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Books > Medicine > Nursing & ancillary services > Specific disorders & therapies > Addiction & therapy
Addiction is something that affects many different people from all walks of life and can be difficult for a therapist to treat, and the client to conquer. In this book fifteen people who have formerly had serious addictions speak about their experiences. Survivors of Addiction draws on first-hand narratives to provide an overview of how and why people become addicted, and explores what happens after the addiction is left behind. Divided into four sections it covers:
By considering psychodynamic and Jungian perspectives as well as the clinical vignettes, this book examines the process of recovery from addiction. It will be key reading for therapists, clinicians and healthcare workers who encounter addictions in their day to day professions and will also be of great interest to those who are, or have been addicted, and their families.
How can the group setting be used to treat those with drug and alcohol problems? Many professionals working across a variety of addictions settings find themselves working in groups and tackling complex issues; however, there is often very little initial training or on-the-job support to help them in this challenging task. Principles and Practice of Group Work in Addictions has been written with the aim of addressing the key areas in working with drug and alcohol misuse while providing practical solutions to the more common problems that emerge in group work. Drawing on the expertise of clinicians who work in the field of addictions, this book offers readers practical advice for everyday practice. Divided into three sections it covers: core group work in addictions practical issues and solutions to common problems specific issues within the field of addictions. Principles and Practice of Group Work in Addictions is illustrated throughout with practical case examples, providing the reader with an insight into group work in this area. The book will supply guidance for mental health professionals including clinicians, psychologists, nurses and medical staff who encounter group work in addictions for the first time, as well as providing further knowledge and support to those who already work in the field.
Mark Schuckita (TM)s Drug and Alcohol Abuse has been a clinical mainstay for over a quarter century. Now the authora (TM)s trusted expertise is available in a new Sixth Edition, thoroughly revised for content, updated references, and streamlined for increased usefulness. Schuckit combines his experience as practitioner, researcher, and teacher to give professionals and students across the health and mental health disciplines a working knowledge of drug-related pathology, beginning with pharmacology, drug mechanisms, and genetic factors. And the Sixth Edition is as accessible as its predecessors, striking the right comfort level for the classroom or the emergency room. -Clinical/emergency orientation suited to both chronic misuse and acute situations -Coverage reflects current trends in alcohol, drug, and multidrug use, abuse, and dependence -Concise chapters for quick reference -Updated bibliographya "approximately 80% of citations are post-2000 -Diagnostic information reflects upcoming changes to the DSM -Latest strategies in treatment (psychological and pharmacological) and rehabilitation All material is organized for ease of use, whether the reader needs fast answers in a crisis, seeks new ideas for helping long-term patients or clients, or is just becoming familiar with the different drug classifications. This new edition offers expanded knowledge of a wide-ranging problem and a growing and clinically important population, and authoritative suggestions for effective care.
Coyote Speaks describes the strengths, the strategies, and the resilience a therapist needs to work successfully with alcoholics and addicts. It reports what a therapist sees, hears, smells, and feels in the midst of treating those yet to achieve sobriety, those recently sober, and those with years of recovery behind them. In the Navajo cosmology, those possessed by Coyote are neither inherently evil nor morally lacking, but like alcoholics and addicts they suffer from a malady of the soul as much as the body. The provocative humor of Coyote stories illustrates the mercurial and quixotic nature of the alcoholic and addict in treatment, while evocative case histories from the author's private practice reveal the humanity behind a disease that binds two individuals in a struggle toward honesty, humility, and sobriety. Coyote Speaks explores the darkness of alcohol and drug addiction, the humility we accept when we acknowledge our limitations as therapists, and the redemption we witness as we attend to a disease that is at best treatable. It is about caring enough, sometimes too much, and about knowing when to let go. It is about the importance of examining the trickster in each of us, and it is about listening, when Coyote speaks.
This proposed book draws on the expertise of 35 experts in the field of Addiction Medicine to provide the reader with a current and comprehensive view of addiction as related to women, pregnancy, newborns, infants and children. The volume begins by placing current attitudes towards addicted women in a historical context, and continues with contributions on the relationship of gender to substance abuse research, addiction as a general health issue in women, and ethical dilemmas faced when approaching drug use during pregnancy. The volume discusses high-risk pregnancies and HIV infection related to maternal drug abuse. It details specific pharmacotherapy such as methadone and buprenorphine, and assesses society's punitive view toward illicit drug using women. Finally, the book describes outcomes of newborns, infants and children born following intrauterine drug exposure. Health providers in many related disciplines, specialists in Addiction Medicine, social workers and ethicists are among those who will gain insight into the complex interdisciplinary matrix of abuse in women, its unique relationship to pregnancy, and its impact on drug-exposed children. This book was published as a special issue in the Journal of Addictive Diseases.
'A masterclass in understanding' ANNIE GRACE, author of This Naked Mind Ten questions to ask yourself, right now: * Do you have a sense that something is wrong, but you don't know what it is? * Do you have a feeling that you are hollow inside, that you are empty or have a void within? * Do you react badly to rejection? * Do you often feel sad, unhappy or down for no obvious reason? * Would you describe yourself as highly sensitive? * Do you have problems with relationships and intimacy? * Do you engage in addictive behaviour - alcohol, drugs, gambling, shopping, food, sex, work, exercise? * Do you have low self-esteem or self-worth - are you not 'good enough'? * Do you have a sense of being numb to your feelings? * Do you rarely experience true joy and happiness? If you have answered 'yes' to most of these questions, there is a strong chance you have experienced emotional neglect or trauma as a child. An emotionally neglected child may struggle to form strong and secure attachments as an adult. They may feel hollow or empty, worthless (or overly important), judge themselves harshly and struggle with addictive tendencies - drinking, eating or exercising too much, for example. If this describes you, Heal Your Inner Child will change your life and give you back the love, compassion and authenticity you needed as a child, and deserve as an adult. Fomer heavy drinker turned sobriety coach Simon Chapple is - like you - a survivor of childhood trauma. His unique brand of straight-talking, practical yet reflective and relatable advice has helped thousands of people quit drinking, and he can help you now to move on from childhood emotional neglect to a place of happiness free from past trauma. How to Heal Your Inner Child is a stepped and safe approach to confronting your past, with space for reflective and supportive strategies that will help you to foster self-compassion and break free from the destructive behaviours that have blighted your life. Clinically endorsed and verified by a psychotherapist, this deeply personal, unflinchingly honest exploration is designed to unlock your own epiphany and support you as you journey to a happier, less troubled and more authentic self.
This book is a treatment manual providing guidance for therapists treating clients with gambling addictions. In this book the authors use a cognitive behavioural approach and provide a session by session guide for overcoming problem gambling. Essential topics covered include:
A Cognitive Behavioural Therapy Programme for Problem Gambling supplies detailed information to help the therapist and client understand gambling behaviours, as well as practical advice on techniques that can be used with the client to change these behaviours. This practical guide includes handouts and exercises that can be downloaded by purchasers of the print edition. It will provide helpful guidance for addiction counsellors and therapists worldwide.
This comprehensive issue on Substance Abuse in youth begins with articles on epidemiological trends, genetic risk factors, neurobiology of substance use disorders, and race and gender associations, and then provides detailed reviews on prevention and various treatment methodologies.? Treatments discussed include individual and group interventions (motivational interviewing and cognitive behavioral therapy), contingency reinforcement, multidimentional family therapy, pharmacotherapy, and post-treatment aftercare.? Also reviewed in detail are substance use disorders and psychiatric comorbidity.? The issue then takes a close look at two emerging areas of concern in youth: gambling and internet occupation, and energy drink use. By all accounts, a must-read issue for psychiatrists everywhere.
This provocative and controversial book challenges a number of widely held ideas in the alcohol/drug field by critically evaluating the bases of these ideas. The field of alcohol/drug studies is fraught with conflict and controversy, and each generation of researchers and practitioners seems to have its own special areas of conflict. In this new volume, experts focus on a number of important issues of current interest and controversy. Is alcoholism a "disease" or is it not? Should federal bans on drugs like heroin and cocaine be removed and will that solve, modify, or exacerbate the problem? Can the risk for alcoholism really be predicted?Professionals from a very wide variety of disciplines--medicine and biochemistry, psychiatry and psychology, philosophy, anthropology, law, social work, and journalism--present their very differing points of view on the perception of alcoholism as a disease and on public policy issues like proposed legislative controls over alcoholic beverages. Current Issues in Alcohol/Drug Studies touches upon a number of questions that will be of interest both to people in alcohol/drug research and in alcohol/drug treatment and prevention. Because it will undoubtedly stimulate further investigation and debate, researchers and policymakers will also find it useful.
Patients who have both a psychiatric disorder and a substance abuse problem cause most clinicians to throw up their hands in despair. The clinical problems that these "dual diagnosis" patients present are enor mously complex. Diagnostically, how is one to tell if disorders of mood and thinking, for instance, are signs of a mental illness or consequences of substance abuse? How is one to obtain important historic information when the patient may be unable or unwilling to provide it and there are no readily available collateral sources of information? In any case, why bother? Treatments for dually diagnosed patients are ineffective; patients won't stay in treatment; recidivism occurs at a very high rate. To make matters even more difficult, traditional health care reim bursement mechanisms do not provide for the multimodality clinical programs and special services needed by the patient who is both mentally ill and a substance abuser. So the clinician needs an effective bureaucratic strategy as well as a treatment strategy. For the most part, clinicians have handled the problem by ignoring it."
Through the vivid, true stories of five addicts, a neuroscientist explains how addiction happens in the brain, and what we can do to overcome it. The psychiatric establishment and rehab industry in the Western world have branded addiction a brain disease, based on evidence that brains change with drug use. But in The Biology of Desire, cognitive neuroscientist and former addict Marc Lewis makes a convincing case that the disease model has become an obstacle to healing. Lewis reveals addiction as an unintended consequence of the brain doing what it's supposed to do - seek pleasure and relief - in a world that's not cooperating. Brains are designed to restructure themselves with normal learning and development, but this process is accelerated in addiction when highly attractive rewards are pursued repeatedly. Lewis shows why treatment based on the disease model so often fails, and how treatment can be retooled to achieve lasting recovery, given the realities of brain plasticity. Combining intimate human stories with clearly rendered scientific explanation, The Biology of Desire is enlightening and optimistic reading for anyone who has wrestled with addiction either personally or professionally.
Women, Girls, and Addiction is the first book on the efficacy of treatment approaches and interventions that are tailored to working with addicted women, and the first publication of any kind to provide a feminist approach to understanding the experience of addiction from the female perspective. Part I of the book provides an overview of feminist theory and addiction counseling, followed by an historical look at women and addiction (research, treatment, demographics). The three chapters in part two give an in-depth look at the biological, psychological, and social factors of the experience of addiction as unique in women. The final section of the book presents a series of chapters spanning the lifespan, which each feature age-specific special issues, treatment strategies, interventions, and commonly encountered topics in therapy with the population.
Solution-Focused Substance Abuse Treatment describes the standard of care for substance abuse treatment, demonstrates how solution-focused brief therapy exceeds this standard, and shows how it can effectively be used in substance abuse evaluation, case management, and both individual and group treatment. Beginning and advanced concepts are provided to address the questions of even the most advanced clinician, all placed in the context of cultural awareness. Most importantly, the author answers the many questions professionals may have about how solution-focused brief therapy can be successfully integrated into the field of substance abuse. It provides a thorough understanding of the issues that therapists face when working with this at times challenging population, and demonstrates how the use of solution-focused brief therapy can minimize power struggles and enhance client success. Sample forms and handouts are included, as are additional resources for effective evaluation and treatment.
This book integrates and synthesizes numerous empirically supported positive psychological constructs and psychotherapeutic theories to help understand addiction and facilitate recovery through the lens of forgiveness. Proposing forgiveness as an alternative and critical tool to understanding the process of addiction and recovery, whether in the context of substance use, compulsive behavior, and/or suicidal behavior, the book discusses multiple theoretical points of view regarding the process of forgiveness. Additionally, foundational theories underlying the process of recovery, the psychological and spiritual nature of forgiveness, and the nature of the association of forgiveness with health all receive detailed coverage. Considerable attention is also paid to the extant empirical support for the association of forgiveness with addiction and recovery. The text's comprehensive integration of theory, research, and clinical application, including guidelines regarding forgiveness as a treatment for recovery from addiction, provide a roadmap forward for addiction counselors and other recovery specialists.
This classic study is concerned with addiction to opiate-type drugs and their synthetic equivalents. Lindesmith proposes and systematically elaborates a rational, general theoretical account of the nature of the experiences which generate the addict's characteristic craving for drugs. While this theoretical position has obvious implications for addictions that resemble opiate addiction in that they also involve drugs which produce physical dependence and withdrawal distress, the author does not extend the theory to these other forms of addiction, such as alcoholism. The central theoretical problem is posed by the fact that some persons who experience the effects of opiate-type drugs and use them for a period sufficient to establish physical dependence do not become addicts, while others under what appear to be the same conditions, do become addicted. The focus of theoretical attention is on those aspects of addiction which may reasonably he regarded as basic or essential in the sense that they are invariably manifested by all types of addicts regardless of place, time, method of use, social class, and other similar variable circumstances. Lindesmith then makes a brief statement of a view of current public policy concerning addiction in the United States reform which, it is believed, would substantially reduce the evils now associated with addiction and the large illicit traffic in drugs. He interviews approximately fifty addicts over a fairly extended period of time sufficient to establish an informal, friendly relationship of mutual trust. The attempt to account for the differential reactions among drug users requires specification of the circumstances under which physical dependence results in addiction and in the absence of which it does not. It also requires careful consideration of the meaning of "addiction," spelled out in terms of behavior and attitudes characteristic of opiate addicts everywhere. This book strives to understand these aspects of addiction with the ultimate goal of understanding the factors which create its foundations. Alfred R. Lindesmith (1905-1991) was professor of sociology at Indiana University and was one of the first scholars to provide a well-researched account on the subject of addiction. He believed that opiate addiction was based on dramatic shifts of an individual's mental and motivation states.
What is it that makes some therapists so much more effective than others, even when they are delivering the same evidence-based treatment? This instructive book identifies specific interpersonal skills and attitudes--often overlooked in clinical training--that facilitate better client outcomes across a broad range of treatment methods and contexts. Reviewing 70 years of psychotherapy research, the preeminent authors show that empathy, acceptance, warmth, focus, and other characteristics of effective therapists are both measurable and teachable. Richly illustrated with annotated sample dialogues, the book gives practitioners and students a blueprint for learning, practicing, and self-monitoring these crucial clinical skills.
This book presents 13 reviews collected to present the new advances
in all areas of addiction research, including knowledge gained from
mapping the human genome, the improved understanding of brain
pathways and functions that are stimulated by addictive drugs,
experimental and clinical psychology approaches to addiction and
treatment, as well as both ethical considerations and social
policy. The book also includes chapters on the history of addictive
substances and some personal narratives of addiction. Introduced by
Sir David King, Science Advisory to the UK Government and head of
the Office of Science and Technology, and Nora Volkow, director of
the National Institute on Drug Abuse in the USA, the book uniquely
covers the full range of disciplines which can provide insight into
the future of addiction, from genetics to the humanities. Written
for a scientific audience, it is also applicable to non-specialists
as well.
Research in the past decade has shown that substance abuse and
substance dependence are treatable. The field has witnessed the
introduction of evidence-based psychological and specific
pharmacological treatments. Unfortunately, many of the empirical
supported therapies for addictions are still not widely applied by
practitioners. The third volume in the "Practical Clinical
Guidebooks Series (PCG), Evidence-Based Treatment in Substance
Abuse "and Dependence would encompass the developments in the field
over the last decade, blending theory, techniques and clinical
flexibility. The book will provide case illustrations on assessment
as well as therapy, and will be suitable for practitioners and
students training in clinical and counseling psychology,
psychiatry, social work and related fields.
"Implementing Evidence-Based Practices for Treatment of Alcohol and Drug Disorders" provides managers and clinicians with results from Practice Improvement Collaboratives (PIC) that demonstrate how substance abuse treatment can be improved by increasing the exchange of knowledge between community-based service providers and the research community. The book examines improvement collaboratives and mentoring strategies for adopting and using evidence-based practices. Contributors address how to determine the best treatment processes to serve clients, how to deal with the hurdles faced in preparing and training counsellors, and how to affect the needed changes in agency activities. This unique professional resource responds to an Institute of Medicine report that found a substantial disconnect between research and practice in treatment for drug and alcohol dependence. Focusing on how to make the changes necessary to support the adoption and use of evidence-based practices, the book documents the activities of four sites to illustrate how investigators and treatment practitioners worked together to implement evidence-based practices. Contributors examine the development and early implementation of Practice Improvement Collaboratives, the investigator-provider-policymaker model, Motivational Enhancement Therapy, the use of Opinion Leaders in training, and targeted strategies that take into account the differences in clinician demographics and training. "Implementing Evidence-Based Practices for Treatment of Alcohol and Drug Disorders" is an essential tool for alcohol and drug counsellors, directors of alcohol and drug treatment clinics, and instructors in counsellor training and academic programs.
1. Metabolism of Ethanol.- 1.1. Pathways of Ethanol Oxidation.- 1.2. Alteration in the Metabolism of Ethanol after Chronic Ethanol Consumption.- 1.3. Effects of Liver Disease, Blood Flow, Circadian Rhythm, Gender, and Other Factors on Hepatic Alcohol Metabolism.- 1.4. Effects of Other Drugs on Ethanol Metabolism.- 1.5. Ethnic and Genetic Factors in Ethanol Metabolism.- 1.6. Extrahepatic Ethanol Metabolism.- 1.7. Summary.- References.- 2. Acetaldehyde and Acetate.- 2.1. Pathways of Acetaldehyde and Acetate Metabolism.- 2.2. Effect of Chronic Ethanol Consumption on Acetaldehyde and Acetate Metabolism.- 2.3. Effect of Liver Injury on Acetaldehyde Metabolism.- 2.4. Effects Attributable to Acetaldehyde and Acetate after Acute and Chronic Ethanol Consumption.- 2.5. Summary.- References.- 3. Alcohol, Hormones, and Metabolism.- 3.1. Hypothalamic-Pituitary-Thyroidal Axis.- 3.2. Parathormone and Calcitonin.- 3.3. Adrenocortical Function: Glucocorticoid Secretion.- 3.4. Adrenocortical Function: Mineralocorticoid Secretion.- 3.5. Adrenal Medullary Function.- 3.6. Growth Hormone.- 3.7. Antidiuretic Hormone and Oxytocin.- 3.8. Pancreatic and Gastrointestinal Hormones.- 3.9. Alteration of Carbohydrate Metabolism by Alcohol.- 3.10. Effects of Ethanol on Ketone Metabolism.- 3.11. Alcoholic Ketoacidosis.- 3.12. Hyperlactacidemia and Lactic Acidosis.- 3.13. Alcoholic Hyperuricemia and Its Relationship to Gouty Attacks.- References.- 4. Ethanol and Lipid Disorders, Including Fatty Liver, Hyperlipemia, and Atherosclerosis.- 4.1. Interaction of the Metabolism of Ethanol and Lipids.- 4.2. Pathogenesis of the Alcoholic Fatty Liver.- 4.3. Agents and Procedures that Prevent the Alcoholic Fatty Liver.- 4.4. Effects of Ethanol on Blood Lipids: Characteristics and Pathogenesis of Alcoholic Hyperlipemia.- 4.5. Ethanol, Atherosclerosis, and High-Density Lipoproteins.- 4.6. Interaction of Ethanol with Vascular Prostacyclin Production.- 4.7. Summary.- References.- 5. Effects of Ethanol on Amino Acid and Protein Metabolism.- 5.1. Effects of Ethanol on Nitrogen Balance and Body Protein Composition.- 5.2. Effects of Ethanol on Amino Acids.- 5.3. Effects of Ethanol on Hepatic Protein Synthesis.- 5.4. Effects of Ethanol on Hepatic Protein Secretion.- 5.5. Effects of Ethanol on Hepatic Protein Catabolism.- 5.6. Hepatic Accumulation of Protein after Chronic Ethanol Feeding.- 5.7. Dietary Requirements for Protein in the Alcoholic.- 5.8. Summary.- References.- 6. Interaction of Ethanol with Other Drugs.- 6.1. Interaction with Drug Absorption.- 6.2. Interaction with Plasma Protein Binding.- 6.3. Interaction with Hepatic Blood Flow.- 6.4. Interaction with Hepatic Cell Uptake.- 6.5. Interaction with Hepatic Metabolism.- 6.6. Pharmacological Interactions.- 6.7. Summary and Therapeutic Guidelines.- References.- 7. Alcohol and the Liver.- 7.1. Epidemiology of Alcoholic Liver Disease.- 7.2. Pathology and Symptomatology of the Various Stages of Alcoholic Liver Injury.- 7.3. Pathogenesis of Alcoholic Liver Injury.- 7.4. Diagnosis of Alcoholic Liver Injury.- 7.5. Prognosis and Treatment of Alcholic Liver Injury.- References.- 8. Alcohol and the Hematologic System.- 8.1. Red Cells.- 8.2. Platelets.- 8.3. Granulocytes.- 8.4. Monocytes and Macrophages.- 8.5. Lymphocytes.- 8.6. Other Factors Favoring Infection.- 8.7. Summary.- References.- 9. Immunologic Reactions in Alcoholic Liver Disease.- 9.1. Morphological Considerations.- 9.2. Genetic Factors.- 9.3. Immunoglobulins, Antibodies, and Immune Complexes.- 9.4. Hepatitis B Virus (HBV).- 9.5. Hepatitis C Virus (HCV).- 9.6. Serum Factors and Cytokine Activity.- 9.7. Cell-Mediated Alterations.- 9.8. Abnormal Antigen Expression on Liver Cells.- 9.9. Alcohol and Alteration of the Immune Response in Alcoholics without ALD.- 9.10. Summary.- References.- 10. Alcohol and the Digestive Tract.- 10.1. Introduction.- 10.2. Oropharynx and Salivary Glands.- 10.3. Esophagus.- 10.4. Stomach.- 10.5. Effect of Alcohol on the Small Intestine.- 10.6...
Every day, huge numbers of people use drugs or alcohol for
recreation, medication, celebration, stress management, social
lubrication, or escape. The abuse of psychoactive chemicals touches
individual lives in countless ways, and clients frequently hint in
therapy sessions at problems related to substance misuse. But
historically, substance abuse treatment has been regarded as a
separate specialty, for which students and trainees often prepare
along tracks different from those leading to licensing or
certification as psychotherapists. Few non-specialists feel
completely competent and willing to grapple closely with the issues
these clients present, in spite of the fact that such problems are
quite frequent among client populations.
Every day, huge numbers of people use drugs or alcohol for
recreation, medication, celebration, stress management, social
lubrication, or escape. The abuse of psychoactive chemicals touches
individual lives in countless ways, and clients frequently hint in
therapy sessions at problems related to substance misuse. But
historically, substance abuse treatment has been regarded as a
separate specialty, for which students and trainees often prepare
along tracks different from those leading to licensing or
certification as psychotherapists. Few non-specialists feel
completely competent and willing to grapple closely with the issues
these clients present, in spite of the fact that such problems are
quite frequent among client populations.
Explore the possibilities for successfully treating incarcerated or community-based substance abusersSubstance Abuse Treatment with Correctional Clients: Practical Implications for Institutional and Community Settings provides key research findings and policy implications for treating alcohol- and drug-addicted correctional clients. This book addresses a range of critical issues associated with delivering treatment in institutional and community settings. The critical thinking questions, tables, extensive bibliographies, and name and subject index will help academics and practitioners in criminal justice, sociology, counseling/psychology, and public policy. Substance Abuse Treatment with Correctional Clients shares the practical knowledge of researchers and practitioners in the fields of drug and alcohol addictions, substance abuse counseling, and criminal justice. The first section provides a review of the theoretical explanations for substance abuse, "best practice" treatment programs for substance abusers, and the use of coerced/mandated treatment. The second section addresses the substance-addicted offender in the institutional setting, the third includes works that describe community-based treatment programs and the problems associated with them, and the fourth looks at special treatment populations, including juveniles and adolescent females. In Substance Abuse Treatment with Correctional Clients, you will find: reviews of various types of treatment programs being used to treat substance-addicted individuals a study of the predictors of success and/or failure in corrections-based substance abuse programming--how to identify and use the predictors to prevent relapse arguments for and against coerced treatment in the correctional environment, and the concept of "motivation" a thorough investigation of the therapeutic community (TC) program for institutional-based substance abusers descriptions of treatment programming designed specifically for substance abusing community corrections clients--drug courts and Pennsylvania's Restrictive Intermediate Punishment treatment programSubstance Abuse Treatment with Correctional Clients guides you through the major policy issues faced by those who provide substance abuse treatment under what can only be described as coercive circumstances. In this important resource, you will discover major treatment modules as well as advice for working with adult, juvenile, and male or female offenders. This book provides you with the techniques that treatment communities need for helping offenders stay clean after they re-enter the community environment. |
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