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| To the Instructor | |
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| To the Student | |
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| About the Author and Contributors | |
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| Theoretical Foundation | |
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| Social Work and Substance Abuse Practice | |
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| Challenges of Working with Substance Abusers | |
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| Professional Challenges | |
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| Personal Challenges | |
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| An Attempt to Clarify Key Terms | |
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| Working Definitions: Use, Abuse, and Dependency | |
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| Traditional Concept of Addiction | |
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| The Difference Between Dependency and Abuse | |
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| Drug Use Trends | |
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| Substance-Related Accidents and Death | |
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| Prevalence of Substance-Related Problems in Practice | |
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| Substance Abuse and Psychiatric Disorders | |
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| Gender Considerations | |
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| Substance Use During Pregnancy | |
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| Age and Risk of Substance Abuse | |
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| Human Diversity | |
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| Social Class (Education, Employment, Income) | |
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| Fields of Practice | |
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| Do You Know What Chemical Dependency Feels Like? | |
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| Summary | |
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| Pharmacology | |
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| Pharmacology (Drug Effects) | |
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| Drug Variability | |
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| Individual Factors | |
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| Environmental/Situational Factors | |
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| Dose | |
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| Drug Mixing | |
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| Methods of Administering Drugs | |
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| Oral | |
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| Inhalation or Smoking | |
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| Injection (IV) | |
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| Mucous Membranes | |
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| Drug Tolerance | |
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| Physical Tolerance | |
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| Psychological Tolerance | |
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| Behavioral Tolerance | |
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| Cross-Tolerance | |
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| Drug Categories | |
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| Central Nervous System (CNS) Depressants | |
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| CNS Stimulants | |
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| Cannabis | |
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| Opiates | |
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| Hallucinogens | |
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| Inhalants | |
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| Summary | |
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| Models of Chemical Dependency | |
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| What Approach Will You Choose? | |
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| The Models | |
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| Moral Model | |
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| Community Model | |
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| Biological Model | |
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| Social Learning Theory Model | |
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| Cognitive-Behavioral Model | |
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| Disease Model | |
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| Summary of Models | |
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| Substance Abuse from a Multi-Systemic, Ecological Perspective | |
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| Systems and Ecological Systems Theory | |
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| A Multi-Systemic Framework for Substance Abuse Practice | |
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| Summary | |
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| Client Engagement | |
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| The Art of Client Engagement | |
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| Definition of Engagement in Substance Abuse Practice | |
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| Client Engagement as an Art | |
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| How Well Do You Communicate? | |
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| Paulo Freire and Dialogue | |
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| Semiotic of Communication | |
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| Tourism as Metaphor for Self-Exploration | |
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| How Should We Treat Our Clients? | |
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| Five Characteristics of Effective Helping Professionals | |
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| Special Issues Involved in Engaging Substance Abuse Clients | |
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| Denial | |
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| Assessing Client Motivation | |
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| The Use of Confrontation to Deal with Denial | |
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| An Alternative Way to Approach Denial | |
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| Summary | |
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| Understanding the Family | |
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| Why Do We Need to Understand Families? | |
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| What Is a Family? | |
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| The Changing Role of Families in Substance Abuse Treatment | |
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| Working with Family Systems | |
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| Definitions of Terms | |
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| Family System | |
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| Subsystem | |
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| Boundaries | |
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| Family Structure | |
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| What Is a Functional Family? | |
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| The Competing Demands of Stability and Change | |
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| How Families Adapt to Chemical Dependency | |
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| Family Resilience | |
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| Chemically Dependent Families | |
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| Family Survival Roles | |
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| The Family Life Cycle | |
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| Other Issues to Consider in a Family Assessment | |
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| Codependency | |
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| Shame | |
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| Effects of Parental Substance Abuse on Older Children | |
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| Emotional Abuse | |
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| Sexual Abuse | |
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| Domestic Violence | |
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| Substance Abuse in Family History | |
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| Summary | |
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| Macro Context for Substance Abuse Assessment | |
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| The Power of Community | |
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| What Is "Community"? | |
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| Symbolic Interactionism and Community Influence | |
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| The Social Self | |
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| Self and Others | |
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| Is the Right to Self-Determination Equally Available to Everyone? | |
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| Self and Community | |
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| Local Community | |
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| Assessing Multiple Communities | |
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| Geographic Community | |
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| Communities of Identification | |
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| Community Resources | |
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| Macro Influences on Substance Abuse Treatment | |
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| Structural and Historical Systems of Oppression: Who Holds the Power? | |
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| Drug Laws and Public Opinion | |
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| Drug Control Policy--A Primer | |
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| Comprehensive Drug Abuse Prevention and Control Act | |
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| Federal Sentencing Reform Act of 1984 | |
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| The Anti-Drug Abuse Act of 1986 | |
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| The Anti-Drug Abuse Act of 1988 | |
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| Impact of Anti-Drug Legislation on Substance Abuse Practice | |
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| Macro Influences on Social Work Practice | |
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| Reimbursement Policies in Substance Abuse Practice | |
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| The Role of Social Workers in the Substance Abuse Field | |
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| Is It Necessary for Helpers to Be in Recovery? | |
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| Summary | |
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| Screening and Assessment | |
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| Introduction to Screening and Assessment | |
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| Definition of Assessment | |
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| How Screening Differs from Assessment | |
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| Substance Abuse Screening Instruments | |
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| The Michigan Alcoholism Screening Test (MAST) | |
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| CAGE | |
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| Addiction Severity Index (ASI) | |
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| Substance Abuse Subtle Screening Inventory-3 (SASSI-3) | |
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| Other Substance Abuse Screening Instruments | |
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| Screening for Problems Related to Substance Abuse | |
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| Physical Problems | |
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| Depression | |
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| Suicidal Ideation | |
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| How Assessment Differs from Diagnosis | |
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| Operating Principles of Substance Abuse Assessment | |
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| Summary | |
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| Substance Abuse Assessment | |
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| Dimensions of Assessment | |
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| Step-by-Step Assessment Process | |
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| Client Description, Presenting Problem, and Context of Referral | |
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| Treatment History | |
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| Substance Use History | |
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| Medical History | |
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| Basic Needs | |
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| Psychological and Emotional Functioning | |
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| Family History and Structure | |
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| Community/Macro Context | |
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| Motivation | |
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| Diagnosis | |
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| The Case History Report | |
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| Summary | |
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| Treatment | |
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| The Substance Abuse Treatment System | |
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| Levels of Substance Abuse Treatment | |
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| Education/Prevention Services (Early Intervention) | |
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| Intervention | |
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| Twelve-Step Support Groups | |
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| Outpatient Treatment | |
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| Intensive Outpatient/Day Treatment | |
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| Inpatient Treatment | |
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| Types of Inpatient/Residential Services | |
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| Making a Referral for Substance Abuse Treatment | |
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| Least Restrictive Environment | |
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| Matching Treatment to Client Needs | |
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| Confidentiality | |
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| Assessing Substance Abuse Treatment Providers | |
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| Follow-Up to Referral | |
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| Summary | |
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| Substance Abuse Treatment Methods | |
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| Recovery: The Holy Grail of Substance Abuse Treatment | |
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| Abstinence | |
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| Confrontation | |
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| Growth | |
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| Transformation | |
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| Recovery for the Substance Abuser | |
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| General Principles of Substance Abuse Treatment | |
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| Chemical Dependency Is an Illness | |
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| Engagement Is Necessary for Successful Treatment | |
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| A Multi-Systemic Approach Works Best | |
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| Aftercare Is Essential | |
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| Clients Need Help in Developing a Social Support Network | |
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| Treatment Planning | |
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| Treatment Plan Format | |
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| Issues in Treatment Planning | |
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| Specific Treatment Methods | |
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| Individual Therapy/Counseling | |
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| Group Therapy/Counseling | |
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| Family Therapy/Counseling | |
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| Community Practice | |
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| Relapse Prevention | |
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| Treatment Issues | |
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| Summary | |
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| Populations at Risk | |
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| African Americans | |
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| Treatment Issues | |
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| Latino Americans | |
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| Treatment Issues | |
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| Native Americans | |
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| Treatment Issues | |
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| Gay, Lesbian, Bisexual, and Transgendered (GLBT) Persons | |
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| Treatment Issues | |
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| Adolescents | |
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| Treatment Issues | |
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| Older Persons | |
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| Treatment Issues | |
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| Persons with Co-occurring Disorders | |
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| Treatment Issues | |
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| Summary | |
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| Appendixes | |
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| Substance Abuse Assessment/Case History Format | |
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| Sample Substance Abuse Assessment/Case History Report | |
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| African American Women: Oppression, Depression, Rage, and Self-Medication, by Lois Smith Owens | |
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| References | |
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| Index | |