23 National Institute on Drug Abuse [Online]. Accessed on June 5, 2020. Available from https://www.drugabuse.gov
24 National Institute for Health and Clinical Excellence (NICE) (2020) [Online]. Available from www.nice.org.uk.
25 Norcross, J. C. (Ed.). (2002). Psychotherapy relationships that work: Therapist contributions and responsiveness to patient needs. New York, NY: Oxford University Press.
26 Norcross, J. C. (Ed.). (2019). Psychotherapy relationships that work (3). Oxford University Press.
27 Norcross, J., Campbell, L., Grohol, J., Santrock, J., Selegea, F., & Sommer, R. (2013). Self-help that works: Resources to improve emotional health and strengthen relationships. Oxford University Press.
28 Norcross, J. C., Hogan, T. P., & Koocher, G. P., & Maggio, L. A. (2017). Clinician's guide to evidence-based practices: Behavioral health and the addictions. Oxford University Press
29 Norcross, J. C. & Lambert, M. J. (2018). Psychotherapy relationships that work III. Psychotherapy, 55 (4), 303–315. 10.1037/pst0000193
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31 Substance Abuse and Mental Health Services Administration's (SAMHSA) National Mental Health Information Center: Center for Mental Health Services (2004). National consensus statement on mental health recovery. Author Available from http://www.westga.edu/∼vickir/MentalHealth/MH01%20Intro-duction/10%20Fundamental%20Components.pdf
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SAMPLE TREATMENT PLAN
1. SUBSTANCE USE DISORDER
| Definitions: | Consistently uses alcohol or other mood-altering drugs until high, intoxicated, or passed out. |
| Unable to stop or cut down use of mood-altering drug once started, despite the verbalized desire to do so and the negative consequences continued use brings. | |
| Denies that chemical dependence is a problem, despite feedback from significant others that the use of the substance is negatively affecting him/her/them and others. | |
| Continues substance use despite knowledge of experiencing persistent physical, legal, financial, vocational, social, and/or relationship problems that are directly caused by the use of the substance. | |
| Exhibits physical withdrawal symptoms (e.g. shaking, seizures, nausea, headaches, sweating, anxiety, insomnia, depression) when going without the substance for any length of time. | |
| Suspends important social, recreational, or occupational activities because they interfere with using the mood-altering drug. | |
| Goals: | Establish and maintain total abstinence, while increasing knowledge of the disease and the process of recovery. |
| Acquire the necessary 12-step skills and/or other skills to maintain long-term sobriety from all mood-altering substances and live a life free of substance abuse. |
| OBJECTIVES | INTERVENTIONS |
|---|---|
| Work cooperatively with the therapist toward agreed-upon therapeutic goals while being as open and honest as comfort and trust allows. (1, 2) | Establish rapport with the client toward building a strong therapeutic alliance; convey caring, support, warmth, and empathy; provide nonjudgmental support and develop a level of trust with the client toward he/she/they feeling safe to discuss his/her/their substance use and its impact on his/her/their life. |
| Strengthen powerful relationship factors within the therapy process and foster the therapy alliance through paying special attention to these empirically supported factors: work collaboratively with the client in the treatment process; reach agreement on the goals and expectations of therapy; demonstrate consistent empathy toward the client's feelings and struggles; verbalize positive regard toward and affirmation of the client; and collect and deliver client feedback as to the client's perception of his/her/their progress in therapy (see Psychotherapy Relationships That Work: Vol. 1 by Norcross & Lambert & Psychotherapy Relationships That Work: Vol. 2 by Norcross & Wampold). | |
| Describe the type, amount, frequency, and history of substance abuse. (1) | Gather a complete drug/alcohol history from the client, including the amount and pattern of his/her/their use, signs and symptoms of use, and negative life consequences (e.g. social, legal, familial, and vocational problems). |
| Participate in a medical evaluation to assess medical health and the medical consequences of substance use. (1) | Refer the client for a thorough physical examination to determine any physical/medical consequences of chemical dependence (include tests for HIV, hepatitis, and sexually transmitted diseases, if warranted). |
| Explore and resolve ambivalence about entering treatment and changing substance use behavior. (1, 2, 3) | Use the nondirective, client-centered, empathic style derived from motivational enhancement therapy (or supplement with “Assessing Readiness and Motivation” in the Addiction Treatment Homework Planner by Lenz, Finley, & Jongsma); explore the client's motivation for change and whether he/she/they are ready to take active steps or would benefit from continued motivational interviewing (see Motivational Interviewing by Miller & Rollnick; Motivational Interviewing and Enhancement by DiClemente, Van Orden, & Wright). |
| Ask the client to make a list of the ways substance abuse has had a negative impact on his/her/their life (e.g. personally, medically, relationally, legally, vocationally, and socially) and the positive impact nonuse may have (or supplement with “Substance Abuse's Negative Impact Versus Sobriety's Positive Impact” in the Adult Psychotherapy Homework Planner by Jongsma & Bruce; or “Consequences of Continuing Addictive Lifestyles” in the Addiction Treatment Homework Planner by Lenz, Finley, & Jongsma). | |
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Using a 12-Step Facilitation Therapy approach (see Twelve-Step Facilitation Therapy Manual by Nowinski et al.), assign the client to complete an Alcoholics Anonymous Step 1 paper admitting to powerlessness over mood-altering chemicals and present it in group therapy or to therapist for feedback (see
|