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The Spectrum of Addiction


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Table of Contents

Preface Acknowledgments Chapter 1 Historical Foundations of Addiction Counseling Learning Objectives Historical Use of Chemical Substances History of the Treatment and Recovery Movement History of Addiction-Related Research Historical Legislation Efforts Impacting the Field The Evolving Addiction Treatment Professional Conclusion Resources for Further Learning References Chapter 2 Understanding the Importance of Evidence-Based Practices for Professional Counselors Learning Objectives Overview of Evidence-Based Practices Defining Evidence-Based Understanding Research in Action Importance and Demand for Evidence-Based Practice Locating Evidence-Based Practices A Caveat: The Common Factors Model and Evidence-Based Practice Conclusion Skills in Action Resources for Further Learning References Chapter 3 Understanding the Brain in the Addictive Process Learning Objectives Knowledge: Enhanced Understanding and Brain Research Evidence-Based Practice Addiction and Brain Changes Future Directions Skills in Action Case Study Experiential Skills Learning Activity Quiz: Brain and Addiction Answer Key: Brain and Addiction Quiz Resources for Further Learning References Chapter 4 Experimentation and Seeking Altered States Learning Objectives Knowledge Social Pressures: Theories Social Pressures: Peer, Family, and Community Influences Family Influences Gender Influences and Altered States Cultural Influences School Influences Other Influences and College Youth American Culture Protective Factors Successful Community-Based Prevention Evidence-Based Practice Skills in Action Resources for Further Learning References Chapter 5 Understanding Risky Use Patterns Learning Objectives Knowledge Risky Drinking Risky Use of Other Mood-Altering Substances Risky Use of Prescription Medication College Students and Binge Patterns: Chemical and Process Evidence-Based Practices Identifying Protective Factors and Advocacy Skills in Action Resources for Further Learning References Chapter 6 Assessment of Risky Use and Addictive Disorders Learning Objectives Risky Use Knowledge Important Considerations: Laying the Groundwork for Assessment Rapport-Building and Trust Issues Assessment of Use Patterns Evidence-Based Practices Extensive Assessment Tools Skills in Action Resources for Further Learning References Chapter 7 Diagnosis of Substance-Related and Addictive Disorders Learning Objectives Knowledge Overview of Current Diagnosis Models National Institute of Mental Health Research Domain Criteria International Classification and Diagnosis DSM-5 and New Updates Evidence-Based Practices Skills in Action Resources for Further Learning References Chapter 8 Brief Counseling Interventions Learning Objectives History of Brief Interventions Need and Evolution of the Brief Intervention Model Definition of Brief Intervention Evidence-Based Practices in Clinical Settings Skills in Action Resources for Further Learning References Chapter 9 Intensive Family Interventions Learning Objectives Knowledge Evidence-Based Practices (EBP) Family Support Skills in Action Conclusion Resources for Further Learning References Chapter 10 Societal Systems Impacted by the Addiction Spectrum: Legal, Workplace, and Medical Settings Learning Objectives Knowledge Legal System and the Impact of the Addiction Spectrum Medical Settings and the Impact of the Addiction Spectrum Evidence-Based Practices Skills in Action Resources for Further Learning References Chapter 11 Intensive Addictions Counseling Learning Objectives Knowledge Evidence-Based Practice Cognitive Behavior Therapy (CBT) Relational Model Motivational Interviewing (MI) Brain Stimulation Approaches Other Considerations for Intensive Counseling of Individuals With Addictive Disorders Tobacco Heroin Cocaine Process Addictions Intensive Levels of Care and Placement Criteria Skills in Action Resources for Further Learning References Chapter 12 Cross Addictions and Comorbidities Learning Objectives Knowledge Cross Addictions: Evidence-Based Knowledge and Substances Cross Addictions: Evidence-Based Knowledge and Process Addictions Cross-Addiction Substance and Process Addictions Skills in Action: Cross Addictions Effective Interventions for Cross Addictions Interventions for Cross Addictions With Emerging Research Support Comorbidity Evidence-Based Practices and Comorbidities Skills in Action: Comorbidity Resources for Further Learning References Chapter 13 Continuing Care and Relapse Prevention Learning Objectives Knowledge Prevalence and Scope of Relapse Understanding the Importance of Continuing Care to Prevent Relapse Evidence-Based Practices Mindfulness Medication-Assisted Treatment (MAT) Relapse Prevention Therapy (RPT) Recovery Communities Skills in Action References Chapter 14 Future Directions for Evidence-Based Addictions Counseling Research Learning Objectives Knowledge Neuroscience and the Brain An Expanding Definition of Addiction: Behavioral/Process Addictions Evidence-Based Practices Holistic Approaches Building Upon and Re-Examining Established Evidence-Based Models Importance of Continued Research Skills in Action Resources for Further Learning References Index About the Authors

About the Author

Laura J. Veach, Ph.D., Professor in the Departments of Surgery and Psychiatry/Behavioral Medicine at Wake Forest School of Medicine in Winston-Salem, NC is licensed in NC as a professional counselor (LPC), a clinical addiction specialist (LCAS), and is a certified clinical supervisor (CCS). Dr. Veach has her Ph.D. in Counselor Education & Supervision from the University of New Orleans. She serves as the Wake Forest Baptist Health Director of Counselor Training in Acute Care Services: Surgery/Trauma/Burns/Medicine and Specialized Screening and Intervention research and trauma-informed counseling with over 35 years of work in counseling and supervision, especially in counseling individuals impacted by substance use disorders. In August 2007 she pioneered alcohol screening and brief counseling intervention services, research, and counselor training at Wake Forest Baptist Medical Level I Trauma Center. She served as Co-Principal Investigator for a Robert Wood Johnson Foundation Grant examining alcohol screening and brief counseling interventions in a prospective clinical trial comparing two counseling interventions. Recently, she received funding from the Childress Institute for Pediatric Trauma as Principal Investigator to conduct ATV safety interventions with pediatric trauma patients and also completed violence intervention research with violently injured youth in hospital trauma centers at Wake Forest and Carolinas Medical Center. In addition, she is a key care manager for an NIH-funded multicenter pragmatic trial examining intensive PTSD interventions in hospitalized trauma patients. She specializes in counseling individuals with addictive and substance-related use disorders, trauma-informed counseling in medical and integrated care settings, behavioral health consulting, and has over 20 publications. She has over 35 years of clinical, management, and start-up experience in counseling settings. In previous counselor education tenured faculty appointments at Wake Forest University and University of North Carolina at Charlotte and in previous behavioral health administration work she created innovative counselor training, addiction treatment programs and managed care services. Dr. Veach served as the 2006 President of the International Association of Addictions and Offender Counseling (IAAOC). She was awarded the IAAOC Counselor Educator Award in March 2007, the Graduate Faculty Award for Excellence in Teaching at Wake Forest University May 2007, and the national ACA Advocacy Award March 2008. She cherishes spending time with her devoted partner, George, and amazing daughter, Alana, as we enjoy our shared vintage auto racing and travel pursuits in the U.S. Dr. Regina Moro currently serves as an Assistant Professor in the Department of Counselor Education at Boise State University in Boise, Idaho. She received her PhD in Counseling from the University of North Carolina at Charlotte with an emphasis in Multicultural Counseling, received a graduate certificate from UNC Charlotte in Substance Abuse Counseling, and an MS in Community Counseling from Syracuse University. Regina is licensed as a Licensed Mental Health Counselor (FL), a Licensed Clinical Addictions Specialist (NC), and is a National Certified Counselor. Her clinical passion involves work with crisis and trauma, including a focus on addiction with individuals and families. Regina has held leadership positions in Counseling organizations, most recently with the International Association of Addictions and Offender Counselors. She enjoys spending her free time enjoying the great outdoors with her partner, Ryan, and their rescue dog, Barkley.


"The Spectrum of Addiction fills a gap in preparing graduate students to better serve clients struggling with addictive behaviors. Its inclusion of the new DSM-5 criteria for addictive behaviors and lifespan focus make this is a unique contribution to the field."

-- Robert Scholz

"This textbook provides an updated, comprehensible 21st-century foundation for the understanding of an age-old struggle with problems surrounding addictions."

-- Arlene Saum

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