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Background and Overview
The TCU Treatment System includes a set of assessments and manual-guided interventions that “target” specific needs and status of clients in different stages of change during treatment. Evidence for these stages provide foundations for the TCU Treatment Process Model (Simpson, 2004; 2006) and involves induction into treatment, engagement in treatment, early recovery in treatment, adequate retention before treatment release, and preparation for community re-entry. The needs and functioning of an organization (i.e., treatment agency) affects the delivery of treatment services and may also need attention. An integrated set of TCU Assessment Forms are available to link client and program measures into this process. All of these TCU resources are “copyrighted” in an effort to limit commercial or for-profit applications, but there is no charge to service providers for downloading and using them. (See Permissions and Obtaining Forms.)
TCU Treatment Manuals are described below, organized according to their typical and strategic applications to the sequence of client needs and progression during treatment. They can be used in various “mix-n-match” combinations or as supplements to other treatment resources. Although they are categorized here in relation to conceptual treatment stages, there is a variety of sequential applications possible within and across the different stages of care. Because the host organization plays a critical role in this process, manuals are also available to help initiate and guide selected organizational interventions.
Historically, these interventions were developed in response to service gaps or unmet counseling and organizational needs of substance abuse treatment programs. Most were participating in on of a series of NIDA-funded grants to TCU (especially DATAR, CETOP, Women/Children, and CJ-DATS projects). Treatment settings have included community-based outpatient methadone and drug-free services, prison-based treatment, and intensive residential care. Their clients have included men and women, sometimes with children, reporting a wide variety of drug use histories and legal involvement (such as in-prison treatments and diversion programs for parolees or probationers). With modest adaptations in language and illustrations, the interventions have been shown to be applicable across highly diverse settings. Manuals have been designed to be highly focused, practical, and flexible in order to meet the therapeutic needs of “real-world” programs. Counselor training events for these materials (generally based on a train-the-trainers model) emphasize intervention objectives, role-playing exercises and practice, and maintaining adherence to core elements of each intervention.
All TCU Manuals rely on a cognitive-based visual representation strategy for counseling—that is, TCU Mapping-Enhanced Counseling (Dansereau, Joe, & Simpson, 1993; Dansereau, Dees, & Simpson, 1994)—shown to enhance client communication, planning, and decision-making skills. As a clinical technique, node-link mapping incorporates visual tools (e.g., guide maps, free-form maps, information maps) that clients and counselors use to more readily identify and address the variety of concepts covered during treatment. Guides for counselor applications of mapping are listed below, which typically serve as reference materials for counselor training events (see also Teaching People How to Map: Leader's Manual—PDF / 556 KB / 19 pages). Following the TIC manuals and mapping guides, there are four groups of intervention manuals listed—treatment induction, engagement, early recovery, and retention/re-entry.
Finally, the last section includes organizational interventions developed as guides to help improve organizational functioning, especially in relation to program readiness for innovation training and adoption (see DATAR and Drugs in the Workplace projects).
Permission to Use TCU Treatment Manuals
The Institute of Behavioral Research at Texas Christian University is pleased to make available, without charge, a wide array of evidence-based mapping guides, client interventions, and organizational interventions developed for substance abuse treatment. Collectively, they are referred to as the “TCU Treatment Manuals.”
Terms of Use: The TCU Treatment Manuals and corresponding handouts and data collection forms may be used for personal, educational, research, and/or informational purposes. Permission is hereby granted to reproduce and distribute copies of these materials (except reprinted passages from copyrighted sources) for nonprofit educational and nonprofit library purposes, provided that copies are distributed at or below costs and that credit for author, source, and copyright are included on each copy. It is requested that IBR be notified of their use, and that copies of reports based on these manuals be sent as a professional courtesy to the IBR. No part of any TCU Treatment Manual or its supporting materials may be copied, downloaded, stored in a retrieval system, or redistributed in any format for ANY COMMERICIAL PURPOSE without the expressed written permission of the university or designated creator of manual materials. Contact ibr@tcu.edu for more information.
TIC Manuals–Targeted Interventions for Corrections
There is a subset of six manuals listed below that deserves to be highlighted. In some ways, they reflect “second-generation TCU manuals” in that they focus on many of the most popular concepts from the original—and typically longer—modules developed in the 1990s. Although their development was prompted initially by specialized treatment needs and requests by IBR collaborators in correctional systems (see Evidence for Corrections-based Treatment), these brief interventions are becoming the most popular of all the manuals listed. The reason is that they build on experiences and client response feedback from previous years, and they update and re-focus on some of the issues that matter most to counselors and clients. More importantly, they are brief and formatted in a way that permits flexibility in when and where they can be used. Two versions of each manual are available, including one with wording and examples for correctional populations (TIC-CJ version) and another one for clients in general community-based program settings. The concepts and contents are the same in both versions.
Each of these Targeted Intervention for Corrections (TIC) modules applies the TCU Mapping-Enhanced Counseling strategy (i.e., node-link mapping), which has been shown to be beneficial in treating correctional populations (Czuchry & Dansereau, 2003, 2005; Czuchry, Sia, & Dansereau, 2006; Dansereau, 2005; Dansereau & Simpson, 2009; NREPP: SAMHSA's National Registry of Evidence-based Programs and Practices, 2008). These life skill interventions are designed to be delivered typically in 3-4 sessions, guided by manuals with user-friendly formatting for explaining purposes and procedures. They are effective individually and collectively for improving knowledge, attitudes, and therapeutic engagement (Joe, Knight, Simpson, Flynn, Morey, & Bartholomew, 2011).
TIC Manual 1. Getting Motivated to Change. TIC-Motivation is based on 4 sessions focused on aspects of cognition that govern decisions to change behavior. It relies on visual-communication tools and related cognitive strategies to engage clients in discussions of this topic (see a related TCU manual, Mapping the Journey). Participants are encouraged to make a commitment on a specific behavior or attitude they are willing to work on and report on to the group over the course of the intervention. It features a leader's script, with notes and suggested discussion questions for exploring the meaning of motivation and ways in which clients can develop it and put it into action. Information is explored from a strength-based perspective that encourages participants to consider goals on which they are willing to work. In addition to leader guides, handout materials for participants are included at the end of the session. Sections of the manual include Motivation 101 Introduction, Art of Self-Motivation, Staying Motivated, and Making Motivation Second Nature.
TIC Manual 2. Understanding and Reducing Angry Feelings. TIC-Anger teaches clients appropriate ways to manage anger so they are more capable of coping with the reality of their situation. This module is considered a basic building block because CJ involved individuals often experience anger, particularly in response to their loss of freedom. The 4-session brief therapeutic intervention is designed to help clients learn to understand and respond to anger in more appropriate ways. They learn to identify anger triggers, differentiate between healthy and unhealthy anger, to set goals, to plan strategies for interrupting angry patterns, and to utilize progressive muscle relaxation. Sections of this intervention include: Understanding Anger, Managing Anger in Relationships, Mapping Worksheets, The Aggression Cycle, and Links of Interest.
TIC Manual 3. Ideas for Better Communication. TIC-Communication focuses on improving relationships. Communication needs may easily take a back seat to more urgent rehabilitation demands within the criminal justice system, but positive communication within relationships serve as a vital tool for improving client morale and performance. The 4 sessions of this intervention address the concepts of "making amends," forgiving and letting go of resentments, and learning to distinguish between healthy supportive relationships versus unhealthy enmeshed ones. Participants are encouraged to build "connections" with others, develop effective listening and problem solving skills, and are challenged to break down destructive relationship roadblocks. Sections of the manual include Communication Roadblocks, Repairing Relationships, Communication Styles, Mapping Worksheets, and Links of Interest.
TIC Manual 4. Unlock Your Thinking, Open Your Mind. TIC-Criminal Thinking includes 4 sessions aimed at addressing the ingrained pattern of criminal thinking. Individuals involved in a lifestyle steeped in drug use and other criminal activity are likely to return to the community and continue making poor decisions based on their thinking errors. Joe, Rowan-Szal, Greener, Simpson, and Vance (2010), however, have reported that the negative effects of criminal orientations and thinking can be offset by establishing higher levels of therapeutic engagement during treatment. In this module, therefore, participants are introduced to various types of mind traps and are challenged to address destructive thinking patterns. Discussions driven by the intervention lead participants towards breaking out of distorted thinking and irresponsible behavioral cycles while striving toward the goal of incorporating recovery-appropriate thoughts, actions, and habits. The manual sections include Feelings, Thoughts, and Mind Traps, Road Block to Healthy Thinking, Thinking and Behavior Cycles, Mapping Worksheets, and Links of Interest.
TIC Manual 5. Building Social Networks. TIC-Social Networks focuses on qualities clients can look for in friends and family who may aid them in achieving their recovery goals. Oftentimes changes in social networks are essential in the recovery process. Upon return to the community, client recovery may be jeopardized if family members or long-time friends are still entangled in a drug-using lifestyle. This intervention walks participants through the steps of taking a peer inventory, making new friends who are drug free, and integrating lifestyle strategies for dealing with old friends and family members who use drugs. The aspects of getting involved in a support group and finding a sponsor also are covered. The 4 sections include Social Networks in Recovery, Support Groups and Your Recovery, When Other Families Use, Mapping Worksheets, and Links of Interest.
TIC Manual 6. Common Sense Ideas for HIV Prevention and Sexual Health. TIC-HIV/Sexual Health equips clients with knowledge and skills necessary to help reduce Human Immunodeficiency Virus (HIV) and sexually transmitted disease (STD) risks. As HIV is substantially higher among U.S. prison and jail populations than among the general public, it is important that correctional settings address this immense problem. This 3-session intervention provides group participants with up-to-date HIV statistics, facts and fiction about HIV transmission, and engages them in an "eye opening" risk game for vicarious learning. Participants are taught how to act assertively to protect their health through the use of practical role-play scenarios designed to identify core issues while portraying healthy ways to handle sexual risk invitations. The sections of the manual include HIV Update, Acting to Protect Your Health, Mapping Worksheets, and Links of Interest for obtaining further health information.
Mapping Guides: A Counseling Strategy Using Visual Representation
Mapping is a visual representation counseling strategy for improving communication and decision-making that can enhance any therapeutic or psycho-educational exercise, either in group or individual settings. Evidence shows it significantly improves treatment engagement and client progress indicators, and helps compensate for a variety of cognitive and social deficits common among drug users in treatment (Dansereau & Dees, 2002; Czuchry & Dansereau, 2003). |
Mapping-Enhanced Counseling: An Introduction
(Bartholomew & Dansereau, 2008; 74 pages) provides an overview with case examples of ways to incorporate mapping-enhanced counseling into your practice.
Mapping New Roads to Recovery: Cognitive Enhancements to Counseling
(Dansereau, Dees, Chatham, Boatler, & Simpson, 1993; 131 pages) is a comprehensive self-paced training manual designed for substance abuse counselors and case workers interested in node-link mapping, a visual representation technique for helping clients improve problem-solving and decision-making skills.
TCU Guide Maps: A Resource for Counselors
(Dees & Dansereau, 2000; 132 pages) is designed to show how "guide maps" serve to enhance counseling sessions in substance abuse treatment. Although the examples used are based on experiences with large-group residential treatment in a criminal justice facility, the maps are appropriate both for group and individual counseling in other settings.
Mapping Your Steps: “Twelve Step” Guide Maps
(Sia, Dansereau, & Dees, 2002; 138 pages; also available in Spanish) provides mapping templates for helping clients work their 12-step program and contemplate deeper, personal relevance of each step. The manual also includes maps to explore popular AA slogans, the Twelve Traditions, and the Serenity Prayer.
Manuals for Motivation and Induction into Treatment
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Client motivation to change, readiness for treatment, and treatment orientation/planning are crucial elements of the induction phase; they are related directly to the level of client engagement during the early months of treatment (Simpson & Joe, 2004). |
Getting Motivated to Change
(Bartholomew, Dansereau, & Simpson, 2006; 63 pages) is a collection of materials for leading 4 counseling sessions that address motivation and readiness for change. Includes a version for criminal justice (CJ) populations.
Mapping Your Treatment Plan: A Collaborative Approach
(Bartholomew, Dansereau, & Simpson, 2007; 54 pages) is a mapping-focused guide for working with clients to establish meaningful and useful treatment goals.
Using Client Assessments to Plan and Monitor Treatment
(Simpson & Bartholomew, 2008; 43 pages) is a guide for using the TCU Client Evaluations of Self and Treatment (TCU CEST) in individual or group counseling settings. This manual is frequently called by a short title, Using CEST Guide.
Preparation for Change: The Tower of Strengths and The Weekly Planner
(Sia, Czuchry, Dansereau, & Blankenship, 1998; 76 pages) introduces two card-sorting activities that counselors can use with their clients to help them enrich self-esteem, maintain motivation (The Tower of Strengths), and remember personal goals through quotes (The Weekly Planner). Both activities are used early in treatment to enhance motivation and encourage openness to change.
Downward Spiral: The game you really don’t want to play (Czuchry, Sia, Dansereau, & Blankenship, 1998; 304 pages)
is a board game with an innovative approach to motivating clients and opening up discussions about the consequences of addiction on themselves and their families. Downward Spiral uses realistic scenarios, factual information, and inspirational quotes to stimulate client thinking about common consequences of substance abuse. The objective of the game is to stay alive, preferably without losing all social and financial resources. The task becomes more challenging the longer the drug-using player stays in the game.
Manuals for Improving Engagement in Treatment
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Treatment engagement is the foundation for achieving therapeutic improvements in client psychosocial functioning. “Engagement” means regular attendance, cognitive re-focusing on treatment issues, and developing rapport and a trusting relationship with counselors (Simpson & Joe, 2004). |
Contingency Management Strategies and Ideas
(Bartholomew, Rowan-Szal, & Simpson, 2006; 31 pages) is a planning guide for using rewards and star charts to reinforce client goal setting, session attendance (i.e., regular and on-time), and participation in treatment settings.
Understanding and Reducing Angry Feelings
(Bartholomew & Simpson, 2005; 42 pages) is a collection of materials for leading 4 counseling sessions that encourage new ways of thinking about and responding to anger. Includes a version for criminal justice (CJ) populations.
Unlock Your Thinking, Open Your Mind
(Bartholomew & Simpson, 2005; 55 pages) is a collection of materials for leading 4 counseling sessions that address unhealthy or destructive thinking patterns that can hamper behavior change. Includes a version for criminal justice (CJ) populations.
Mapping Your Journey: A Treatment Guidebook
(Dansereau & Simpson, 2005; 59 pages) is a collection of materials and visual guides for systematically exploring needs and planning treatment, improving communication, and reviewing treatment progress.
Manuals for Improving Early Recovery in Treatment
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Progress in making psychosocial, cognitive, and behavioral changes – including learning life and social skills as well as basic “relapse prevention” concepts – is needed to initiate the recovery process. It also is related to achieving longer retention in treatment (Simpson & Joe, 2004). |
Ideas for Better Communication
(Bartholomew & Simpson, 2005; 39 pages) is a collection of materials for leading 4 counseling sessions on ways to improve relationships through communication. Includes a version for criminal justice (CJ) populations.
Building Social Networks
(Bartholomew & Simpson, 2005; 36 pages) is a collection of materials for leading 4 counseling sessions on ways to build and strengthen social support in recovery. Includes a version for criminal justice (CJ) populations.
Time Out! For Me: An Assertiveness/Sexuality Workshop for Women
(Bartholomew, Chatham, & Simpson)1994; 210 pages) provides substance abuse counselors or case workers with a curriculum for leading a 6-session workshop for women in their treatment programs.
Time Out! For Men: A Communication Skills and Sexuality Workshop for Men
(Bartholomew & Simpson, 1996; 230 pages) is a companion piece to the Time Out! For Me curriculum for women. It provides substance abuse counselors or case workers with guidelines for leading an 8-session workshop for men that focuses on improving their intimate relationships.
Manuals for Improving Retention and Re-entry
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Retention in treatment increases as recovery-oriented “thinking and acting” is stabilized and emphasis is given to community re-entry issues, especially for improving family relationships and support systems. Longer retention is related to better client outcomes following discharge (Simpson & Joe, 2004). |
Partners in Parenting
(Bartholomew, D. Knight, Chatham, & Simpson, 2000; 306 pages) contains materials for an 8-session structured
workshop in which participants practice parenting strategies and
discuss their experiences with others.
Straight Ahead: Transition Skills for
Recovery
(Bartholomew, Simpson, & Chatham, 1993; 193 pages) provides substance abuse treatment professionals
with a step-by-step curriculum for leading a 10-session workshop designed
to reinforce key relapse prevention and related recovery concepts.
Mapping Your Reentry Plan: Heading Home
(Bartholomew, Dansereau, K. Knight, Simpson, 2007; 72 pages) provides substance abuse treatment professionals
with focused, easily accessible, and brief adaptive applications for helping clients identify goals for reentry and aftercare. This manual is targeted primarily for criminal justice (CJ) populations.
Common Sense Ideas for HIV Prevention and Sexual Health
(Bartholomew & Simpson, 2005; 40 pages) is a collection of materials for leading 4 counseling sessions that address the knowledge and skills to reduce HIV and other STD risks. Includes a version for criminal justice (CJ) populations.
Approaches to HIV/AIDS Education in Drug Treatment
(Bartholomew & Simpson, 2002; 200 pages) is an easy-to-follow manual designed to assist counselors in leading educational groups on HIV/AIDS and related risks. The manual includes a 4-session core curriculum that addresses HIV transmission, safer sex and injection practices, HIV testing, and personal risk reduction.
Manuals for Organizational Interventions
More attention has been given in recent years to the needs and functioning of organizations as they relate to the collective behaviors of staff members, especially in terms of agency “effectiveness” and efforts to implement innovations through team building.
Mapping Organizational Change: A Guidebook on Program Needs
(Dansereau & Simpson, 2006; 20 pages) is a collection of mapping tools that guide discussions among organizational leaders and key staff to systemize the communication, goal setting, and change process.
Team Awareness: Small Business (4-hour Edition)
Training for Workplace Substance Abuse Prevention
(Small Business Wellness Initiative, SBWI, 2004; 4-hour training package) is a 4-hour team-based training program that integrates team building exercises with peer referral and stress management skills. Understanding the time constraints of small businesses, the training was modified from the original 8-hour program. It is designed specifically to increase the awareness of behavioral health as a group concern rather than an individual burden.
Team Awareness: Drugs in the Workplace (8-hour Edition)
Training for Workplace Substance Abuse Prevention
(Bennett, Bartholomew, Reynolds, & Lehman, 2002; 8-hour training package from the Drugs in the Workplace Project) is an 8-hour workplace training program that addresses behavioral risks associated with substance abuse among employees, their coworkers and, indirectly, their families. This program has been shown to increase employee help-seeking for and supervisor responsiveness to troubled workers, enhance the work climate, and reduce problem drinking.
