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PTSD
A Program for Addiction Professionals
Clinicians Guide
Hazelden
Center City, Minnesota 55012
hazelden.org
2010 by Dartmouth
All rights reserved. Published 2010
Printed in the United States of America
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Failure to comply with these terms may expose you to legal action and damages for
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Editors note
The names, details, and circumstances may have been changed to protect the privacy
of those mentioned in this publication.
This publication is not intended as a substitute for the advice of health care
professionals.
Alcoholics Anonymous and AA are registered trademarks of Alcoholics Anonymous
World Services, Inc.
Cover design by David Spohn
Interior design by Madeline Berglund
Typesetting by Madeline Berglund
Illustrations by Patrice Barton
Illustrations for handout 17, Feelings from A to Z, by David Swanson
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CONTENTS
List of Figures
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Acknowledgments
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Part 1: Background
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Chapter 4: Evidence for CBT for PTSD among People with Severe Mental Illnesses
and Other Vulnerable Populations
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Chapter 5: Evidence and Experience of CBT for PTSD in Addiction Treatment Programs
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CONTENTS
Part 4: Modules
Core Modules
Module 1: Engagement
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117
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Optional Modules
Module 7: Substance Use and Crisis Plan
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Conclusion
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Additional Resources
References
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FIGURES
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ACKNOWLEDGMENTS
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ACKNOWLEDGMENTS
The authors would also like to specifically thank their colleagues from
the Dartmouth Psychiatric Research Center, including Stan Rosenberg,
Harriet Rosenberg, Robert E. Drake, Matthew Merrens, Mary Brunette,
Gregory McHugo, Tracy Stecker, Melinda Fox, and Haiyi Xie; from the
Veterans Affairs National Center for PTSD at White River Junction (VT),
including Paula Schnurr and Matthew Friedman; and from Hazelden
Publishing, in particular, Richard Solly.
Last but not least, a special debt of gratitude goes to Stephanie Acquilano
and Chantal Lambert Harris, whose untiring and dedicated efforts have been
essential to the development of this intervention.
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xiii
INTRODUCTION
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INTRODUCTION
or exclusive, though patients did need to meet formal diagnostic criteria for
DSM-IV PTSD. Since the intervention was developed within these parameters,
we suggest, as you consider implementing CBT for PTSD, that you keep the
following in mind:
For CBT for PTSD to be effective, the substance use disorder must be
adequately treated, either in a formal addiction treatment program or by
a clinician with expertise and skill in treating co-occurring substance use
and post-traumatic stress disorders.
CBT for PTSD focuses on symptoms associated with trauma and PTSD.
Even though it is designed for persons with co-occurring PTSD and substance use disorders, it focuses less on the substance use and presumes,
instead, that addiction and recovery are being addressed within the context of routine addiction treatment.
Although CBT for PTSD was originally developed for individual therapy
formats and for delivery in a predetermined sequence of modules, this
clinicians guide offers strategies for implementation in one-on-one or
group formats and for sequential or standalone module delivery. This
corresponds to how we foresee the interventions being useful to community programs and clinicians, and therefore to patients.
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INTRODUCTION
Additional resources are included at the end of the guide to help support
you in this work.
The three-ring binder contains handouts for the patient. It also contains
the Clinician Checklist and the Supervisor Adherence and Competence
Rating Scale. All of this material is also found on the CD-ROM.
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