Based on the structured outpatient group program pioneered at the Harvard Cocaine Recovery Project, this volume is a guide to helping chemically dependent outpatient clients take the critical first steps toward recovery. The book describes the initial month-long cessation and early recovery group - the "Clean Start" group - which was designed to help clients achieve stable abstinence and prepare them for long-term treatment. Delineating an affordable outpatient alternative to existing drug treatment modalities, the book offers group leaders a "cookbook" of step-by-step instructions, complete with "scripts," for leading sessions.
Part I, "Program Theory and Design," establishes the rationale of the program and offers a coherent account of how to help groups of addicts separate themselves from drug use and lay the foundation for further recovery. It discusses the design of the program and the needs of clients in terms of a social conditioning model of addiction. Illuminated by a sample session, the format and topics for the group sessions are described, as are ways to deal with specific problems such as relapse.
Part II, "The Individual Clean Start Sessions," reviews the format and content of each of the program's ten sessions. Providing carefully developed "scripts" for leading structured drug-free group sessions, chapters also offer practical pointers on technique and copies of handout sheets. Some of the scripts address crucial topics that have not been fully covered in other programs, such as how to overcome resistance to change, and how to increase motivation for recovery. Thoroughly tested by Harvard Medical School researchers, the sessions are clear and easy to follow for leaders and group members. They engage clients and are designed to fit in a logical progression. Of special note: These scripts can be readily adapted for use in individual sessions or inpatient programs.
Representing a timely new direction in affordable outpatient treatment, CLEAN START will be of enormous value and interest to addiction specialists and counselors, as well as psychiatrists, clinical psychologists and sociologists, and social workers. Written in a clear, accessible style, it also serves as a text for graduate-level courses in drug abuse treatment and group therapy.

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