patterns of Use: From Initiation to Treatment
- Chapter 3: Physiological Effects of Alcohol, Drugs, and Tobacco on Women
- Chapter 4: Screening and Assessment
- Chapter 5: Treatment Engagement, Placement, and Planning
- Chapter 6: Substance Abuse Among Specific Population Groups and Settings
- Chapter 7: Substance Abuse Treatment for Women
- Chapter 8: Recovery Management and Administrative Considerations
- Appendix A: Bibliography
- Appendix B: CSAT’s Comprehensive Substance Abuse Treatment Model for Women and Their Children
- Appendix C: Screening and Assessment Instruments
- Appendix D: Allen Barriers to Treatment Instrument
- Appendix E: DSM-IV-TR Criteria for Posttraumatic Stress Disorder
- Appendix F: Integration Self-Assessment for Providers
- Appendix G: Resource Panel Members
- Appendix H: Cultural Competency and Diversity Network Participants
- Appendix I: Field Reviewers
- Appendix J: Acknowledgments
- TIP 50. Addressing Suicidal Thoughts and Behaviors in Substance Abuse Treatment
- Consensus Panel
- What Is a TIP?
- Foreword
- How This TIP Is Organized
- Part 1, Chapter 1, Addressing Suicidal Thoughts and Behaviors in Substance Abuse Treatment: Information You Need To Know
- Part 1, Chapter 2, Addressing Suicidal Thoughts and Behaviors in Substance Abuse Treatment: Clinical Vignettes Demonstrating How To Apply the Information
- Part 2, Chapter 1, Addressing Suicidal Thoughts and Behaviors: An Implementation Guide for Administrators
- Part 2, Chapter 2, Addressing Suicidal Thoughts and Behaviors in Substance Abuse Treatment: Building a Suicide Prevention- and Intervention-Capable Agency
- Part 3, Section 1, Addressing Suicidal Thoughts and Behaviors in Substance Abuse Treatment: A Review of the Literature
- Part 3, Section 2, Addressing Suicidal Thoughts and Behaviors in Substance Abuse Treatment: Annotated Bibliography
- Part 3, Section 3, Addressing Suicidal Thoughts and Behaviors in Substance Abuse Treatment: General Bibliography
- Appendix A—Biblography
- Appendix B—Advisory Meeting Panel
- Appendix C—Stakeholders Meeting Participants
- Appendix D—Field Reviewers
- Appendix E—Acknowledgments
- TIP 49. Incorporating Alcohol Pharmacotherapies Into Medical Practice
- Consensus Panel
- Expert Advisory Board
- What Is a TIP?
- Foreword
- Chapter 1—Introduction
- Chapter 2—Acamprosate
- Chapter 3—Disulfiram
- Chapter 4—Oral Naltrexone
- Chapter 5—Extended-Release Injectable Naltrexone
- Chapter 6—Patient Management
- Appendix A—Bibliography
- Appendix B—NIAAA's A Pocket Guide for Alcohol Screening and Brief Intervention
- Appendix C—Excerpts From Quick Guide for Clinicians Based on TIP 45, Detoxification and Substance Abuse Treatment
- Appendix D—Excerpts From Quick Guide for Clinicians Based on TIP 24, A Guide to Substance Abuse Services for Primary Care Clinicians
- Appendix E—Resource Panel
- Appendix F—Field Reviewers
- Appendix G—Acknowledgments
- TIP 48. Managing Depressive Symptoms in Substance Abuse Clients During Early Recovery
- Foreword
- How This TIP Is Organized
- Part 1, Chapter 1, Managing Depressive Symptoms in Substance Abuse Clients During Early Recovery
- Part 1, Chapter 2, Managing Depressive Symptoms in Substance Abuse Clients During Early Recovery
- Part 2, Chapter 1, Managing Depressive Symptoms: An Implementation Guide for Administrators
- Part 2, Chapter 2, Managing Depressive Symptoms: An Implementation Guide for Administrators
- Part 3, Managing Depressive Symptoms: A Review of the Literature, Section 1—A Review of the Literature
- Part 3, Managing Depressive Symptoms: A Review of the Literature, Section 2—Annotated Bibliography
- Part 3, Managing Depressive Symptoms: A Review of the Literature, Section 3—General Bibliography
- Appendix A—Bibliography
- Appendix B—Center for Epidemiologic Studies Depression Scale (CES-D)
- Appendix C—Fidelity Checklists
- Appendix D—DSM-IV-TR Mood Disorders
- Appendix E—Advisory Meeting Panel
- Appendix F—Field Reviewers
- TIP 47. Substance Abuse: Clinical Issues in Intensive Outpatient Treatment
- Consensus Panel
- Foreword
- Executive Summary
- Chapter 1. Introduction
- Chapter 2. Principles of Intensive Outpatient Treatment
- Chapter 3. Intensive Outpatient Treatment and the Continuum of Care
- Chapter 4. Services in Intensive Outpatient Treatment Programs
- Chapter 5. Treatment Entry and Engagement
- Chapter 6. Family-Based Services
- Chapter 7. Clinical Issues, Challenges, and Strategies in Intensive Outpatient Treatment
- Chapter 8. Intensive Outpatient Treatment Approaches
- Chapter 9. Adapting Intensive Outpatient Treatment for Specific Populations
- Chapter 10. Addressing Diverse Populations in Intensive Outpatient Treatment
- Appendix A. Bibliography
- Appendix B. Urine Collection and Testing Procedures and Alternative Methods for Monitoring Drug Use
- Appendix C. Resource Panel
- Appendix D. Cultural Competency and Diversity Network Participants
- Appendix E. Field Reviewers
- TIP 46. Substance Abuse: Administrative Issues in Outpatient Treatment
- Consensus Panel
- KAP Expert Panel and Federal Government Participants
- Foreword
- Executive Summary
- Chapter 1. Introduction
- Chapter 2. Management Issues
- Chapter 3. Managing Human Resources
- Chapter 4. Preparing a Program To Treat Diverse Clients
- Chapter 5. Outpatient Treatment Financing Options and Strategies
- Chapter 6. Performance Improvement and Outcomes Monitoring
- Appendix A—Bibliography
- Appendix B—Resource Panel
- Appendix C—Cultural Competency and Diversity Network Participants
- Appendix D—Field Reviewers
- TIP 45. Detoxification and Substance Abuse Treatment
- Consensus Panel
- KAP Expert Panel and Federal Government Participants
- Consulting Members
- Foreword
- Executive Summary
- 1 Overview, Essential Concepts, and Definitions in Detoxification
- 2 Settings, Levels of Care, and Patient Placement
- 3 An Overview of Psychosocial and Biomedical Issues During Detoxification
- 4 Physical Detoxification Services for Withdrawal From Specific Substances
- 5 Co-Occurring Medical and Psychiatric Conditions
- 6 Financing and Organizational Issues
- Appendix A: Bibliography
- Appendix B: Common Drug Intoxication Signs and Withdrawal Symptoms
- Appendix C: Screening and Assessment Instruments
- Appendix D: Resource Panel
- Appendix E: Field Reviewers
- TIP 44. Substance Abuse Treatment for Adults in the Criminal Justice System
- Consensus Panel
- Foreword
- Executive Summary
- 1 Introduction
- 2 Screening and Assessment
- 3 Triage and Placement in Treatment Services
- 4 Substance Abuse Treatment Planning
- 5 Major Treatment Issues and Approaches
- 6 Adapting Offender Treatment for Specific Populations
- 7 Treatment Issues in Pretrial and Diversion Settings
- 8 Treatment Issues Specific to Jails
- 9 Treatment Issues Specific to Prisons
- 10 Treatment for Offenders Under Community Supervision
- 11 Key Issues Related to Program Development
- Appendix A: Bibliography
- Appendix B: Glossary
- Appendix C: Screening and Assessment Instruments
- Appendix D: Resource Panel
- Appendix E: Cultural Competency and Diversity Network Participants
- Appendix F: Special Consultants
- Appendix G: Field Reviewers
- TIP 43. Medication-Assisted Treatment for Opioid Addiction in Opioid Treatment
Programs
- Consensus Panel
- Editorial Advisory Board
- Consensus Panelists
- KAP Expert Panel and Federal Government Participants
- Foreword
- Executive Summary
- Chapter 1. Introduction
- Chapter 2. History of Medication-Assisted Treatment for Opioid Addiction
- Chapter 3. Pharmacology of Medications Used To Treat Opioid Addiction
- Chapter 4. Initial Screening, Admission Procedures, and Assessment Techniques
- Appendix 4-A. Example of Standard Consent to Opioid Maintenance Treatment
- Chapter 5. Clinical Pharmacotherapy
- Chapter 6. Patient-Treatment Matching: Types of Services and Levels of Care
- Chapter 7. Phases of Treatment
- Chapter 8. Approaches to Providing Comprehensive Care and Maximizing Patient Retention
- Chapter 9. Drug Testing as a Tool
- Chapter 10. Associated Medical Problems in Patients Who Are Opioid Addicted
- Chapter 11. Treatment of Multiple Substance Use
- Chapter 12. Treatment of Co-Occurring Disorders
- Appendix 12-A. Internet Resources for Accessing Psychiatric Instruments
- Chapter 13. Medication-Assisted Treatment for Opioid Addiction During Pregnancy
- Chapter 14. Administrative Considerations
- Appendix A: Bibliography
- Appendix B: Abbreviations and Acronyms
- Appendix C: Glossary
- Appendix D: Ethical Considerations in MAT
- Appendix E: Resource Panel
- Appendix F: Field Reviewers
- TIP 42. Substance Abuse Treatment for Persons With Co-Occurring Disorders
- Consensus Panel
- KAP Expert Panel and Federal Government Participants
- Foreword
- Executive Summary
- 1 Introduction
- 2 Definitions, Terms, and Classification Systems for Co-Occurring Disorders
- 3 Keys to Successful Programming
- 4 Assessment
- 5 Strategies for Working With Clients With Co-Occurring Disorders
- 6 Traditional Settings and Models
- 7 Special Settings and Specific Populations
- 8 A Brief Overview of Specific Mental Disorders and Cross-Cutting Issues
- 9 Substance-Induced Disorders
- Appendix A: Bibliography
- Appendix B: Acronyms
- Appendix C: Glossary of Terms
- Appendix D: Specific Mental Disorders: Additional Guidance for the Counselor
- Appendix E: Emerging Models
- Appendix F: Common Medications for Disorders
- Appendix G: Screening and Assessment Instruments
- Appendix H: Screening Instruments
- Appendix I: Selected Sources of Training
- Appendix J: Dual Recovery Mutual Self-Help Programs and Other Resources for Consumers and Providers
- Appendix K: Confidentiality
- Appendix L: Resource Panel
- Appendix M: Cultural Competency and Diversity Network Participants
- Appendix N: Field Reviewers
- TIP 41. Substance Abuse Treatment: Group Therapy
- Consensus Panel
- KAP Expert Panel and Federal Government Participants
- Foreword
- Executive Summary
- 1 Groups and Substance Abuse Treatment
- 2 Types of Groups Commonly Used in Substance Abuse Treatment
- 3 Criteria for the Placement of Clients in Groups
- 4 Group Development and Phase‐Specific Tasks
- 5 Stages of Treatment
- 6 Group Leadership, Concepts, and Techniques
- 7 Training and Supervision
- Appendix A: Bibliography
- Appendix B: Adult Patient Placement Criteria
- Appendix C: Sample Group Agreement
- Appendix D: Glossary
- Appendix E: Association for Specialists in Group Work Best Practice Guidelines
- Appendix F: Resource Panel
- Appendix G: Cultural Competency and Diversity Network Participants
- Appendix H: Field Reviewers
- TIP 40. Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid
Addiction
- Consensus Panel
- Panelists
- Buprenorphine Expert Panel
- Foreword
- Executive Summary
- 1 Introduction
- 2 Pharmacology
- 3 Patient Assessment
- 4 Treatment Protocols
- 5 Special Populations
- 6 Policies and Procedures
- Appendix A. Bibliography
- Appendix B Assessment and Screening Instruments
- Appendix C DSM‐IV‐TR Material
- Appendix D Consent to Release of Information Under Title 42, Part 2, Code of Federal Regulations
- Appendix E Clinical Toolbox: Chapter 3 Supplemental Information
- Appendix F Federation of State Medical Boards—Model Policy Guidelines for Opioid Addiction Treatment in the Medical Office
- Appendix G Stages of Change
- Appendix H Sample Treatment Agreement/Contract
- Appendix I Glossary
- Appendix J Field Reviewers
- TIP 39. Substance Abuse Treatment and Family Therapy
- Consensus Panel
- KAP Expert Panel and Federal Government Participants
- Foreword
- Executive Summary
- Chapter 1 Substance Abuse Treatment and Family Therapy
- Chapter 2 Impact of Substance Abuse on Families
- Chapter 3 Approaches to Therapy
- Chapter 4 Integrated Models for Treating Family Members
- Chapter 5 Specific Populations
- Chapter 6 Policy and Program Issues
- Appendix A: Bibliography
- Appendix B: Glossary
- Appendix C: Guidelines for Assessing Violence
- Appendix D: Resources
- Appendix E: Resource Panel
- Appendix F: Cultural Competency and Diversity Network Participants
- Appendix G: Field Reviewers
- TIP 38. Integrating Substance Abuse Treatment and Vocational Services
- Editorial Advisory Board
- Consensus Panel
- Foreword
- Executive Summary and Recommendations
- Chapter 1—The Need for Vocational Services
- Chapter 2—Vocational Programming And Resources
- Chapter 3—Clinical Issues Related to Integrating Vocational Services
- Chapter 4—Integrating Onsite Vocational Services
- Chapter 5—Effective Referrals and Collaborations
- Chapter 6 --Funding and Policy Issues
- Chapter 7—Legal Issues
- Chapter 8—Working With the Ex-Offender
- Appendix A -- Bibliography
- Appendix B --Resources: Tools and Instruments
- Appendix C—Published Resource Materials
- Appendix D—Addiction Severity Index
- Appendix E—State Employment Agencies
- Appendix F—Federal Funding Sources
- Appendix G—Sample Individualized Written Rehabilitation Program
- Appendix H—Resource Panel
- Appendix I—Field Reviewers
- Figure 1-1: Challenges to Employment
- Figure 1-2: Strategies for Promoting Employment
- Figure 2-1: Vocational Services Provided to a Residential Treatment Facility
- Figure 2-2: Vocational Information From Initial Screen
- Figure 2-3: Assessment Tools
- Figure 2-4: Prevocational Counseling Activities
- Figure 2-5: Job Search Resources: America's Job Bank on the Internet
- Figure 2-6: Vocational Opportunities of Cherokee, Inc.: Rehabilitation Facility Providing Primarily Onsite Services
- Figure 2-7: The Michigan Drug Addiction and Alcoholism Referral and Monitoring Agency: A Case Management Model
- Figure 2-8: Combating Alcohol and Drugs Through Rehabilitation and Education (CADRE)
- Figure 2-9: The Texas Workforce Commission: Project RIO (Re-Integration of Offenders)
- Figure 2-10: Basic Materials for a Vocational Reference Library
- Figure 3-1: Early-Stage Vocational Issues and Approaches
- Figure 3-2: Answering Questions Related to Substance Use History-A Sample Scenario
- Figure 4-1: Steps for Planning an Integrated Program
- Figure 4-2: Job Clubs
- Figure 4-3: Focus on Client Outcomes: The Future for Substance Abuse Treatment Providers
- Figure 5-1: Data-Matching Software
- Figure 5-2: Steps for Establishing an Authentically Connected Network
- Figure 5-3: Characteristics of Authentically Connected Referral Networks
- Figure 6-1: Agency Self-Assessment Categories
- Figure 7-1: Americans With Disabilities Act and Rehabilitation Act Protections
- Figure 7-2: Services Provided Under the Workforce Investment Act of 1996
- Figure 7-3: Sample Consent Form
- Figure 7-4: Making a Referral to a Vocational or Training Program
- Figure 8-1: A Program That Addresses Women's Issues
- Figure 8-2: Summary of Program Examples
- Figure F-1: Federal Funding Sources
- Figure F-2: Federal Sources of Discretionary, Time-Limited Project Grants
- TIP 37. Substance Abuse Treatment for Persons with HIV/AIDS
- Editorial Advisory Board
- Consensus Panel
- Foreword
- Executive Summary and Recommendations
- Chapter 1-- Introduction to HIV/AIDS
- Chapter 2—Medical Assessment and Treatment
- Chapter 3—Mental Health Treatment
- Chapter 4—Primary and Secondary HIV Prevention
- Chapter 5—Integrating Treatment Services
- Chapter 6—Accessing and Obtaining Needed Services
- Chapter 7—Counseling Clients With HIV And Substance Abuse Disorders
- Chapter 8—Ethical Issues
- Chapter 9—Legal Issues
- Chapter 10—Funding and Policy Considerations
- Appendix A -- Bibliography
- Appendix B—Glossary
- Appendix C—1993 Revised Classification System For HIV Infection and Expanded AIDS Surveillance Case Definition For Adolescents and Adults
- Appendix D --Screening Instruments
- Appendix E—Sample Codes of Ethics
- Appendix F—AIDS-Related Web Sites
- Appendix G—State and Territorial Health Agencies/Offices of AIDS
- Appendix H—Mini Mental State Examination (MMSE)
- Appendix I—Standards of Care: Client Assessment/Treatment Protocol
- Appendix J -- Resource Panel
- Appendix K—Field Reviewers
- TIP 36. Substance Abuse Treatment for Persons with Child Abuse and Neglect Issues
- Editorial Advisory Board
- Consensus Panel
- Foreword
- Executive Summary and Recommendations
- Chapter 1—Working With Child Abuse and Neglect Issues
- Chapter 2—Screening and Assessing Adults For Childhood Abuse and Neglect
- Chapter 3—Comprehensive Treatment for Adult Survivors of Child Abuse and Neglect
- Chapter 4—Therapeutic Issues for Counselors
- Chapter 5—Breaking the Cycle: The Substance-Dependent Client as Parent/Caregiver
- Chapter 6—Legal Responsibilities and Recourse
- Chapter 7—Emerging and Continuing Issues
- Appendix A --Bibliography
- Appendix B --Protecting Clients' Privacy
- Appendix C --Implications of Recent Federal Legislation for Clients in Treatment
- Appendix D—Obtaining Screening and Assessment Tools
- Appendix E --Resources Related to Childhood Trauma Among Adults
- Appendix F --Resource Panelists
- Appendix G—Field Reviewers
- TIP 35. Enhancing Motivation for Change in Substance Abuse Treatment
- Editorial Advisory Board
- Consensus Panel
- Foreword
- Executive Summary and Recommendations
- Chapter 1-- Conceptualizing Motivation And Change
- Chapter 2—Motivation and Intervention
- Chapter 3—Motivational Interviewing as a Counseling Style
- Chapter 4—From Precontemplation to Contemplation: Building Readiness
- Chapter 5—From Contemplation to Preparation: Increasing Commitment
- Chapter 6—From Preparation to Action: Getting Started
- Chapter 7—From Action to Maintenance: Stabilizing Change
- Chapter 8—Measuring Components of Client Motivation
- Chapter 9—Integrating Motivational Approaches Into Treatment Programs
- Chapter 10—Directions for Future Research
- Appendix A -- Bibliography
- Appendix B—Screening and Assessment Instruments
- Appendix C—Ordering Information for Assessment Instruments
- Appendix D—Resource Panel
- Appendix E --Field Reviewers
- TIP 34. Brief Interventions and Brief Therapies for Substance Abuse
- Editorial Advisory Board
- Consensus Panel
- Foreword
- Executive Summary and Recommendations
- Chapter 1—Introduction to Brief Interventions and Therapies
- Chapter 2—Brief Interventions in Substance Abuse Treatment
- Chapter 3—Brief Therapy in Substance Abuse Treatment
- Chapter 4—Brief Cognitive-Behavioral Therapy
- Chapter 5—Brief Strategic/Interactional Therapies
- Chapter 6 --Brief Humanistic and Existential Therapies
- Chapter 7—Brief Psychodynamic Therapy
- Chapter 8—Brief Family Therapy
- Chapter 9—Time-Limited Group Therapy
- Appendices
- TIP 33. Treatment for Stimulant Use Disorders
- Editorial Advisory Board
- Consensus Panel
- Foreword
- Executive Summary and Recommendations
- Chapter 1—Introduction
- Chapter 2—How Stimulants Affect the Brain and Behavior
- Chapter 3—Approaches to Treatment
- Chapter 4—Practical Application of Treatment Strategies
- Chapter 5—Medical Aspects of Stimulant Use Disorders
- Chapter 6—Treatment Issues for Special Groups and Settings
- Appendices
- TIP 32. Treatment of Adolescents with Substance Use Disorders
- Editorial Advisory Board
- Consensus Panel
- Foreword
- Executive Summary and Recommendations
- Chapter 1--Substance Use Among Adolescents
- Chapter 2—Tailoring Treatment to the Adolescent's Problem
- Chapter 3—General Program Characteristics
- Chapter 4—Twelve-Step-Based Programs
- Chapter 5—Therapeutic Communities
- Chapter 6—Family Therapy
- Chapter 7—Youths With Distinctive Treatment Needs
- Chapter 8—Legal and Ethical Issues
- Appendix A -- Bibliography
- Appendix B —Medical Management of Drug Intoxication and Withdrawal
- Appendix C --Field Reviewers
- TIP 31. Screening and Assessing Adolescents for Substance Use Disorders
- Editorial Advisory Board
- Consensus Panel
- Foreword
- Executive Summary and Recommendations
- Chapter 1-- Introduction
- Chapter 2—Preliminary Screening of Adolescents
- Chapter 3—Comprehensive Assessment of Adolescents for Referral and Treatment
- Chapter 4 --Legal Issues in the Screening And Assessment of Adolescents
- Chapter 5—Screening and Assessment of Adolescents in Juvenile Justice Settings
- Appendix A--Bibliography
- Appendix B—Instrument Summaries
- Appendix C --Drug Identification and Testing in The Juvenile Justice System
- Appendix D—Field Reviewers
- TIP 30. Continuity of Offender Treatment for Substance Use Disorders from Institution to
Community
- Editorial Advisory Board
- Consensus Panel
- Foreword
- Executive Summary and Recommendations
- Chapter 1—Introduction
- Chapter 2—Case Management and Accountability
- Chapter 3—Guidelines for Institution and Community Programs
- Chapter 4—Administrative Guidelines
- Chapter 5—Ancillary Services
- Chapter 6—Special Populations
- Appendix A -- Bibliography
- Appendix B—Instruments
- Appendix C — Resource Panel
- Appendix D—Field Reviewers
- Tables and Figures
- TIP 29. Substance Use Disorder Treatment For People With Physical and Cognitive
Disabilities
- Editorial Advisory Board
- Consensus Panel
- Foreword
- Executive Summary and Recommendations
- Chapter1—Overview of Treatment Issues
- Chapter 2—Screening Issues
- Chapter 3—Treatment Planning and Service Delivery
- Chapter 4 --Treatment Planning and the Community: Linkages and Case Management
- Chapter 5—Administrative Tasks
- Appendix A -- Bibliography
- Appendix B—Information Resources
- Appendix C—How To Refer to People With Disabilities
- Appendix D—Alcohol and Drug Programs and The Americans With Disabilities Act
- Appendix E—Resource Panel
- Appendix F—Field Reviewers
- TIP 28. Naltrexone And Alcoholism Treatment 28
- Editorial Advisory Board
- Consensus Panel
- Foreword
- Executive Summary and Recommendations
- Chapter 1 --The Current Situation
- Chapter 2—Pharmacological Management With Naltrexone
- Chapter 3 --Basic Neurobiological and Preclinical Research
- Chapter 4 --Clinical Findings
- Chapter 5 --Clinical Profile
- Appendix A -- Bibliography
- Appendix B--Naltrexone and the Formulary
- Appendix C --Translating Research Into Practice
- Appendix D --Instruments
- Appendix E --Resource Panel
- Appendix F --Field Reviewers
- TIP 27. Comprehensive Case Management for Substance Abuse Treatment
- Editorial Advisory Board
- Consensus Panel
- Foreword
- Executive Summary
- Chapter 1 - Substance Abuse and Case Management: An Introduction
- Chaper 2 - Applying Case Management to Substance Abuse Treatment
- Chapter 3 - Case Management in the Community Context: An Interagency Perspective
- Chapter 4 - Evaluation and Quality Assurance of Case Management Services
- Chapter 5 - Case Management for Clients With Special Needs
- Chapter 6 - Funding Case Management in a Managed Care Environment
- Appendix A - Bibliography
- Appendix B - Practice Dimensions
- Appendix C - Managed Healthcare Organizational Readiness Guide and Checklist: Special Report By James B. Bixler, M.S
- Appendix D - Resource Panel
- Appendix E - Field Reviewers
- Exhibits
- TIP 26. Substance Abuse Among Older Adults
- Editorial Advisory Board
- Consensus Panel
- Foreword
- Executive Summary and Recommendations
- Chapter 1 - Substance Abuse Among Older Adults: An Invisible Epidemic
- Chapter 2 - Alcohol
- Chapter 3 - Use and Abuse of Psychoactive Prescription Drugs and Over-the-Counter Medications
- Chapter 4 - Identification, Screening, and Assessment
- Chapter 5 - Referral and Treatment Approaches
- Chapter 6 - Outcomes and Cost Issues in Alcohol Treatment for Older Adults
- Appendix A - Legal and Ethical Issues
- Appendix B - Tools
- Appendix D - Resource Panel
- Appendix E - Field Reviewers
- Appendix C - Bibliography
- TIP 25. Substance Abuse Treatment and Domestic Violence
- Editorial Advisory Board
- Consensus Panel
- Foreword
- Executive Summary and Recommendations
- Chapter 1—Effects of Domestic Violence on Substance Abuse Treatment
- Chapter 2—Survivors of Domestic Violence: An Overview
- Chapter 3 -- Batterers: An Overview
- Chapter 4—Screening and Referral of Survivors and Batterers in Substance Abuse Treatment Programs
- Chapter 5—Legal Issues
- Chapter 6 -- Linkages: A Coordinated Community Response
- Appendix A -- Bibliography
- Appendix B—Federal Confidentiality Regulations
- Appendix C—Instruments
- Appendix D—Sample Personalized Safety Plan For Domestic Violence Survivors
- Appendix E—Hotlines and Other Resources For Domestic Violence and Related Issues
- Appendix F—Resource Panel
- Appendix G—Field Reviewers
- Tables and Figures
- TIP 24. A Guide to Substance Abuse Services for Primary Care Clinicians
- Editorial Advisory Board
- Consensus Panel
- Foreword
- Executive Summary and Recommendations
- Chapter 1—Substance Abuse and Primary Care
- Chapter 2—Screening for Substance Use Disorders
- Chapter 3—Brief Intervention
- Chapter 4—Assessment
- Chapter 5—Specialized Substance Abuse Treatment Programs
- Chapter 6—Implementation and Recommendation Summary
- Appendix A—Pharmacotherapy
- Appendix B—Legal and Ethical Issues
- Appendix C—Screening and Assessment Instruments
- Appendix D—Substance Abuse Resources for the Primary Care Setting
- Appendix F—Resource Panel
- Appendix G—Field Reviewers
- Tables and Figures*
- Appendix E -- Bibliography
- TIP 23. Treatment Drug Courts: Integrating Substance Abuse Treatment With Legal Case Processing
- Consensus Panel
- Foreword
- Chapter 1—Introduction
- Chapter 2—Key Elements of Treatment Drug Courts
- Chapter 3—Program Planning
- Chapter 4—Designing the Program
- Chapter 5—Implementation
- Chapter 6—Program Evaluation
- Chapter 7—Program Costs and Financing
- Chapter 8—Legal and Ethical Issues
- Appendix A -- Bibliography
- Appendix B—Federal Resource Panel
- Appendix C—Federal Resource Panel
- TIP 22. LAAM in the Treatment of Opiate Addiction
- Consensus Panel
- Foreword
- Chapter 1 - Introduction
- Chapter 2 - Clinical Profile of LAAM
- Chapter 3 - Clinical Application of LAAM Therapy
- Chapter 4 - Treatment Planning
- Chapter 5 - Management and Administrative Issues
- Chapter 6 - Regulatory and Ethical Issues
- Appendix A - Bibliography
- Appendix B - Training Resources
- Appendix C - Federal Resource Panel
- Appendix D - Field Reviewers
- TIP 21. Combining Alcohol and Other Drug Abuse Treatment With Diversion for Juveniles in
the Justice System
- Consensus Panel
- Foreword
- Chapter1—Introduction
- Chapter 2 -- Goals of AOD Treatment-Focused Diversion Programs
- Chapter 3—Collaborating on a Diversion Program
- Chapter 4—Planning Juvenile Diversion to AOD Abuse Treatment
- Chapter 5 -- Program Implementation Issues
- Appendix A -- Bibliography
- Appendix B -- Glossary
- Appendix C—CSAT Juvenile Justice Treatment Planning Chart
- Appendix D—Oregon's Department of Human Services Multiagency Release
- Appendix E—Assessment Instruments for Adolescent Populations
- Appendix F—Desktop Guide to Good Juvenile Probation Practice (Legal Rights of Juvenile Offenders)
- Appendix G - "Multicultural Awareness: Developing Cultural Understanding in the Juvenile Justice System[1]
- Appendix H—Prospectus for a Consensus Development Panel
- Appendix I—Federal Resource Panel
- Appendix J—Field Reviewers
- TIP 20. Matching Treatment to Patient Needs in Opioid Substitution Therapy
- Consensus Panel
- Foreword
- Chapter 1 -- Patient Matching: Historical Perspective and Overview
- Chapter 2—Assessing Patient Needs
- Chapter 3—Phases of Treatment
- Chapter 4—Treatment Elements
- Chapter 5—Self-Monitoring and Evaluation
- Chapter 6 -- Cost-Effectiveness of Opioid Substitution Therapy
- Appendix A -- Bibliography
- Appendix B —Massachusetts Methadone Treatment Criteria
- Appendix C -- Methodological Approaches to Cost-Efficiency and Cost-Effectiveness Analyses
- Appendix D—Federal Resource Panel
- Appendix E—Field Reviewers
- TIP 19. Detoxification From Alcohol and Other Drugs
- Consensus Panel
- Foreword
- Chapter 1—Introduction
- Chapter 2—Detoxification Settings and Patient Matching
- Chapter 3—Clinical Detoxification Protocols
- Chapter 4—Special Populations
- Chapter 5—Improving Quality and Measuring Outcomes of AOD Detoxification Services
- Chapter 6—Costs and Current Payment Mechanisms for AOD Detoxification
- Appendix A -- Bibliography
- Appendix B—Glossary
- Appendix C—Resource List
- Appendix D—Acronyms
- Appendix E - Legal and Ethical Issues for Detoxification Programs
- Appendix F—Federal Resource Panel
- Appendix G—Field Reviewers
- TIP 18. The Tuberculosis Epidemic: Legal and Ethical Issues for Alcohol and Other Drug Treatment Providers
- Consensus Panel
- Foreword
- Chapter 1—Introduction
- Chapter 2—Summary of Recommendations
- Chapter 3—The Facts About Tuberculosis
- Chapter 4—AOD Programs and Public Health: Joining Together to Fight the Spread of TB
- Chapter 5—Providing TB-Related Services to Patients
- Chapter 6—Toward a Safe Workplace
- Appendix A—Bibliography
- Appendix B—Legal Questions and Answers Regarding TB-Related Discrimination in the AOD Setting
- Appendix C—Sample Forms
- Appendix D—Massachusetts Policy for TB Control in Substance Abuse Treatment Centers
- Appendix E—A Massachusetts Pamphlet on HIV and TB
- Appendix F—A Massachusetts Pamphlet on the Connection Between Substance Abuse and Certain Communicable Diseases
- Appendix G—New York State OASAS Administrative Bulletin on TB Control In Drug Treatment Programs
- Appendix H—New York City TB/Methadone Registry Match Procedure
- Appendix I—New York State Division Of Substance Abuse Services Tuberculosis Update
- Appendix J—CDC: Essential Components of a TB Prevention and Control Program; and Screening for TB and TB Infection in High-Risk Populations
- Appendix K—Federal Resource Panel
- Appendix L—Field Reviewers
- TIP 17. Planning for Alcohol and Other Drug Abuse Treatment for Adults in the Criminal Justice
System
- Consensus Panel
- Foreword
- Chapter 1—Introduction
- Chapter 2—The Effectiveness of AOD Treatment in the Criminal Justice System
- Chapter 3—The AOD-Involved Offender
- Chapter 4—The Criminal Justice Continuum
- Chapter 5—The AOD Abuse Treatment System
- Chapter 6—Collaboration Between Systems
- Chapter 7—Coordinated Training
- Chapter 8—Confidentiality Issues 5
- Chapter 9—Evaluation
- Appendix A -- Bibliography
- Appendix B—CSAT Criminal Justice Treatment Planning Chart
- Appendix C—Sample Interagency Agreement
- Appendix D—Federal Resource Panel
- Appendix E—Field Reviewers
- TIP 16. Alcohol and Other Drug Screening of Hospitalized Trauma Patients
- Consensus Panel
- Foreword
- A Note to Readers
- Chapter 1—Introduction
- Chapter 2—Trauma Patients
- Chapter 3 -- Effects of Alcohol and Other Drugs on Trauma Patients
- Chapter 4—Screening and Assessment
- Chapter 5—Cost-Benefit Issues Affecting Implementation of Screening
- Chapter 6—Legal and Ethical Concerns
- Chapter 7—Recordkeeping and Quality Improvement
- Appendix A -- Bibliography
- Appendix B—Glossary of Medical Terms
- Appendix C—Federal Resource Panel
- Appendix D—Field Reviewers
- TIP 15. Treatment for HIV-Infected Alcohol and Other Drug Abusers
- Consensus Panel
- Foreword
- Chapter 1 - The HIV Challenge to AOD Treatment
- Chapter 2—Overview of AOD Treatment Services
- Chapter 3 - Primary Medical Care for HIV-Infected AOD Abuse Patients
- Chapter 4—Mental Health and Counseling Needs of HIV-Infected AOD Abusers
- Chapter 5—Social Services for HIV-Infected AOD Abusers
- Chapter 6—Linkages and Services Integration: Policy and Implementation
- Chapter 7 - Key Legal Issues in HIV/AIDS and AOD Abuse Treatment
- Appendix A -- Bibliography
- Appendix B—Summary of Block Grants: Interim Final Rule (1993)
- Appendix C—Elements of a Needle Exchange Program
- Appendix D—Cultural Proficiency Questionnaire
- Appendix E - Information About the Ryan White Comprehensive AIDS Resources Emergency Act of 1990 (The CARE Act)
- Appendix F—Standards of Care
- Appendix G—National HIV/AIDS Organizations and Hotlines
- Appendix H—Sample Memorandum of Understanding
- Appendix I - Federal Resource Panel
- Appendix J—Field Reviewers
- TIP 12. Combining Substance Abuse Treatment with Intermediate Sanctions for Adults in the
Criminal Justice System
- Consensus Panel
- Foreword
- Chapter 1—Introduction and Purpose
- Chapter 2—An Overview of the Criminal Justice System
- Chapter 3—The AOD Abuse Treatment System
- Chapter 4—Combining AOD Abuse Treatment and Intermediate Sanctions
- Chapter 5—Issues in Combining Treatment and Intermediate Sanctions
- Chapter 6—Planning: Approaches for Developing Policy
- Chapter 7 - Ethical and Legal Issues
- Appendix A -- Bibliography
- Appendix B—Costing Issues
- Appendix C—Cultural Competence
- Appendix D—Federal Resource Panel
- Appendix E—Field Reviewers
- TIP 11. Simple Screening Instruments for Outreach for Alcohol and Other Drug Abuse and
Infectious Diseases
- Consensus Panel
- Foreword
- Chapter 1 - Introduction
- Chapter 2 - Development of the Simple Screening Instrument For AOD Abuse
- Chapter 3 - Development of the Simple Screening Instrument for Infectious Diseases
- Chapter 4 - Training and Implementation
- Chapter 5 - Legal Issues Surrounding Client Confidentiality
- Appendix A - References
- Appendix B - Sample Curriculum for Outreach Workers
- Appendix C - Cultural Competence
- Appendix D - Federal Resource Panel
- Appendix E - Field Reviewers
- TIP 10. Assessment and Treatment Planning for Cocaine-Abusing Methadone-Maintained Patients
- Consensus Panel
- Foreword
- Note From the Chair
- Chapter 1-Overview
- Chapter 2-Statement of the Problem
- Chapter 3-Screening, Admission, and Assessment Techniques
- Chapter 4-Treatment Interventions and Related Issues
- Chapter 5-Legal and Ethical Issues
- Chapter 6-Evaluating Program Performance
- Chapter 7-Consensus Panel Recommendations for Further Research
- Appendix A - Glossary
- Appendix B - Levels of Care
- Appendix C - Acronyms
- Appendix D - TB/PPD Testing - Sample Forms
- Appendix E - Multidrug Abuse Patterns
- Appendix F - Diagnostic Assessment Instruments
- Appendix G - DSM-IV Criteria for Substance-Related Disorders
- Appendix H - Psychiatric Disorders
- Appendix I - Internal Trigger Questionnaire and External Trigger Questionnaire
- Appendix J - Self-Help Groups
- Appendix K - Federal Resource Panel
- Appendix L - Field Reviewers
- References
- TIP 9. Assessment and Treatment of Patients with Coexisting Mental Illness and Alcohol
and Other Drug Abuse
- Consensus Panel
- Foreword
- Chapter 1 --Introduction
- Chapter 2—Dual Disorders: Concepts and Definitions
- Chapter 3 -- Mental Health And Addiction Treatment Systems: Philosophical and Treatment Approach Issues
- Chapter 4—Linkages For Mental Health and AOD Treatment
- Chapter 5—Mood Disorders
- Chapter 6—Anxiety Disorders
- Chapter 7—Personality Disorders
- Chapter 8—Psychotic Disorders
- Chapter 9—Pharmacologic Management
- Appendix A -- Bibliography
- Appendix B—Treatment of Patients With Dual Disorders: Sample Cost Data
- Appendix C—Federal Resource Panel
- Appendix D—Field Reviewers
- TIP 8. Intensive Outpatient Treatment for Alcohol and Other Drug Abuse
- Consensus Panel
- Foreword
- Chapter 1—Introduction
- Chapter 2—Placement Criteria and Expected Treatment Outcomes
- Chapter 3—Components of an Effective IOT Program
- Chapter 4—Staffing Issues and Guidelines
- Chapter 5—The Treatment Needs Of Special Groups
- Chapter 6—Special Fiscal and Administrative Issues
- Chapter 7—Legal Issues for IOT Programs1
- Appendix A -- References
- Appendix B—Sample IOT Program Schedules
- Appendix C—Federal Resource Panel
- Appendix D—Field Reviewers
- TIP 7. Screening and Assessment for Alcohol and Other Drug Abuse Among Adults in the
Criminal Justice System
- Consensus Panel
- Foreword
- Chapter 1—Introduction
- Chapter 2—Criminal Justice and Assessment: An Overview
- Chapter 3—Screening, Assessment, and Readiness for Treatment
- Chapter 4—Treatment Planning And Treatment Progress
- Chapter 5—Special Assessment Issues
- Chapter 6 -- Legal and Ethical Issues
- Appendix A—References and Bibliography
- Appendix B—CSAT Criminal Justice Treatment Planning
- Appendix C—Screening and Assessment Instruments
- Appendix D—Supplementary Instruments Recommended for the Assessment of Life Domains and Problem Areas of Adult Clients
- Appendix E—Federal Resource Panel
- Appendix F—Field Reviewers
- TIP 6. Screening for Infectious Diseases Among Substance Abusers
- Consensus Panel Members
- Foreword
- Definition of the Term "Drug Use"
- Chapter 1 - Introduction
- Chapter 2 - Issues for Counselors
- Chapter 3 - Legal and Ethical Issues
- Chapter 4 - Issues for Treatment Program Administrators: Staff and Community Development and Environmental Safety
- Chapter 5 - The Initial Patient Contact
- Chapter 6 - Summary Statement on Tuberculosis
- Chapter 7 - Tuberculosis
- Chapter 8 - Multidrug-Resistant Tuberculosis
- Chapter 9 - Human Immunodeficiency Virus and the Acquired Immunodeficiency Syndrome
- Chapter 10 - Syphilis
- Chapter 11 - Introduction to Viral Hepatitis
- Chapter 12 - Viral Hepatitis B
- Chapter 13 - Viral Hepatitis C
- Chapter 14 - Viral Hepatitis A
- Chapter 15 - Viral Hepatitis D
- Chapter 16 - Gonorrhea
- Chapter 17 - Chlamydia
- Chapter 18 - Herpes Simplex
- Chapter 19 - Chancroid
- Appendix A - Bibliography
- Appendix B - Federal Resource Panel on Screening for Infectious Diseases Among Substance Abusers
- Appendix C - TIP Field Reviewers
- Appendix D - Resource List
- Appendix E - Program Models and Sample Budgets
- Appendix F - Quality Assurance
- Appendix G - HIV/AIDS Prevention Bulletin
- TIP 5. Improving Treatment for Drug-Exposed Infants
- Consensus Panel
- Chapter 1 - Introduction
- Chapter 2 - Medical Management of The Drug-Exposed Infant
- Chapter 3 - Followup and Aftercare of Drug-Exposed Infants
- Chapter 4 - Psychosocial Services for Drug-Exposed Infants and Their Families
- Chapter 5 - Ethical and Legal Guidelines
- Chapter 6 - Quality Assurance Guidelines
- Appendix A - Resources
- Appendix B - Sample Programs
- Appendix C - Urine toxicology Guidelines
- Appendix D - Description of IDEA
- Appendix E - Family Service Plan
- Appendix F - Medical Glossary
- Appendix G - Cost Factors
- Appendix H - Federal Resource Panel
- Appendix I - Field Reviewers
- References
- TIP 2. Pregnant, Substance-Using Women
- Consensus Panel on Pregnant, Substance-Using Women
- Foreword
- Introduction
- Chapter 1—Alcohol and Other Drug Treatment Guidelines for Pregnant, Substance-Using Women
- Chapter 2—Medical Guidelines for Pregnant, Substance-Using Women
- Chapter 3—Legal and Ethical Guidelines for the Care of Pregnant, Substance-Using Women
- Appendix A—Training Guidelines for Programs
- Appendix B—Assessment Instruments
- Appendix C—Continuum of Care Model Program
- Appendix D—Quality Assurance Monitoring
- Appendix E—Glossary of Terms
- Appendix F—References
- Appendix G—Federal Resource Panel on Pregnant, Substance-Using Women
- Appendix H—Contributors
- Appendix I—Comprehensive Care Flow Charts
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Substance Abuse Treatment for Persons With Co-Occurring Disorders - SAMHSA/CSAT ...
Substance Abuse Treatment for Persons With Co-Occurring Disorders - SAMHSA/CSAT Treatment Improvement ProtocolsBookshelf
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Appendix M: Cultural Competency and Diversity Network Participants - SAMHSA/CSAT...
Appendix M: Cultural Competency and Diversity Network Participants - SAMHSA/CSAT Treatment Improvement ProtocolsBookshelf
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Appendix N: Field Reviewers - SAMHSA/CSAT Treatment Improvement Protocols
Appendix N: Field Reviewers - SAMHSA/CSAT Treatment Improvement ProtocolsBookshelf
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Appendix L: Resource Panel - SAMHSA/CSAT Treatment Improvement Protocols
Appendix L: Resource Panel - SAMHSA/CSAT Treatment Improvement ProtocolsBookshelf
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Appendix J: Dual Recovery Mutual Self-Help Programs and Other Resources for Cons...
Appendix J: Dual Recovery Mutual Self-Help Programs and Other Resources for Consumers and Providers - SAMHSA/CSAT Treatment Improvement ProtocolsBookshelf
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