DSM-IV Diagnostic Criteria for Substance Dependence
The DSM-IV describes substance dependence as a maladaptive pattern of substance use, leading to clinically significant impairment or distress, as manifested by three or more of the following occurring at any time in the same 12-month period:
Tolerance, as defined by either of the following:
A need for markedly increased amounts of the substance to achieve
intoxication or desired effect
Markedly diminished effect with continued use of the same amount of the
substance.
Withdrawal, as manifested by either of the following:
The characteristic withdrawal syndrome for the substance.
The same (or closely related) substance is taken to relieve or avoid
withdrawal symptoms.
The substance is often taken in larger amounts or over a longer period than
was intended.
There is persistent desire or unsuccessful efforts to cut down or control
substance use.
A great deal of time is spent in activities necessary to obtain or use the
substance, or to recover from its effects.
Important social, occupational, or recreational activities are given up or
reduced because of substance use.
Substance use is continued despite knowledge of having a persistent or
recurrent physical or psychological problem that is likely to have been caused
or exacerbated by the substance.
(Adapted with permission from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Washington, D.C.: American Psychiatric Association, 1994.)
Cultural Sensitivity Training Materials and Resources
Materials
Sue, D.W., and Sue, D. Counseling the Culturally Different: Theory and Practice, Second Edition. New York: John Wiley & Sons, 1990.
Finnegan, D.G., and McNally, E.B. Dual Identities: Counseling Chemically Dependent Gay Men and Lesbians. Center City, Minnesota: Hazelden Educational Materials, 1987.
Goodchilds, J.D., ed. Psychological Perspectives on Human Diversity in America. Washington, D.C.: American Psychological Association, 1991.
Hidalgo, H., Peterson, T.L., and Woodman, N.J., eds. Lesbian and Gay Issues: A Resource Manual for Social Workers. Silver Spring, Maryland: National Association of Social Workers, Inc., 1985.
Weinstein, D.L., ed. Lesbians and Gay Men: Chemical Dependency Treatment Issues. Binghamton, New York: Haworth Press, Inc., 1992.
Agency
Technical Assistance Center, Institute on Black Chemical Abuse, 2616 Nicollet Avenue, Minneapolis, MN 55408, 612-871-7878.
Selected Comparisons of Recovery and Mental Health Models
Recovery Model
Mental Health Model
Disease process
Biopsychosocial/spiritual factors
Chronic condition
Relapse issues
Genetic/physiological component
Chemical use primary
Out of control
Denial
Despair
Family issues
Social stigma
Abstinence early goal
Recovery long-term goal
Powerlessness
No use of mood altering chemicals
Education about illness
Halfway houses, ALANO clubs
Sponsors
AA, Al-Anon, self-help groups
Concrete action
Self-examination and acceptance
Label self as alcoholic/addict
Practice of communication, social skills
Slogans, stories, affirmations
Stepwork
Use of spiritual concepts
Family therapy
Group and individual work
Continuum of care
Nutrition, exercise, growth as value
Syndrome concept
Biopsychosocial factors and some attention to philosophical issues
Chronic condition of many major disorders
Relapse issues
Genetic/physiological component in many disorders
Psychiatric disorder primary
Ineffective coping
Poor insight
Demoralization
Family issues
Social stigma
Stability early goal
Rehabilitation long-term goal
Empowerment
Psychotropic medications used
Education about illness
Group homes, day treatment
Case manager/therapist
Support groups
Behavior change
Awareness and insight
See self as whole person with a disorder
Practice of communication, social skills
Positive self-talk, imagery
Psychotherapy
Use of existential, transpersonal concepts
Family therapy
Group and individual work
Continuum of care
Wellness concepts
Reprinted with permission from Evans, K., and Sullivan, J.M. Dual Diagnosis: Counseling the Mentally Ill Substance Abuser. New York: Guilford Press, 1990.
1 Payer mix includes all categories; percentages not provided. 2Ten adult programs and four adolescent programs. 3 In total of three centers 4 Full day = 2-week program; Partial day = 4-week progra 5 19 adult, 4 adolescent programs with >3,000 patients 6 Executive director's salary is in a management contract and is $70,000 for management. 7 Part-time, 10 hours 8 Master's-level substance abuse therapist; various disciplines 9 Bachelor's-level clinician with AOD credentials 10 Includes center directors and marketing budget. Directors provide some direct service.
Consent for the Release of Confidential Information
I, ___________________________________________________________________, authorize
(Name of patient)
______________________________________________________________________________
(Name or general designation of program making disclosure)
to disclose to __________________________________________________________________
(Name of person or organization to which disclosure is to be made)
the following information: ________________________________________________________
(Nature of the information, as limited as possible)
______________________________________________________________________________
______________________________________________________________________________
The purpose of the disclosure authorized herein is to: ___________________________________
______________________________________________________________________________
(Purpose of disclosure, as specific as possible)
______________________________________________________________________________
I understand that my records are protected under the Federal regulations governing Confidentiality of Alcohol and Drug Abuse Patient Records, 42 CFR Part 2, and cannot be disclosed without my written consent unless otherwise provided for in the regulations. I also understand that I may revoke this consent at any time except to the extent that action has been taken in reliance on it, and that in any event this consent expires automatically as follows:
______________________________________________________________________________
(Specification of the date, event, or condition upon which this consent expires)
Dated: _________________________
________________________________________
(Signature of participant)
__________________________________
(Signature of parent, guardian, or authorized representative when required)
Prohibition on Redisclosing Information Concerning AOD Abuse Treatment Patients
This notice accompanies a disclosure of information concerning a client in alcohol/drug abuse treatment, made to you with the consent of such client. This information has been disclosed to you from records protected by Federal confidentiality rules (42 CFR Part 2). The Federal rules prohibit you from making any further disclosure of this information unless further disclosure is expressly permitted by the written consent of the person to whom it pertains or as otherwise permitted by 42 CFR Part 2. A general authorization for the release of medical or other information is NOT sufficient for this purpose. The Federal rules restrict any use of the information to criminally investigate or prosecute any alcohol or drug abuse patient.
Consent for the Release of Confidential Information: Criminal Justice System Referral
I, ____________________________________________________________, hereby consent to
(Name of defendant)
communication between ______________________________________________________and
(treatment program )
_______________________________________________________________________________
(Court, probation, parole, and/or other referring agency)
the following information: _________________________________________________________
(Nature of the information, as limited as possible)
The purpose of and need for the disclosure is to inform the criminal justice agenc(ies) listed above of my attendance and progress in treatment. The extent of information to be disclosed is my diagnosis, information about my attendance or lack of attendance at treatment sessions, my cooperation with the treatment program, prognosis, and
_______________________________________________________________________________
_______________________________________________________________________________
I understand that this consent will remain in effect and cannot be revoked by me until:
_____ There has been a formal and effective termination or revocation of my release from confinement, probation, or parole, or other proceeding under which I was mandated into treatment, or
_____ __________________________________________________________________
(other time when consent can be revoked and/or expires)
I also understand that any disclosure made is bound by Part 2 of Title 42 of the Code of Federal Regulations governing Confidentiality of Alcohol and Drug Abuse Patient Records and that recipients of this information may redisclose it only in connection with their official duties.
_________________________ _________________________________________
(Date) (Signature of defendant/patient)
_________________________________________
(Signature of parent, guardian, or authorized representative if required)
XYZ Service Center ("the Center") and the _____________________________________
_______________________________________________________________________
(Name of the program)
("the Program") hereby enter into a qualified service organization agreement, whereby the Center agrees to provide the following services:
______________________________________________________________________________
(Nature of services to be provided)
Acknowledges that in receiving, storing, processing, or otherwise dealing
with any information from the Program about the patients in the Program, it is
fully bound by the provisions of the Federal regulations governing
Confidentiality of Alcohol and Drug Abuse Patient Records, 42 CFR Part 2: and
Undertakes to resist in judicial proceedings any effort to obtain access to
information pertaining to patients otherwise than as expressly provided for in
the Federal confidentiality regulations, 42 CFR Part 2.
Site Map
Help
Account
Cart
Home
