[...]... Tim and Mary Tracey, Fran Venegas, Tina and Brian Westmoreland, and, most especially, my parents, Ted and Dorie Glidden, and my mother-in-law, Ginny Tracey Finally, and most important, my work infinitely benefits from the patience, love, and inspiration provided by my husband, Terry, and the kids (some grown up already!) whom I adore: Trevor, Beilee, Erin, Cameron, and Kendra —Cynthia Glidden- Tracey. .. number of clients suffer from more than two disorders at once The National Co-Morbidity Study (1994; cited in Ordorica & Nace, 1998) estimated that one sixth of the U.S population had a history of three or more disorders including alcohol dependence A 1997 follow-up study (also cited in Ordorica & Nace, 1998) found that fully 86% of alcoholic women and 78% of alcoholic men had a lifetime co-occurrence... potential clients Furthermore, by consuming, translating, and adding to the research literature on substance use disorders and their treatment, mental health professionals and researchers are in a position to help reduce the high personal and social costs of drug and alcohol abuse and dependence Co-Morbid Disorders and Overlapping Problems Whether treated or not, substance abuse issues occur within the... Disorders High co-morbidity rates have also been documented between substance use disorders and psychotic disorders—namely, schizophrenia Clients with one of these disorders are four times more likely to also meet the criteria for the other (Ordorica & Nace, 1998; Ott et al., 1999) Some evidence suggests that alcoholism is likely to develop after the onset of schizophrenia (Ordorica & Nace, 1998) With. .. presence and nature of concomitant difficulties, and plan treatment according to the findings of initial and ongoing assessments Effective treatment planning and implementation for clients with co-morbid disorders and multiple problems require the practitioner to be adept at assessing, diagnosing, educating, motivating, and intervening with complex clients Also the practitioner may need to coordinate efforts... problems presented by clients who have troubles with legal or other formal consequences, in addition to more private ones For example, when a judge, probation or parole officer, or child protective service agency has mandated treatment for drug or alcohol problems, the client often views participation in therapy as voluntary only to the extent that compliance with the treatment mandate helps the client... not think about it With other clients, evidence of a pattern indicating substance abuse is more subtle, like with Andre, who presented with a sharp increase in obsessive thoughts and compulsive behavior since his father's death last year Over many therapy sessions, Andre gradually reveals that his father was an alcoholic who died of lung cancer after years of smoking cigarettes Andre also mentions... lower priority or dismissed as irrelevant, or if the client's substance use has changed or become associated with new problems that develop during the course of treatment For examples, a client already in therapy for depression, anxiety, or grief may begin drinking or "drugging" more heavily in response to current stressors, or may be arrested for driving under the influence of drugs or alcohol Clearly,... disorder in their lifetimes, with 11.3% prevalence within a given year Compared with other psychological problems, substance abuse is one of the most frequently occurring forms of mental health disorder in the general population Anxiety disorders are the other most prevalent psychological disorders, with an estimated 14.6% of the population experiencing an anxiety disorder in their lifetime (Ordorica... additional mental disorder ADDICTION AMONG CLIENTS 11 The substance abuse treatment field is increasingly recognizing that substance use disorders frequently co-exist with other diagnosable disorders (Westermeyer, 1998) and personal problems (Miller & Rollnick, 2002) In response, there is a major trend toward improving the quality and integration of treatment approaches for co-morbid disorders (Frances . Lacey Library of Congress Cataloging-in-Publication Data Glidden- Tracey, Cynthia. Counseling and therapy with clients who abuse alcohol or other drugs : an integrative approach / Cynthia.