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Richard N. Rosenthal, M.D.
Expert Advisory Board Chair
Treatment Improvement Protocol (TIP) Series
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Substance Abuse and Mental Health Services Administration
Center for Substance Abuse Treatment
1 Choke Cherry Road
Rockville, MD 20857
Consensus Panel
Chair, Part 1 and Part 2 Consensus Panels
Rose M. Urban, M.S.W., J.D., LCSW, LCAS
KAP Project Co-Director
The CDM Group, Inc.
Bethesda, Maryland
Part 1 Consensus Panel Members
Bruce Carruth, Ph.D.
KAP Expert Content Director
The CDM Group, Inc.
Bethesda, Maryland
Jennifer Frey, Ph.D.
KAP Expert Content Director
The CDM Group, Inc.
Bethesda, Maryland
Michael Klitzner, Ph.D.
KAP Expert Content Director
The CDM Group, Inc.
Bethesda, Maryland
Sheldon R. Weinberg, Ph.D.
Senior Research/Applied Psychologist
The CDM Group, Inc.
Bethesda, Maryland
Part 2 Consensus Panel Members
Jennifer Frey, Ph.D.
KAP Expert Content Director
The CDM Group, Inc.
Bethesda, Maryland
Nancy VanDeMark, Ph.D.
Director, Research and Program Evaluation
Arapahoe House, Inc.
Thornton, Colorado
Expert Advisory Board
Richard N. Rosenthal, M.D., Chair
Professor of Clinical Psychiatry
Columbia University College of Physicians and Surgeons
Chairman, Department of Psychiatry
St. Luke's Roosevelt Hospital Center
New York, New York
Patricia A. Burke, M.S.W., LCSW, BCD, C-CATODSW
Private Practice
West Baldwin, Maine
Dennis C. Daley, LCSW, BCD
Associate Professor of Psychiatry
Western Psychiatric Institute and Clinic
University of Pittsburgh Medical Center
Pittsburgh, Pennsylvania
William Mock, Ph.D., LISW, LICDC, SAP
Director
The Center for Interpersonal Development
Lakewood, Ohio
Paul Nagy, LPC, CCAS, CCS
Program Director, Duke Addictions Program and
Clinical Associate, Duke University Department of Psychiatry and Behavioral Sciences
Durham, North Carolina
Bette Ann Weinstein, Ph.D., LCSW
Private Practice
Delray Beach, Florida
Treatment Improvement Protocols (TIPs), developed by the Center for Substance Abuse Treatment (CSAT), part of the Substance Abuse and Mental Health Services Administration (SAMHSA) within the U.S. Department of Health and Human Services (DHHS), are best-practices guidelines for the treatment of substance use disorders. CSAT draws on the experience and knowledge of clinical, research, and administrative experts to produce the TIPs, which are distributed to facilities and individuals across the country. As alcohol and drug use disorders are increasingly recognized as a major problem, the audience for the TIPs is expanding beyond public and private treatment facilities to include practitioners in mental health, criminal justice, primary care, and other healthcare and social service settings.
The recommendations contained in each TIP are grounded in evidence that includes scientific research findings and the opinion of the TIP consensus panel of experts that a particular practice will produce a specific clinical outcome (measurable change in client status). In making recommendations, consensus panelists engage in a process of “evidence-based thinking” in which they consider scientific research, clinical practice theory, practice principles, and practice guidelines, as well as their own individual clinical experiences. Based on this thinking, they arrive at recommendations for optimal clinical approaches for given clinical situations. Relevant citations (to research outcome reports, theoretic formulations, and practice principles and guidelines) are provided.
Beginning with this TIP, 48, CSAT is embarking on a new approach to and format for TIPs. CSAT recognizes that its primary constituency is substance abuse treatment counselors. Working with and enabling the efforts of substance abuse counselors are program administrators and clinical supervisors. Market research conducted on the TIP series over the past several years has indicated these individuals want products that are short, concise, focused on how to perform relevant activities, and targeted to their particular needs. To those ends, this TIP is organized into three parts:
Part 1 for substance abuse counselors focuses on providing appropriate counseling methods and frameworks.
Part 2 for program administrators focuses on providing administrative support to implement adoption of the counseling recommendations made in Part 1.
Part 3 for clinical supervisors, program administrators, and interested counselors is an online literature review that provides an in-depth look at relevant published resources. Part 3 will be updated every 6 months for 5 years.
Ideally, a supervisor might assemble a small group of counselors, hand out copies of this TIP (which are free), and begin a series of six or so meetings where the materials in the TIP would be reviewed, discussed, and in other ways used as an educational and training vehicle for the improvement of counseling skills (with the particulars of how this training would be done determined by the individual supervisor, based upon her or his unique situation, needs, and preferences). Thus, after a relatively short period of time and with few or no additional resources, this TIP could meet the challenge of fostering improvement in the delivery of substance abuse treatment services.
This TIP was produced as a prototype for the new TIP series. Accordingly, the development process for this TIP differs from previous TIPs. The topic for this TIP was selected following an advisory meeting of experts in substance use disorders (Appendix E). Clinical staff members of the CDM/JBS Joint Venture developed the prototype (see p. v). An Expert Advisory Board, consisting of a chair and five panel members, was assembled to review the document (see p. vi). The Board provided guidance for revising the TIP prior to field review. The TIP then was field reviewed by an external group of subject matter experts, who provided suggestions for further refining the document (see Appendix F).
TIPs can be accessed via the Internet at www.kap.samhsa.gov. The online Managing Depressive Symptoms: A Review of the Literature, Part 3, which will be updated every 6 months for 5 years, is also available at http://www.kap.samhsa.gov.
Richard N. Rosenthal, M.D.
Expert Advisory Board Chair
Treatment Improvement Protocol (TIP) Series
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Substance Abuse and Mental Health Services Administration
Center for Substance Abuse Treatment
1 Choke Cherry Road
Rockville, MD 20857
Consensus Panel
Chair, Part 1 and Part 2 Consensus Panels
Rose M. Urban, M.S.W., J.D., LCSW, LCAS
KAP Project Co-Director
The CDM Group, Inc.
Bethesda, Maryland
Part 1 Consensus Panel Members
Bruce Carruth, Ph.D.
KAP Expert Content Director
The CDM Group, Inc.
Bethesda, Maryland
Jennifer Frey, Ph.D.
KAP Expert Content Director
The CDM Group, Inc.
Bethesda, Maryland
Michael Klitzner, Ph.D.
KAP Expert Content Director
The CDM Group, Inc.
Bethesda, Maryland
Sheldon R. Weinberg, Ph.D.
Senior Research/Applied Psychologist
The CDM Group, Inc.
Bethesda, Maryland
Part 2 Consensus Panel Members
Jennifer Frey, Ph.D.
KAP Expert Content Director
The CDM Group, Inc.
Bethesda, Maryland
Nancy VanDeMark, Ph.D.
Director, Research and Program Evaluation
Arapahoe House, Inc.
Thornton, Colorado
Expert Advisory Board
Richard N. Rosenthal, M.D., Chair
Professor of Clinical Psychiatry
Columbia University College of Physicians and Surgeons
Chairman, Department of Psychiatry
St. Luke's Roosevelt Hospital Center
New York, New York
Patricia A. Burke, M.S.W., LCSW, BCD, C-CATODSW
Private Practice
West Baldwin, Maine
Dennis C. Daley, LCSW, BCD
Associate Professor of Psychiatry
Western Psychiatric Institute and Clinic
University of Pittsburgh Medical Center
Pittsburgh, Pennsylvania
William Mock, Ph.D., LISW, LICDC, SAP
Director
The Center for Interpersonal Development
Lakewood, Ohio
Paul Nagy, LPC, CCAS, CCS
Program Director, Duke Addictions Program and
Clinical Associate, Duke University Department of Psychiatry and Behavioral Sciences
Durham, North Carolina
Bette Ann Weinstein, Ph.D., LCSW
Private Practice
Delray Beach, Florida
Treatment Improvement Protocols (TIPs), developed by the Center for Substance Abuse Treatment (CSAT), part of the Substance Abuse and Mental Health Services Administration (SAMHSA) within the U.S. Department of Health and Human Services (DHHS), are best-practices guidelines for the treatment of substance use disorders. CSAT draws on the experience and knowledge of clinical, research, and administrative experts to produce the TIPs, which are distributed to facilities and individuals across the country. As alcohol and drug use disorders are increasingly recognized as a major problem, the audience for the TIPs is expanding beyond public and private treatment facilities to include practitioners in mental health, criminal justice, primary care, and other healthcare and social service settings.
The recommendations contained in each TIP are grounded in evidence that includes scientific research findings and the opinion of the TIP consensus panel of experts that a particular practice will produce a specific clinical outcome (measurable change in client status). In making recommendations, consensus panelists engage in a process of “evidence-based thinking” in which they consider scientific research, clinical practice theory, practice principles, and practice guidelines, as well as their own individual clinical experiences. Based on this thinking, they arrive at recommendations for optimal clinical approaches for given clinical situations. Relevant citations (to research outcome reports, theoretic formulations, and practice principles and guidelines) are provided.
Beginning with this TIP, 48, CSAT is embarking on a new approach to and format for TIPs. CSAT recognizes that its primary constituency is substance abuse treatment counselors. Working with and enabling the efforts of substance abuse counselors are program administrators and clinical supervisors. Market research conducted on the TIP series over the past several years has indicated these individuals want products that are short, concise, focused on how to perform relevant activities, and targeted to their particular needs. To those ends, this TIP is organized into three parts:
Part 1 for substance abuse counselors focuses on providing appropriate counseling methods and frameworks.
Part 2 for program administrators focuses on providing administrative support to implement adoption of the counseling recommendations made in Part 1.
Part 3 for clinical supervisors, program administrators, and interested counselors is an online literature review that provides an in-depth look at relevant published resources. Part 3 will be updated every 6 months for 5 years.
Ideally, a supervisor might assemble a small group of counselors, hand out copies of this TIP (which are free), and begin a series of six or so meetings where the materials in the TIP would be reviewed, discussed, and in other ways used as an educational and training vehicle for the improvement of counseling skills (with the particulars of how this training would be done determined by the individual supervisor, based upon her or his unique situation, needs, and preferences). Thus, after a relatively short period of time and with few or no additional resources, this TIP could meet the challenge of fostering improvement in the delivery of substance abuse treatment services.
This TIP was produced as a prototype for the new TIP series. Accordingly, the development process for this TIP differs from previous TIPs. The topic for this TIP was selected following an advisory meeting of experts in substance use disorders (Appendix E). Clinical staff members of the CDM/JBS Joint Venture developed the prototype (see p. v). An Expert Advisory Board, consisting of a chair and five panel members, was assembled to review the document (see p. vi). The Board provided guidance for revising the TIP prior to field review. The TIP then was field reviewed by an external group of subject matter experts, who provided suggestions for further refining the document (see Appendix F).
TIPs can be accessed via the Internet at www.kap.samhsa.gov. The online Managing Depressive Symptoms: A Review of the Literature, Part 3, which will be updated every 6 months for 5 years, is also available at http://www.kap.samhsa.gov.
Part 1, Chapter 1, Managing Depressive Symptoms in Substance Abuse Clients During Early Recovery
Part 1, Chapter 2, Managing Depressive Symptoms in Substance Abuse Clients During Early Recovery
Part 2, Chapter 1, Managing Depressive Symptoms: An Implementation Guide for Administrators
Part 2, Chapter 2, Managing Depressive Symptoms: An Implementation Guide for Administrators
Part 3, Managing Depressive Symptoms: A Review of the Literature, Section 2—Annotated Bibliography
Part 3, Managing Depressive Symptoms: A Review of the Literature, Section 3—General Bibliography
Appendix B—Center for Epidemiologic Studies Depression Scale (CES-D)
Appendix C—Fidelity Checklists
Appendix D—DSM-IV-TR Mood Disorders
