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CMT8824 - What Every Mental Health Clinician Needs to Know about Involuntary and Court Ordered Substance Abuse Treatment presents



by Ron Fagan, M.A., Ph.D.

Ron Fagan, M.A., Ph.D. is formerly a Professor of Sociology at Pepperdine University in Malibu, California. Dr. Fagan currently works as a Care Manager with Anthem.

This course is the copyrighted property of and may not be copied in part or in entirety without the express written permission of For information on how to secure permission to use this course or any part of this course, contact us at:


This course may not be utilized without first making proper payment. Entering this course in an unauthorized manner would represent an ethical violation. 

Course Objectives

This course is designed to provide the mental health clinician with a comprehensive overview of the topic of involuntary and court mandated substance abuse treatment. Upon completing this course, the trainee will understand the following:

-The history and effectiveness of court and work mandated substance abuse treatment
-The responsibilities of the client, clinician and organization in work mandated treatment for substance abuse
-Treatment complexities in work mandated treatment for substance abuse
-The responsibilities of the client, clinician and court system in court mandated treatment for substance abuse
-Treatment complexities in court mandated treatment
-Ways to increase motivation for change in court and work mandated treatment for substance abuse
-DiClemente’s Five-stage Model of Change and its relevance to substance abuse treatment

This beginning level course is primarily designed for clinicians early in their career, or for clinicians reviewing basic concepts in this treatment area.

Course length:

4 contact hours: Core clinical


Section I: Introduction
Section II: Mandated and Involuntary Clients
Section III: Legally Requiring Treatment
Section IV: Required Treatment in the Workplace
Section V: Required Treatment in the Criminal Justice System
Section VI: Confidentiality Issues
Section VII: Effectiveness of Legally Required Treatment
Section VIII: Enhancing Motivation for Change
Section IX: Five Stage Model of Change
Conclusions and Summary of Material
Addendum and Printable Supplemental Materials
References and Test



Section I: Introduction

Throughout history people have used a variety of mind- or mood-altering drugs. Drug abuse and addiction comprise a public health problem that affects many people and has wide-ranging individual and social consequences. Despite decades of education, prevention and treatment programs, and enforcement and interdiction efforts, the problems of alcohol and other drug (AOD) use continue to exist in America today.

AOD use, abuse, and dependence are not easily understood or treated. There are multiple pathways to AOD abuse and dependence. For each individual there is a specific combination of biological, psychological, and social factors that have played a role in the development of their AOD problems. AOD abuse and addiction are treatable disorders, but nine out of ten people with AOD use disorders who did not seek treatment did so primarily because they did not believe they needed treatment.

However, even when people realize they may have an AOD problem this does not mean that they will seek out treatment. If people seek treatment it is usually late in the development of their AOD problem, they usually first seek treatment for AOD related health problems - not their AOD problem - and they usually have experienced social pressure by friends and associates to reduce their AOD use. (9)

It is estimated that slightly over 3% of the total population ages 12 and older (almost 8 million people) need treatment for a diagnosable drug problem and almost 8% of the population (over 18 million people) need treatment for a serious alcohol problem. But less than 10 % of AOD abusers enter treatment or are in self-help programs for their abuse. Once in treatment, 40 to 70% drop out of treatment, a rate that is slightly higher than the drop-out rate for psychotherapy in general. We also know that when clients drop out of treatment they do so early, usually within the first month of treatment. (39)

Companies and organizations are paying increased attention to ways in which they can get more people into treatment earlier and, once in treatment, increase client involvement and retention. One controversial way that is increasingly being used in the workplace and the criminal justice system is the use of coerced or required AOD treatment. While more and more clients are coming to treatment involuntarily, most mental health professionals have received little or no training on how to work with this client population. (12)

This training course has been developed to provide the mental health clinician with a detailed introduction into this area of practice.

In preparation for the post-test at the end of the course, we will provide section by section review questions for the trainee. Successful understanding of the review questions will provide the trainee with a good mastery of the course material and easy passage through the course test.

Review Questions for Introductory Section

About what percentage of AOD clients use self-help resources, or get treatment for their abuse?

About what percentage of AOD clients in treatment drop out of treatment?

When are AOD clients most likely to drop out of treatment?