The Addiction Counselor's Documentation Sourcebook
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CD Contents xi
Introduction xv
Chapter One Precontact: Referral Forms 1.1
Form 1.1: Referral for Services 1.2
Form 1.2: Appointment Notification/Confirmation Letter 1.3
Form 1.3: Referral and Treatment Compliance Follow-Up Letter 1.4
Form 1.4: Thank You for Your Referral 1.5
Form 1.5: HIPAA Notice of Privacy Practices 1.6
HIPAA Privacy Authorization for Use and Disclosure of Personal Health Information 1.8
Form 1.6: HIPAA-Client Sign-In Sheet 1.9
Chapter Two Intake and Assessment Forms 2.1
Form 2.1: Initial Client Information Fact Sheet 2.3
Form 2.2: Confidential Brief Health Information Form 2.4
Form 2.3: Therapist Clinical Assessment 2.5
Form 2.4: Chemical Dependence Assessment Matrix 2.11
Form 2.5: Substance Abuse Assessment Matrix 2.13
Form 2.6: Acuity of Need/Level of Treatment Assessment Matrix 2.15
Form 2.7: Informed Consent and Payment Agreement for Services 2.17
Form 2.8: Authorization for Disclosure of Information 2.18
Form 2.9: Client Rights and Limits of Confidentiality Handout and Acknowledgment 2.19
Chapter Three Treatment Forms 3.1
Form 3.1: Behavioral Contract 3.3
Form 3.2: Contract against Suicide, Self-Harm, or Harm to Others 3.4
Form 3.3: Client Input for Treatment Planning 3.5
Form 3.4: Master Treatment Plan 3.6
Form 3.5: Treatment Plan Update/Revision Form 3.9
Form 3.6: Group Therapy Progress Note 3.10
Form 3.7: Individual/Family Therapy Session Progress Note 3.11
Form 3.8: Telephone Contact Progress Note 3.12
Form 3.9: Therapeutic Materials Loan Record 3.13
Form 3.10: Eye Movement Desensitization and Reprocessing (EMDR) Information Handout 3.14
Form 3.11: Eye Movement Desensitization and Reprocessing (EMDR) Consent for Treatment 3.18
Form 3.12: Eye Movement Desensitization and Reprocessing (EMDR) Progress Note 3.19
Form 3.13: Recovery Program Meeting Review/Critique Form 3.21
Chapter Four Treatment Forms: Program Administration Documentation 4.1
Form 4.1: Client Encounter Summary Log Sheet 4.3
Form 4.2: Monthly Progress Note/Report 4.4
Form 4.3: Recovery Program Attendance Verification Form 4.6
Form 4.4: Request/Referral for Extended Services 4.7
Form 4.5: Request/Referral for Additional Services 4.8
Form 4.6: Request for Drug Screening by External Providers 4.9
Form 4.7: Treatment Program Attendance/Completion Record 4.10
Form 4.8: Certificate of Completion 4.11
Form 4.9: Case Staffing Record 4.12
Form 4.10: Treatment Termination Warning 4.13
Form 4.11: Treatment Termination Notification 4.14
Form 4.12: Treatment Discharge Summary 4.15
Form 4.13: Request for an Accounting of Disclosures 4.16
Form 4.14: Disclosure Tracking Log 4.17
Chapter Five Program Evaluation 5.1
Form 5.1: Outcome Measurement Tracking Form 5.11
Form 5.2: Informed Consent for Participation in Outcome Assessment 5.12
Chapter Six Addictive Behaviors: Materials for Use in Psychoeducational Groups 6.1
Presentation 6.1: Psychopharmacology, Part I 6.3
Presentation 6.2: Psychopharmacology, Part II 6.9
Presentation 6.3: The Process of Addiction 6.16
Presentation 6.4: The Process of Relapse 6.20
Presentation 6.5: Addiction and Contemporary Culture 6.23
Presentation 6.6: Switching Addictions: Other Compulsive Behaviors 6.27
Chapter Seven Recovery Resources and Skills: Materials for Use in Psychoeducational Groups 7.1
Presentation 7.1: The Process of Recovery 7.3
Presentation 7.2: Recovery Programs and Resources 7.8
Presentation 7.3: Lifestyle Changes 7.13
Presentation 7.4: Common Problems and Issues in Recovery 7.16
Presentation 7.5: Relapse Prevention, Part I 7.22
Presentation 7.6: Relapse Prevention, Part II 7.26
Presentation 7.7: Physical and Emotional Self-Care 7.29
Presentation 7.8: Stress Management 7.33
Presentation 7.9: Communication Skills 7.37
Presentation 7.10: Healthy Relationship Skills 7.43
Presentation 7.11: Setting and Achieving Goals 7.48
Presentation 7.12: Problem-Solving Skills 7.51
Presentation 7.13: Coping with Anger and Resentment 7.54
Presentation 7.14: Coping with Depression and Anxiety 7.58
Presentation 7.15: Resisting Pressures to Drink or Use 7.62
Chapter Eight Other Mental Health Issues: Materials for Use in Psychoeducational Groups 8.1
Presentation 8.1: Family Dynamics 8.3
Presentation 8.2: Domestic Violence 8.8
Presentation 8.3: Suicide Awareness and Prevention, Part I 8.13
Presentation 8.4: Suicide Awareness and Prevention, Part II 8.18
Presentation 8.5: Trauma and Posttraumatic Stress Disorder 8.23
Presentation 8.6: Co-Occurring Disorders 8.28
Presentation 8.7: Codependency 8.32
Presentation 8.8: Grief and Loss 8.35
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