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Lesson One: Introduction Obstacles to Motivation Negative vs. Positive Motivation Common Myths Basic Principles The Four Processes of MI Four Basic Tools: OARS
Lesson Two: Engaging Your Clients Open Questions Reflective Listening Affirming Summaries Exploring Values and Goals Exploring Discrepancy
Lesson Three: The Focusing Process Using OARS Offering Information Reframing
Lesson Four: Evoking Your Client’s Motivation to Change Ambivalence Change Talk Sustain Talk Scaling Other Strategies to Evoke Change Talk Responding to Change Talk Responding to Sustain Talk Warning Signs Building Hope/Addressing Low Confidence Counseling with Neutrality Tipping the Decisional Balance
Lesson Five: The Planning Stage Signs of Readiness Developing the Change Plan OARS During the Planning Stage Exploring and Setting Goals Non-abstinence Goals for Substance Abusers Reinforcing Commitment to Change The Importance of Self-Efficacy Negotiating a Change Plan Initiating the Change Plan Stabilizing Change Lesson Six: Practice Reflections Open Questions Change Talk Jeopardy  Lesson One: The Myth of Treatment Readiness Inspiring Hope in “Hopeless” Clients Hope-Inspiring Reflections Lesson Two: Using Scaling Techniques Case Study Normalizing Exploring Exceptions Case Study Lesson Three: The Concept of “Denial” Classic Definition Alternative Definition Respecting Preferred Views Case Study Turning Client Complaints Into Treatment Goals Lesson Four: Externalizing Problems Consciousness Raising Developing Discrepancy Mystery Questions Case Study Using Decisional Balance Sheets Case Study Lesson Five: Reaching Mandated Clients Differentiating Yourself from the Referral Source Questions for Mandated Clients and Referring Parties Homework Case Study Lesson Six: Practical Considerations Ethical Considerations Summary and Conclusions Lesson One: Clinical Issues Related to Integration of Vocational Services Incorporating Vocational Services Addressing Vocational Goals and Employment Needs Competency Areas for Employment Identifying Employment Goals Lesson Two: Resources, Challenges, and Screening Protocols Employment as a Goal Challenges to Employing Clients in Treatment Vocational Needs Availability of Vocational Services Medicaid and Managed Care Programs Vocational Programming and Resources Vocational Rehabilitation Counseling Screening Lesson Three: Assessment and Ongoing VR Services Functional Assessment Categories of Functional Limitations Six-Realm Classification System Setting and Achieving Goals Prevocational and Ongoing Services Lesson Four: Training, Education, and Employment Services School-To-Work Transition Programs On-The-Job Training Apprenticeship Programs Technical Schools and Colleges Community Sponsored Adult Education Colleges and Universities Job-Seeking Skills and Training Job Development and Placement Approaches Supported Work Programs Lesson Five: Job Retention and Advancement Overview of Resources State Employment Services Commissions State Vocational Rehabilitation Agencies Seeking and Securing Funds for Vocational Services Resources for Veterans Community Level Providers Community Based Rehabilitation Centers Mental Health Agencies Lesson Six: Additional Considerations Finding and Maintaining Employment Coping with Medical and Psychological Challenges Lesson One: Introduction Relationships Between Substance Abuse and Psychiatric Problems Terminology Differences Between the Mental Health and Addiction Treatment Systems The Medical System Lesson Two: Case Management The Role of Abstinence Sequential, Simultaneous, or Integrated Treatment? Treatment Engagement, Continuity, and Comprehensiveness Phases of Treatment Individual Case Management Lesson Three: Mood Disorders Depressive Disorders Symptoms of Depression Treatment Considerations Bi-Polar Disorders Symptoms Treatment Considerations Levels of Care Lesson Four: Anxiety Disorders Generalized Anxiety Disorder Panic Disorders Agoraphobia Obsessive-Compulsive Disorder Post Traumatic Stress Disorder Lesson Five: Personality Disorders Antisocial Personalities Borderline Personalities Paranoid Personalities Schizoid Personalities Schizotypal Personalities Histrionic Personalities Narcissistic Personalities Avoidant Personalities Dependent Personalities Obsessive-Compulsive Personalities Lesson Six: Challenges and Linkages Policy and Planning Challenges Data Collection and Need Assessment Challenges Program Development Challenges Screening, Assessment, and Referral Challenges Case Management Challenges Staffing Challenges Social Service System Linkage Challenges Health Care System Linkage Challenges Criminal Justice System Linkage Challenges Meeting the Challenges Lesson One: Introduction Consequences of Adolescent Substance Use Treatment Needs of Adolescents Risk Behaviors of Adolescents Tailoring Treatment to Adolescent Populations Lesson Two: Assessment and Placement Factors Affecting Placement Risk and Protective Factors The Continuum of Treatment Placement Guidelines Outpatient Treatment Residential Treatment Continuing Care Lesson Three: Program Considerations Staff Skills Development Program Components Treatment Planning Linkages Program Evaluation Lesson Four: Three Widely Available Approaches Twelve Step Programs Therapeutic Communities Family Therapy Lesson Five: Adolescents with Special Treatment Needs Working with the Juvenile Justice System Diversion Programs Homeless Adolescents Sexual Orientation Coexisting Disorders Lesson Six: Legal and Ethical Issues Confidentiality Consent Forms Reporting Child Abuse or Neglect Court-Ordered Disclosure Medical Emergencies Lesson One: Introduction Prevalence Health Impact Psychological Effects Demographics Lesson Two: Women’s Treatment Methods and Models Effective Treatment for Women Case Management Special Issues for Women in Treatment Issues of Sexuality Women, Violence, and Substance Abuse Children Dual Disorders Lesson Three: Outreach and Identification of Women in Need Barriers to Outreach and Treatment Helping Women Overcome Their Fears Barriers Unique to Special Populations of Women Ethnic and Racial Populations Other Sub-Groups Lesson Four: Comprehensive Treatment The Intake Interview Orientation to Treatment Comprehensive Assessment Treatment Planning Lesson Five: Strategies for Providing Comprehensive Treatment Strategies Relationships and Special Populations Addressing Spiritual Needs Discharge Continuing Care Lesson Six: Special Populations and Case Studies Age Groups Women in the Criminal Justice System Women with Disabilities Cultural Knowledge Case Studies Lesson One: From the Instructor Introduction Lesson Two: Reflective Listening Simple Reflections Paraphrasing Complimenting Differentiating Yourself for the Mandating Party Lesson Three: “How” and “What” Questions Reflective Listening Revisited Embellished Reflections “Columbo” Questions Lesson Four: Turning Promises Into Treatment Tasks Exploring Exceptions Lesson Five: Reframing Externalizing Lesson Six: Achieving Goals vs. Solving Problems Discussing Goals Agreeing on a Goal Finding Competence “Owning” Competence Expanding Competence Lesson One: Introduction Overview of Stages Benefits of Model Lessons Two and Three: The Precontemplation Stage Characteristics of Precontemplators Goals for Precontemplators Achieving Goals Helpful Techniques for Discouraged Precontemplators Sharing Counseling Notes Focusing on the Future Helpful Techniques for Other Precontemplators “Columbo” Questions Other Techniques Developing a “Yes” Set Lesson Four: The Contemplation Stage Characteristics of Contemplators Goals for Contemplators Helpful Techniques for Contemplation Case Study Lesson Five: The Preparation Stage Characteristics of Those on the Preparation Stage Goals for Preparation Helpful Techniques for Preparation Asking “How” and “What” Instead of “Why” Mapping the Problem Pattern Interruption Exploring Exceptions Lesson Six: The Action and Maintenance Stages Characteristics of Those on the Action Stage Characteristics of Those on the Maintenance Stage Case Study in Maintenance Relapse Summary of Stages and “Dos” and “Don’ts” for Each Stage Lesson One: Introduction The Major Areas of Disagreement Preventing Litigation Substance Abuse Client Rights Case Studies Lesson Two: The Client/Counselor Relationship Non-Discrimination and Respectful Treatment Fees for Service Competence Disclosure and Informed Consent Dual Relationships and Conflicts of Interest Confidentiality Evaluation and Assessment Treatment Planning and Documentation Other Considerations Client empowerment Cultural sensitivity Termination Self-Assessment Checklist Lesson Three: Professional Relationships and Professional Responsibilities Ethical Conduct Toward Other Professionals Relationships With Employers Responsibilities to the Counseling Profession Research Competence Advertising Professional Relationships Credentials For Counselors Who Are Educators or Trainers For Supervisors and Administrators Self-Assessment Checklist for Supervisors Responsibility to Society Other Concerns Lesson Four: Resolving Ethical Issues Seven Steps for Ethical Decision-Making Five Guidelines for Making Ethical Decisions Lessons Five and Six: Specific Relevant Codes and Ethics Resources Ethical Standards from NAADAC The ACA Code of Ethics The NASW Code of Ethics Clinical Supervisor Codes Prevention Codes Criminal Justice System Codes Lesson One: Introduction Interagency Case Management Importance with Substance Abuse Clients Models of Case Management Brokerage Models Strengths-based Models PACT Model Clinical/Rehabilitation Approach Lesson Two: Core Competencies and Principles of Case Management Case Management Principles Core Competencies Lesson Three: Community Linkages Forging the Linkages Identifying Potential Partners The Agency Environment Potential Conflicts Lesson Four: Case Management and the Substance Abuse Treatment Continuum Outreach and Pre-Treatment Primary Treatment Aftercare Lesson Five: Case Management for Clients with Special Needs General Rules Clients with HIV Infection and AIDS MICA Clients Homeless Clients Women Adolescents Criminal Justice Clients Clients with Physical Disabilities Gay, Lesbian, Transgendered, and Bisexual Clients Rural Clients Lesson Six: Evaluation and Quality Assurance Brief Overview of Research Evaluating Case Management Programs Selecting Measurements Court-Ordered Disclosure Client Satisfaction Measuring Client Outcomes Data Helpful to Case Managers Data Helpful to Clients and Family Members Lesson One: Introduction The Impact of Substance Abuse on Families The Goals of Family Therapy Families with Children Families without Children Blended Families Clients with Grown Children Adolescents in Traditional Families Lesson Two: A Comparison of the Two Approaches to Treatment Regulation, Licensure, and Certification Barriers to Treatment Screening and Assessment The Identified Client The Presenting Problem Process vs. Content Family Interventions Counselor Self-Disclosure Spirituality Lesson Three: Models of Family Therapy Basic Concepts Specific Models of Family-Involved Substance Abuse Treatment Lesson Four: Family-Involved Substance Abuse Treatment—An Integrated Model The Benefits of an Integrated Model Limitations of an Integrated Model Three Levels of Family-Involved Substance Abuse Treatment Brief Overview of Several Specific Integrated Models How to Decide Which Model to Use Lesson Five: Special Populations Women Children Adolescents Older Adults African-Americans Hispanics/Latinos Asian-Americans American Indians Sexual Orientation Physical and Cognitive Disabilities Rural Populations Lesson Six: Practical Considerations for Implementation Family-Friendly Case Management Levels of Family Recovery Lesson One: Introduction 42 CFR Part 2 HIPAA Penalties for Non-Compliance Lesson Two: Permitted Disclosures Under 42 CFR Part 2 Medical Emergencies Crimes Administrative Disclosures QSOs Audits and Evaluations Research “Duty to Warn” Under Age Clients Common Violations Lesson Three: HIPAA Covered Transactions Protected Information Permitted Disclosures Necessary Safeguards Counseling Notes Marketing Client Rights Lesson Four: How to Communicate, Store Data, and Handle Requests for Protected Information Telephone and Mail Correspondence Computer Files, Faxes, and E-Mails Telephone Calls and Visits to Clients Reporting Crimes Subpoenas, Search Warrants, and Arrest Warrants Court Ordered Disclosures Underage Clients Employee Assistance Programs Getting Payment for Treatment Marriage and Family Treatment Fundraising and Publicity When Consent Is Revoked Lesson Five: Mandated Reporting Child Abuse and Neglect Developing a Program Policy on Mandated Reporting Limiting Damage to the Therapeutic Relationship Lesson Six: Compliance Checklists and Sample Forms Lesson One: Introduction to Psychotherapeutic Medications Definitions: Episode, remission, recurrence, recovery, relapse; acute, continuation, and maintenance phases Helping clients understand what to expect from medication How to be most helpful to the prescribing physician Dealing with Depression Medication Policies
Lesson Two: "Stepwise" Treatment for Addiction and Co-occurring Disorders Factors influencing addiction and other disorders Finding a balance between helpful and detrimental pharmacological effects Psychoactive mediations Physicians’ Offices Reinforcement Potential Stepwise treatment principles Conversations with clients Outpatient Programs Non-pharmacologic, non-psychoactive, and psychoactive approaches
Lesson Three: Common Medications for Co-Occurring Disorders Generic vs. brand Antipsychotics/neuroleptics Anti-manic meds Anti-depressant meds Anti-anxiety meds Narcotic and opioid analgesics Anti-parkinsonian medications Hypnotics
Lesson Four: Introduction to Addiction Treatment Meds Benefits of OUD medication treatment Most commonly used medication treatments How OUD medications work Potential side effects Considerations for pregnant women Matching service and diagnosis
Lesson Five: The Opioid Use Disorder Medications Assessing which clients are best suited Integrating Care Naltrexone Buprenorphine Methadone Contraindications Take-Home doses
Sources Consulted Lesson One: Introduction The Case for Teaching Self-Advocacy Course Goals Principles of Recovery Lesson Two: Using the Life Wheel to Teach Self-Advocacy Food and Clothing Housing Recreation Employment, Education, and Training Physical and Emotional Health Social Income Maintenance Spirituality Lesson Three: Power and Assertiveness Personal Power and Authority Developing Assertiveness Skills Lesson Four: The Therapeutic Relationship Establishing a Partnership Stages of Change Model Transparency and the D-I-E Model Case Study Lesson Five: WRAPs and Wraparound Planning Designing a Wellness Recovery Action Plan (WRAP) Case Study Lesson Six: Teaching Self-Advocacy in Groups Group Rules Techniques that Promote Self-Advocacy in Group Therapy Lesson One: Introduction Evidence Base History of How Case Study Lesson Two: Types of Dialectical Behavior Therapy Cognitive Analytic Therapy Schema Therapy Mindfulness Based Cognitive Therapy Lesson Three: Universal Problem Inventories Negative Automatic Thought Inventories Case Studies D-I-E-D-E-P Method Thought Stopping and Substitution Lesson Four: Practical Examples of Daily Thought Records Dealing with Cravings Dealing with Triggers Exposure Therapy for Anxiety Disorders Extinction and Exposure Inventory for Phobias Extinction and Exposure Plan D-I-E-D-E-P Method Homework and Record Keeping Worry Appointments Lesson Five: Note-taking Progress Assessments When Symptoms Increase Building the Therapeutic For Clients Who Want To Look Into Their Pasts For Clients Who Don’t Want To Look Into Their Pasts For Clients Who Say They Want Lesson One: Introduction Types of Groups Guidelines for Successful Group Leadership Co-leading Groups Building Motivation Lesson Two: Personal Qualities Conducive to Successful Group Leadership Active Listening Consistency Empathy Humility Humor Integrity Optimism A non-judgmental stance Self-awareness Self-confidence Self-control Trust Lesson Three: Group Leadership Skills and Styles Psycho-educational groups Skills development groups Cognitive-behavioral groups Support groups Interpersonal process groups Relapse prevention groups Expressive groups Solution-focused groups Lesson Four: Therapeutic Techniques Psycho-educational groups Skills development groups Cognitive-behavioral groups Support groups Interpersonal process groups Relapse prevention groups Expressive groups Solution-focused groups Lesson Five: Addressing Common Problems and Avoiding Common Mistakes Overheated emotions Avoiding a leader-centered group Handling boundary violations Violations of abstinence Physical boundary violations Shame Transference and counter-transference Handling overly talkative clients Bolting Handling clients who participate minimally Handling conflicts in group Managing groups within groups Administrative discharges Lesson Six: Integrating Care Co-occurring disorders Medication Integrating the 12 Steps Integrating group and individual counseling Confidentiality Summary—twelve ways to be a better group leader Lesson One: Introduction Lesson Two: Taking the Most Helpful Approach Lessons Three and Four: How to Respond—G-A-T-E Lesson Five: Core Competencies Lesson Six: Legal and Ethical Issues Lesson One: Introduction The Case for Implementing EBPs Definitions Diffusion of Innovation Theories Transtheoretical Models Implementation Models Principles of Implementing Change Matching Your Program with Appropriate EBPs Gauging Your Readiness to Change Checking Your Program for Warning Signs Lesson Three: Planning Selecting the Change Team Defining Your Destination Eliminating Obstacles to Change Getting All Staff On Board Mapping the Implementation Plan Communicating Your Plan’s Relevance Overcoming Obstacles in the Implementation Phase Lesson Five: Evaluation What to Measure Selecting the Evaluation Team Outside Evaluators Estimating Cost Planning the Evaluation Collecting Data Analyzing Data Reporting Lesson Six: Sustainability Monitoring Progress and Making Adjustments Maintenance Phase Extension Phase Adaption Phase Lesson One: Introduction Screening and Assessment Carbon Monoxide Monitors Stages of Change Model Lesson Two: Evidence-Based Practices--Medications NRTs Other Medications Lesson Three: Evidence-Based Practices—Motivational Interviewing Spirit and Guiding Principles of MI Dealing with “Resistance” by Using O-A-R-S Identifying and Eliciting Change Talk Using Scaling Questions The Five “Rs” Providing Information Motivational Groups Lesson Four: Evidence-Based Practices—CBT and RPT Cognitive Behavioral Therapy Relapse Prevention Therapy Psycho-educational Groups Lesson Five: Treatment Planning Assessment Treatment Plan Principles Diagnosing Tobacco Use Disorders Problem Statements, Goal Statements, and Objectives Lesson Six: Special Considerations for Co-occurring Disorders Tobacco Use and Mental Health Tobacco Use and Special Populations Brief Summary Lesson One: Introduction Central Principles of Clinical Supervision Suggestions for New Supervisors Handling Challenging Situations Models of Supervision Lesson Two: Key Issues in Supervision Counselor Development Supervisor Development Ethical and Legal Issues Dual Relationships and Boundaries Informed Consent Confidentiality Cultural and Contextual Factors Sample Forms Lesson Three: Monitoring Performance Individual Development Plans (IDPs) Evaluations of Counselors Addressing Burnout and Compassion Fatigue Gate-Keeping Methods of Observation Supervision vs. Therapy Counter-transference Balancing Clinical and Administrative Supervision Time Management Structuring Initial Sessions Lesson Four: Methods and Techniques of Clinical Supervision Verbal Reports Written File Reviews Case Consultation and Case Management Direct Observation Audio-taping Video-taping One-way Windows Co-facilitation and Modeling Role-playing Lesson Five: Administrative Supervision Documentation Recordkeeping Legal and Ethical Issues Lesson One: Introduction
Stages of Change
Stages of Treatment
Lesson Two: Treatment Planning
Assessment
Stage-Informed Planning for Each Stage
Group vs. Individual Treatment
The Therapeutic Alliance
The Therapeutic Frame
Lesson Three: Research-Based Approaches
Motivational Interviewing
Cognitive-Behavioral Therapy
Relapse Prevention/12 Step Facilitation
Lesson Four: Persuasion Groups
Goals
Format
Guidelines
Addressing Disruptive Behavior
Lesson Five: Active Treatment/Relapse Prevention Groups
Goals
Format
Guidelines
Lesson One: Introduction Prevalence Ingredients Symptoms DSM V Diagnosis Risk Factors Acute Stress Disorder Adjustment Disorders Lesson Two: Trauma’s Effects on the Brain Survival Brain Intellectual Brain Hypothalamus Cortisol/Adrenaline Healing Strategies Lesson Three: Gender Differences, Sexual Abuse, and Traumatic Grief Gender Differences Coping with Traumatic Memories Traumatic Grief Differentiating PTSD and Traumatic Grief Factors that Complicate the Grieving Process Anticipatory Grief Lesson Four: Violent Events, Coping Styles, and Resilience Homicide, Suicide, and Murder Accidents Survivors’ Needs Coping Styles Coping Strategies and the Search for Meaning Resilience and Post-Traumatic Growth Lesson Five: Trauma-Informed Counseling Techniques General Guidelines Grounding Self-soothing, Self-care, and Self-efficacy Debriefing Educational Interventions Role Playing Exposure Therapy EMDR Spirituality Interpersonal Therapy Cognitive Therapy Group Therapy Forgiveness Art Therapy Dos and Don’ts Lesson Six: Counselor Wellness Role Modeling Preventing Burnout What Programs Can Do to Support Counselor Wellness Lesson One: Introduction The case for improving cultural competence Cultural identity Common characteristics of culture Definitions of race Definitions of ethnicity Lesson Two: Important Factors in Race, Ethnicity, and Cultural Identity Language and communication Geographic location Worldview, values, and traditions Family and kinship Gender roles Socio-economic status and education Immigration and migration Acculturation and Cultural Identification Assimilation, segmented assimilation, biculturalism, and enculturation Heritage and history Sexuality Perspectives on health, illness, and healing Religion and spirituality Lesson Three: Core Competencies for Clinical Staff Self-knowledge Trust and power Knowledge of other cultural groups Culturally responsive attitudes and behaviors Values and biases Personal space Culturally specific meanings of touch Culturally based experiences of power and powerlessness Communication styles Goals for culturally informed counseling Lesson Four: Organizational Cultural Competence Awareness and commitment Defined values and principles Creating a cultural awareness committee Ongoing training Clinical supervision Outreach Lesson Five: Drug Cultures and the Cultures of Recovery Cultures specific to certain drugs Cultures specific to sexual preference The relationship between mainstream and drug cultures Online drug cultures Drug cultures in assessment and engagement Finding alternatives to drug cultures Developing a culture of recovery Course summary Lesson One: Introduction Basics of detox services Three essential components Settings, Levels of Care, and Patient Placement
Lesson Two: The Most Common Detox Settings Physicians’ Offices Outpatient Programs Freestanding Urgent Care Centers and ERs Freestanding Substance Abuse Treatment or Mental Health Facilities Intensive Outpatient and Partial Hospitalization Programs Acute Care Inpatient Settings Other Placement Considerations
Lesson Three: Psychosocial and Biomedical Issues Conducting the Initial Evaluation Addressing Immediate Medical Concerns Addressing Immediate Mental Health Needs Dealing with Anger, Aggression, and Violence General Guidelines for Addressing Nutritional Concerns Considerations for Adolescents Gender-Specific Concerns Considerations for Chronic Relapsers Educating Patients on the Withdrawal Process
Lesson Four: Alcohol Detox Initial Screening Blood Alcohol Content Blood Alcohol Levels Urine Drug Screens Withdrawal Signs and Symptoms Managing Withdrawal Without Medication Managing Withdrawal With Medications What To Do In The Event Of A Seizure
Lesson Five: Detox From Other Substances Opioids Benzodiazepines and Other Sedative-Hypnotics Detox From Stimulants Inhalants and Solvents Nicotine Marijuana and Hashish Anabolic Steroids Club Drugs Hallucinogens Gamma-hydroxybutyrate (GHB) Ecstacy Ketamine and PCP Management of Polydrug Abuse Outline for Avoiding Boundary Violations Part One: Confidentiality (3 clock hours)
Course Outline for "Avoiding Boundary Violations Part Two: Counselor Ethics" (3 clock hours)
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