Counseling addicted families : an integrated assessment and treatment model

In Counseling Addicted Families,Gerald A. Juhnke and William Bryce Hagedorn recognize that even those treatment providers who understand the importance of the familial context of addiction are often stymied by the variety of family treatment theories and their often imperfect fit for cases of addiction. In this book, Juhnke and Hagedorn provide a truly integrated model for assessment and treatment. Based upon the authors' combined twenty-three years of experience in clinical and treatment supervision, the Integrated Family Addictions Model consists of six progressive treatment tiers which organize the relevant family treatment theories into a graduated and coherent sequence, beginning with the briefest and least costly forms of therapy.

Author Notes

Gerald A. Juhnke, Ed.D., LPC, NCC, MAC, CCAS, ACS, Professor and Doctoral Program Director, Department of Counseling, Educational Psychology, and Adult & Higher Education, University of Texas at San Antonio
W. Bryce Hagedorn, Ph.D., LMHC, NCC, MAC, Assistant Professor and Program Director of Counselor Education, Department of Educational and Psychological Studies, Florida International University

Preface	p. vii
Chapter 1 The Definition and Prevalence of Addiction: Impacts on the Family and the Nation	p. 1
Chapter 1 Learning Objectives	p. 1
Introduction	p. 1
Addiction-A Working Definition	p. 2
Helping Clients and Families Understand	p. 2
Clinical Definitions-Can We Agree?	p. 4
Now to Complicate Matters...	p. 5
Addiction-Prevalence and Impacts	p. 10
An Accurate Count-Is It Possible?	p. 10
How Much Does It All Cost?	p. 14
Impacts of Chemical Addictions	p. 14
Impacts of Process Addictions	p. 27
The Final Calculations	p. 39
Skill Builder	p. 40
Skill Builder Responses and Answers	p. 46
References	p. 50
Chapter 2 Helping Clients and Families Understand Addictions: Etiological Theories and Models	p. 61
Chapter 2 Learning Objectives	p. 61
Introduction	p. 61
Theory, Theory, Theory...Why Can't We Just Wing It?	p. 63
Moving from Moral to Multifaceted-A Discussion of Addiction Theories	p. 66
Why Don't They Just Stop?-The Moral Model of Addictive Disorders	p. 68
Clinical Case Example	p. 69
Summary and Integration	p. 71
I Can't Help It-I Have a Disease: The Physiological Theory of Addiction	p. 71
The Disease/Medical Model	p. 72
Support for the Physiological Theory: The Impact of Genetics	p. 74
Clinical Case Example	p. 77
Summary and Integration	p. 84
Numbing Out-The Psychological Theory of Addictive Disorders	p. 87
The Influence of Behavioral Theory	p. 88
Hiding the Hurt: The Self-Medication Hypothesis	p. 89
Living the Lifestyle: The Addictive Personality	p. 90
Clinical Case Example	p. 92
Summary and Integration	p. 94
"Where'd You Learn to Drink Like That?"-The Influence of the Environment on Addictive Disorders	p. 97
Sociological Theory	p. 97
Social Learning Theory	p. 100
Summary and Integration	p. 101
Which Came First, the Chicken or the Egg?-The Biopsychosocialspiritual Approach to Addictive Disorders	p. 102
Spirituality and Addiction	p. 103
Clinical Case Example	p. 105
Summary and Integration	p. 112
Conclusions	p. 113
Skill Builder	p. 117
Skill Builder Responses and Answers	p. 123
References	p. 128
Chapter 3 Family Addictions Assessment	p. 141
Chapter 3 Learning Objectives	p. 141
Introduction	p. 141
The Clinical Family Addictions Assessment Interview	p. 143
Six Clinical Family Addiction Assessment Phases	p. 149
Drug Detection Testing and Specialty Assessment Instruments	p. 168
Drug Detection Testing	p. 169
Specialty Assessment Instruments	p. 179
Therapeutic Feedback	p. 200
Sincere Accomplishment Reviews and Compliments	p. 200
When Perceptions Don't Match	p. 204
Summary	p. 204
Skill Builder	p. 205
Skill Builder Responses	p. 210
References	p. 212
Chapter 4 The Sequential Family Addictions Counseling Model	p. 215
Chapter 4 Learning Objectives	p. 215
Introduction	p. 215
Why Family Counseling?	p. 217
What Is Family Counseling?	p. 219
Common Family Therapy Terms and Constructs	p. 220
Equifinality	p. 220
Homeostasis	p. 221
Family Roles	p. 223
Family Boundaries	p. 225
Domestic Violence and Addicted Families	p. 226
The Model	p. 229
General Model Overview	p. 229
Stage 1 The Change Model and Motivational Interviewing	p. 233
Stage 2 Solution-Focused Therapy	p. 239
Stage 3 Cognitive-Behavioral Family Therapy	p. 247
Stage 4 Structural Family Counseling	p. 257
Stage 5 Extended Family Systems Counseling	p. 266
Stage 6 Modified Intergenerational Family-of-Origin Therapy	p. 278
Summary	p. 286
Stage 7 Psychodynamic Object Relations Family Therapy	p. 286
Conclusion	p. 293
Skill Builder	p. 294
Skill Builder Responses	p. 296
References	p. 297
Chapter 5 Special Topics in Counseling Addicted Families	p. 301
Chapter 5 Learning Objectives	p. 301
Introduction	p. 301
Social Justice	p. 302
Stigmatization and Discrimination toward Addicted Families	p. 302
Ignorance Is No Excuse	p. 304
Multicultural Topics	p. 307
Self-Assessment	p. 308
Multicultural Family Addictions Counseling	p. 309
Multicultural Resources	p. 310
Life-Threatening Behaviors	p. 311
Suicide	p. 311
Substance-Related Familial Violence	p. 326
Conclusion	p. 334
Skill Builder	p. 335
Skill Builder Responses	p. 340
References	p. 345
Final Comments	p. 349
Index	p. 351

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