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Chemical Dependency Counseling

Chemical Dependency Counseling
A Practical Guide

Sixth Edition

October 2021 | 856 pages | SAGE Publications, Inc
Helping individuals recover from addiction is one of the most rewarding professions in the world. Chemical Dependency Counseling: A Practical Guide is the most comprehensive text written for those counselors and professionals who work with or plan to work with clients struggling with chemical dependency in a variety of settings.

Following the model of twelve-step programs, providing a ground-up introduction to guide the counselor through treatment from A to Z, and can be used as a core text for courses in addiction or substance abuse counseling. Author Robert R. Perkinson presents state-of-the-art tools necessary to deliver outstanding treatment and meet the highest standards demanded by accrediting bodies. 

This 6th edition continues to outline the best evidence-based treatment in the world, with a concentration on the following: cognitive behavioral therapy; motivational enhancement; medication assisted treatment, skills training; and 12-step facilitation. 

1. First Contact
Treatment Works

The Motivational Interview

How to Assess Motivation

2. First Hours of Treatment
The First Hours

How to Greet Clients

Beginning the Therapeutic Alliance

Dealing With Early Denial

How to Check for Organic Brain Dysfunction

The Initial Assessment

How to Conduct a Crisis Intervention

American Society of Addiction Medicine Patient Placement Criteria

Diagnostic and Statistical Manual

Diagnosis: Substance Use Disorder

How to Determine the Level of Care Needed

Criteria for Outpatient Treatment (Adults)

Criteria for Inpatient Treatment (Adults)

Criteria for Outpatient Treatment (Adolescents)

Criteria for Inpatient Treatment (Adolescents)

The Client’s Reaction to Intoxication

What to Do With an Intoxicated Client

How Clients React in Detoxification

The AMA Threat

How to Develop and Use the AMA Team

How to Use the In-House Intervention

How to Respond to Clients Who Leave AMA

3. Biopsychosocial Interview
The Biopsychosocial Interview

How to Conduct the Interview

A Sample Biopsychosocial Interview

4. Treatment Plan
How to Build a Treatment Plan

The Diagnostic Summary

The Problem List

Goals and Objectives

How to Develop Goals

How to Develop Objectives

How to Develop Interventions

How to Evaluate the Effectiveness of Treatment

How to Select Goals, Objectives, and Interventions

Treatment Plan Review


How to Write Progress Notes

Formal Treatment Plan Review

5. Individual Treatment
The Therapeutic Alliance

How to Develop a Therapeutic Alliance

How to Be Reinforcing

How to Use Empathy

Transference and Countertransference

Examples of Empathic Statements

How to Be Confrontive

Behavior Therapy

When a Client Breaks a Rule

Why We Concentrate on Behavior Therapy

Cognitive Therapy

Interpersonal Therapy

How to Choose the Therapeutic Modality

6. Group Therapy
Benefits of the Group Process

Preparation for the Group

The Agenda Group

The Honesty Group

How to End Each Group

The Euphoric Recall Group

The Reading Group

The Relapse Prevention Group

The Spirituality Group

The Childhood Group

Men’s Group/Women’s Group

The Community Group

The Personal Inventory Group

Skills Training Group

Problem-Solving Skills Group

7. Drugs of Abuse
Drugs of Abuse


Alcohol-Induced Organic Mental Disorders






Club Drugs


Treatment Outcome

8. Recovery Skills
The Chemical Use History


Love, Trust, and Commitment


Relationship Skills

Addictive Relationships

Communication Skills


Impulse Control

Relapse Prevention

Stress Management

9. Steps
The Committee

Step One

Step Two

Step Three

Step Four

Step Five

Step Six

Step Seven

Step Eight

Step Nine

Step Ten

Step Eleven

Step Twelve

10. Lectures
The Disease Concept

Defense Mechanisms

The Great Lie

Normal Development

Physical Addiction and Recovery

Alcoholics Anonymous



11. Special Problems
The Psychiatric/Psychological Assessment

How to Develop the Treatment Plan

The Depressed Client

The Angry Client


The Antisocial Personality

The Borderline Client

The Narcissistic Client

The Anxious Client

Post-Traumatic Stress Disorder

Panic Attacks

The Psychotic Client

Acquired Immune Deficiency Syndrome

The Client With Low Intellectual Functioning

The Client Who Cannot Read

The Elderly Client

The Client With Early Childhood Trauma

Love in the Treatment Center

The Pathological Gambler

12. Adolescent Treatment
The Normal Adolescent


Ages 13 to 16

Ages 16 to 19

The Adolescent Chemical Dependency Counselor

The Point System

The Primary Elements in Adolescent Treatment

The Rules

Communication Skills



Fun in Sobriety

The Reinforcers


Group Therapy

Peer Pressure

Continuing Education

Continuing Care

The Parents Support Group

The Behavioral Contract

Phases of Adolescent Treatment

13. The Family Program
The First Family Contact

How to Handle the Early “Against Medical Advice” Risk

Common Family Problems

How to Treat Family Members

The Family Program Schedule

How to Work With the Family in Group

The Conjoint Session

14. The Clinical Staff
The Physician/Addictionologist

The Psychologist/Psychiatrist

The Social Worker/Mental Health Counselor

The Nurse

The Clinical Director

The Clinical Supervisor

The Chemical Dependency Counselor

The Rehabilitation Technician or Aide

The Recreational Therapist

Clinical Staffing

Team Building

Commitment to Coworkers


Staff–Client Problems

What to Do When a Client Does Not Like a Counselor

What to Do When a Client Complains About a Rule

The Work Environment

15. Discharge Summary and Continuing Care
Outpatient Discharge Criteria

Inpatient Discharge Criteria

How to Develop a Discharge Summary

The Discharge Summary

Saying Good-Bye

16. The Good Counselor
Good Counselors Are Caring

Good Counselors Love Their Work

Good Counselors Do Not Become Overly Involved

Good Counselors Do Not Lie

Good Counselors Are Gentle

Good Counselors Like Themselves

Good Counselors Are Supersensitive

Good Counselors Have a Sixth Sense

Good Counselors Do Not Become Overly Emotional

Good Counselors Are Active Listeners

Good Counselors Do Not Talk Too Much

Good Counselors Maintain Boundaries

Good Counselors Are Client-Centered

Good Counselors Have Effective Relationship Skills

Good Counselors Have a Sound Code of Ethics

Appendix 1. Short Michigan Alcoholism Screening Test (SMAST)
Appendix 2. AUDIT Questionnaire
Appendix 3. CRAFFT Interview
Appendix 4. Biopsychosocial Assessment
Appendix 5. Rethinking Drinking: Alcohol and Your Health
Appendix 6. Alcohol Withdrawal Scale
Appendix 7. Clinical Opiate Withdrawal Scale (COWS)
Appendix 8. DSM-5 Psychoactive Substance Use Disorder
Appendix 9. Daily Craving Record
Appendix 10. Sample Biopsychosocial Interview
Appendix 11. Hamilton Depression Rating Scale
Appendix 12. Step One
Appendix 13. Personal Recovery Plan
Appendix 14. Feelings
Appendix 15. Chemical Use History
Appendix 16. Relapse Prevention
Appendix 17. Codependency
Appendix 18. Anger Management
Appendix 19. Stress Management
Appendix 20. Relationship Skills
Appendix 21. Honesty
Appendix 22. Love, Trust, and Commitment
Appendix 23. Barriers in Thinking
Appendix 24. Self-Discipline
Appendix 25. Communication Skills
Appendix 26. Drug Categories for Substances of Abuse
Appendix 27. Heroin
Appendix 28. National Cancer Institute Guide to Quitting Smoking
Appendix 29. Drug Abuse Screening Test
Appendix 30. Impulse Control
Appendix 31. Addictive Relationships
Appendix 32. Alcohol Abstinence Self-Efficacy Scale
Appendix 33. Step Two
Appendix 34. Step Three
Appendix 35. Step Four
Appendix 36. Step Five
Appendix 37. Psychotherapeutic Medications
Appendix 38. Narcissism
Appendix 39. Hamilton Anxiety Rating Scale
Appendix 40. Post-traumatic Stress Disorder (PTSD) Checklist Civilian Version
Appendix 41. Post-traumatic Stress Disorder (PTSD) Checklist Military Version
Appendix 42. Gambling History
Appendix 43. Pressure Relief Group Meeting and Budget Form
Appendix 44. Honesty for Gamblers
Appendix 45. Step One for Gamblers
Appendix 46. Step Two for Gamblers
Appendix 47. Step Three for Gamblers
Appendix 48. Step Four for Gamblers
Appendix 49. Step Five for Gamblers
Appendix 50. Relapse Prevention for Gamblers
Appendix 51. Adolescent Unit Level System
Appendix 52. Adolescent Unit Point System
Appendix 53. Peer Pressure
Appendix 54. The Behavioral Contract
Appendix 55. Family Questionnaire
Appendix 56. Sample Discharge Summary
Appendix 57. NAADAC Code of Ethics
Appendix 58. Fagerström Test for Nicotine Dependence
Appendix 59. Diagnostic/Integrated Summary
Appendix 60. Mental Health Screening
Appendix 61. Adult Nurses Intake
Appendix 62. Adolescent Nurses Intake
Appendix 63. Adult Inpatient Program Schedule
Appendix 64. Adolescent Inpatient Program Schedule
Appendix 65. Gambling Inpatient Program Schedule
Appendix 66. Adult Outpatient Program Schedule
Appendix 67. Adolescent Outpatient Program Schedule
Appendix 68. Gambling Outpatient Program Schedule
Appendix 69. Day Treatment Program Schedule
Appendix 70. Strengths, Needs, Abilities, and Preferences
About the Author


Instructor Resources

Calling all instructors!

Log on to SAGE’s password-protected Instructor Teaching Site for complete and protected access to all text-specific Instructor Resources. Simply provide your institutional information for verification and within 72 hours you’ll be able to use your login information for any SAGE title!

Password-protected Instructor Resources include the following:

· A Microsoft® Word test bank is available containing multiple choice, true/false, short answer, and essay questions for each chapter. The test bank provides you with a diverse range of pre-written options as well as the opportunity for editing any question and/or inserting your own personalized questions to effectively assess students’ progress and understanding.

·Editable, chapter-specific Microsoft® PowerPoint® slides offer you complete flexibility in easily creating a multimedia presentation for your course. Highlight essential content and features.

·Chapter-specific discussion questions help launch classroom interaction by prompting students to engage with the material and by reinforcing important content.

I chose to adopt this book because it has everything that I was looking for in regards to Client Management Procedures. I also liked the appendix that was included in the book. It was the one book that combined three books into one. It is well written, and I like all the examples that are given.

Mrs Jennifer Suzanne Colby
Social Work, Fort Hays State University
October 21, 2022

Previous Edition in use. This version has additional stats that are useful and information more current to counseling with skills importance in mind.

Mr Louis Leake
Other, Fayetteville Tech Cmty College
June 9, 2022
Key features


  • Updated exercises necessary to work through all 12 steps of recovery to help counselors improve client success rates.
  • New tools, including the Fagerstrom Test for Nicotine Dependence, Mental Health Screening Form III, and instructions for logging into Online Recovery Support.
  • Recommendations on how to manage a successful first year in recovery to guide counselors in ongoing treatment.
  • The latest research on chemical dependency and addiction and how findings inform healthcare policy changes and approaches to treatment.
  • New discussion on new synthetic and designer drugs.


  •  Chapters cover the gamut of treatment issues, including:
    • developing the therapeutic alliance
    • screening
    • detoxification
    • biopsychosocial assessment
    • dual-diagnosis
    • more
  • Includes 68 appendices, which cover:
    • screening questionnaires
    • scales
    • history assessments
    • personal recovery plans
    • in-patient and out-patient schedules
    • more
  • Case studies and step-by-step instructions with clear explanations and procedures that show what counselors need to use in all phases of patient care.
  • Content developed by leaders in the field, including treatment centers and professionals around the world.
  • State-of-the-art tools, forms and tests necessary to deliver outstanding treatment and meet the highest standards demanded by accrediting bodies.

Sage College Publishing

You can purchase this book and request an instructor sample on our US College site:

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