Joseph Hyde MA, LMHC, CAS, is a Lecturer/Clinical Instructor in the Department of Social Welfare and Continuing Education at Stony Brook University. He serves as Senior Subject Matter Expert at JBS International supporting health and behavioral centers throughout the US.

Maria Torres LMHC, PhD, is Assistant Professor, Stony Brook University School of Social Welfare.

Win Turner LADC, PhD, is Co-Director of the Center for Behavioral Health Integration/Vermont and has served as project director for multiple federal and state initiatives.

R. Lyle Cooper MSW, PhD, is an associate professor in Meharry Medical College's Department of Family and Community Medicine. Dr. Cooper also serves as the Associate Director of the Meharry Addiction Clinic.

Figures and Tables vii

Acknowledgements viii

Introduction 1

To Students and Fellow Practitioners 1

Key References Include 1

The Following Features Help Make this Guide Practical 2

The Guide is Organized Into Three Main Sections 2

1 An Overview of Proven Tools and Techniques for Motivational Interviewing/Motivational Enhancement Theory, and Cognitive Behavioral Therapy Treatment 3

Motivational Interviewing and Motivational Enhancement Therapy 3

Motivational Interviewing and the Process of Change 5

The Two Phases of Motivational Interviewing 6

Cognitive Behavioral Therapy 14

Treating Co-occurring Disorders 18

Recovery Supports 20

Patient Activation Within the Context of ICBT 20

On Spirituality 20

Enhancing Cultural Relevance in Clinical Practice 22

2 Clinician Guidance for 16 Sessions of Integrated Cognitive Behavioral Therapy 28

Introduction 28

Law of Thirds 29

Review of Progress and Between-session Challenges 33

Session 1. Eliciting The Life Movie 36

Session 2. Enhancing Situational Awareness 55

Session 3. Learning Assertiveness 69

Session 4. Supporting Recovery Through Enhanced Social Supports 85

Session 5. Supporting Recovery Through Healthy Replacement Activities 97

Session 6. Problem Solving 107

Session 7. Handling Urges, Cravings, and Discomfort 120

Session 8. Working with Thoughts: Part 1 139

Session 9. Working with Emotions 154

Session 10. Making Important Life Decisions 172

Session 11. Enhancing Self-awareness of Substance Use 191

Session 12. Using Mindfulness, Meditation, and Stepping Back 208

Session 13. Addressing Suicidality 220

Session 14. Using Medication in Support of Treatment and Recovery 229

Session 15. Engaging with Self-help 244

Session 16. Using an MI/CBT Approach for Traumatic Stress and Substance Use 252

3 Techniques and Tools Supporting Fidelity of Implementation and Clinical Supervision 279

Introduction 279

Acronyms 280

Adherence Tools and Techniques: Checklists 281

Clinical Supervision Techniques to Improve Adherence 282

ICBT Clinician Checklist Protocol 283

References 290

Index 297