Dennis C. Daley - Improving treatment compliance: counseling and systems strategies for substance abuse and dual disorders
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Improving treatment compliance: counseling and systems strategies for substance abuse and dual disorders
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Counseling and Systems Strategies for Substance Abuse and Dual Disorders
Dennis C. Daley Allan Zuckoff
Page iv
Hazelden Center City, Minnesota 55012-0176 1-800-328-0094 1-651-257-1331 (Fax) www.hazelden.org
1999 by Dennis C. Daley and Allan Zuckoff All rights reserved. Published 1999 Printed in the United States of America No portion of this publication may be reproduced in any manner without the written permission of the publisher
Library of Congress Cataloging-in-Publication Data
Daley, Dennis C. Improving treatment compliance: counseling and systems strategies for substance abuse and dual disorders/ Dennis C. Daley, Allan Zuckoff. p. cm. Includes bibliographical references and index. ISBN: 1-56838-281-2 1. Substance abuseTreatment. 2. Dual diagnosis Treatment. 3. Patient compliance. 4. AddictsCounsel ing of. I. Zuckoff, Allan.1960- . II. Title. RC564.D345 1999 616.86'06dc21 98-47969 CIP
Editor's note
All the stories in this book are based on actual experiences. The names and details have been changed to protect the privacy of the people involved.
03 02 01 00 99 5 4 3 2 Cover design by David Spohn Interior design by Donna Burch Typesetting by Stanton Publication Services, Inc.
Page v
For Bonnie, who has taught me most about empathy, and Alexander, who shows me its power. AZ
To my son, Chris, who continues to bring tremendous joy to my life. It is a pleasure to watch you develop into such a fine young man. DD
Page vii
CONTENTS
List of Charts
VIII
Acknowledgments
IX
Part I: Overview of Compliance Problems, Causes, and Effects
Chapter 1 Introduction and Overview
3
Chapter 2 Types of Compliance Problems
9
Chapter 3 Factors Affecting Client Compliance
21
Chapter 4 Effects of Compliance Problems
41
Part II: Counseling and Systems Strategies to Improve Compliance
Chapter 5 Counseling Strategies to Improve Compliance
51
Chapter 6 Systems and Agency Strategies to Improve Compliance
85
Part III: Clinical Applications of Motivational Strategies
Chapter 7 A Motivational Approach to Improving Compliance
105
Chapter 8 Pretreatment Motivational Counseling
125
Chapter 9 Transitional Motivational Counseling
147
Chapter 10 Motivational Counseling in Early Recovery
173
Notes
217
Index
235
About the Authors
243
Page viii
CHARTS
Chart 1 Continuum of Compliance
7
Chart 2 Sample Clinician Compliance
18
Chart 3 Ways Poor Compliance Shows
19
Chart 4 Factors Affecting Compliance
40
Chart 5 Counseling Strategies to Improve Compliance
83
Chart 6 Systems Strategies to Improve Compliance
100
Page ix
ACKNOWLEDGMENTS
We wish to thank the following individuals for their help and support in the preparation of this book: Ihsan Salloum, M.D., M.P.H.; Crystal Spotts, M.Ed.; and our colleagues at the Center for Psychiatric and Chemical Dependency Services for their involvement in clinical protocols aimed at improving compliance among our clinic clients; Michael Thase, M.D., for his support of our clinical work and research on compliance and motivation at Western Psychiatric Institute and Clinic; Karen Chernyaev of Hazelden for her excellent editorial support and interest in making this project feasible; Judy Peacock and Kathryn Kjorlien for their outstanding copyedit of the book; Cindy Hurney for her outstanding help in library research, word processing, organizing and formatting the book, and generally keeping us on track when we threatened to go astray; and Natalie Daley, M.S.W., for her critical review of the book. We also are grateful to the National Institute on Drug Abuse for support of our research on developing clinical interventions to improve motivation for change and compliance with treatment.
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