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The Addiction Counselor's Documentation Sourcebook


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Table of Contents

CD Contents. Introduction. Chapter One: Precontact: Referral Forms. Form 1.1: Referral for Services. Form 1.2: Appointment Notification/Confirmation Letter. Form 1.3: Referral and Treatment Compliance Follow-Up Letter. Form 1.4: Thank You for Your Referral. Form 1.5: HIPAA Notice of Privacy Practices. HIPAA Privacy Authorization for Use and Disclosure of Personal Health Information. Form 1.6: HIPAAa??Client Sign-In Sheet. Chapter Two: Intake and Assessment Forms. Form 2.1: Initial Client Information Fact Sheet. Form 2.2: Confidential Brief Health Information Form. Form 2.3: Therapist Clinical Assessment. Form 2.4: Chemical Dependence Assessment Matrix. Form 2.5: Substance Abuse Assessment Matrix. Form 2.6: Acuity of Need/Level of Treatment Assessment Matrix. Form 2.7: Informed Consent and Payment Agreement for Services. Form 2.8: Authorization for Disclosure of Information. Form 2.9: Client Rights and Limits of Confidentiality Handout and Acknowledgment. Chapter Three: Treatment Forms. Form 3.1: Behavioral Contract. Form 3.2: Contract against Suicide, Self-Harm, or Harm to Others. Form 3.3: Client Input for Treatment Planning. Form 3.4: Master Treatment Plan. Form 3.5: Treatment Plan Update/Revision Form. Form 3.6: Group Therapy Progress Note. Form 3.7: Individual/Family Therapy Session Progress Note. Form 3.8: Telephone Contact Progress Note. Form 3.9: Therapeutic Materials Loan Record. Form 3.10: Eye Movement Desensitization and Reprocessing (EMDR) Information Handout. Form 3.11: Eye Movement Desensitization and Reprocessing (EMDR) Consent for Treatment. Form 3.12: Eye Movement Desensitization and Reprocessing (EMDR) Progress Note. Form 3.13: Recovery Program Meeting Review/Critique Form. Chapter Four: Treatment Forms: Program Administration Documentation. Form 4.1: Client Encounter Summary Log Sheet. Form 4.2: Monthly Progress Note/Report. Form 4.3: Recovery Program Attendance Verification Form. Form 4.4: Request/Referral for Extended Services. Form 4.5: Request/Referral for Additional Services. Form 4.6: Request for Drug Screening by External Providers. Form 4.7: Treatment Program Attendance/Completion Record. Form 4.8: Certificate of Completion. Form 4.9: Case Staffing Record. Form 4.10: Treatment Termination Warning. Form 4.11: Treatment Termination Notification. Form 4.12: Treatment Discharge Summary. Form 4.13: Request for an Accounting of Disclosures. Form 4.14: Disclosure Tracking Log. Chapter Five: Program Evaluation. Form 5.1: Outcome Measurement Tracking Form. Form 5.2: Informed Consent for Participation in Outcome Assessment. Chapter Six: Addictive Behaviors: Materials for Use in Psychoeducational Groups. Presentation 6.1: Psychopharmacology, Part I. Presentation 6.2: Psychopharmacology, Part II. Presentation 6.3: The Process of Addiction. Presentation 6.4: The Process of Relapse. Presentation 6.5: Addiction and Contemporary Culture. Presentation 6.6: Switching Addictions: Other Compulsive Behaviors. Chapter Seven: Recovery Resources and Skills: Materials for Use in Psychoeducational Groups. Presentation 7.1: The Process of Recovery. Presentation 7.2: Recovery Programs and Resources. Presentation 7.3: Lifestyle Changes. Presentation 7.4: Common Problems and Issues in Recovery. Presentation 7.5: Relapse Prevention, Part I. Presentation 7.6: Relapse Prevention, Part II. Presentation 7.7: Physical and Emotional Self-Care. Presentation 7.8: Stress Management. Presentation 7.9: Communication Skills. Presentation 7.10: Healthy Relationship Skills. Presentation 7.11: Setting and Achieving Goals. Presentation 7.12: Problem-Solving Skills. Presentation 7.13: Coping with Anger and Resentment. Presentation 7.14: Coping with Depression and Anxiety. Presentation 7.15: Resisting Pressures to Drink or Use. Chapter Eight: Other Mental Health Issues: Materials for Use in Psychoeducational Groups. Presentation 8.1: Family Dynamics. Presentation 8.2: Domestic Violence. Presentation 8.3: Suicide Awareness and Prevention, Part I. Presentation 8.4: Suicide Awareness and Prevention, Part II. Presentation 8.5: Trauma and Posttraumatic Stress Disorder. Presentation 8.6: Co-Occurring Disorders. Presentation 8.7: Codependency. Presentation 8.8: Grief and Loss. CD-ROM Information.

About the Author

Brenda S. Lenz, MS, is an educator and licensed counselor specializing in treating addictions in women and adolescents. She is currently a substance abuse counselor at Marquette University.

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