Clients who have multiple addictions and disorders are more difficult to engage and treat than clients with a single disorder. Many of the current systems are ill-equipped to address the myriad challenges of these clients—their relapse and recidivism rates are higher, and many of these clients tend to slip through the cracks, often going back and forth among addictions treatment, psychiatric and medical hospitalizations, and incarceration. Too many difficult-to-reach clients are at risk for relapse because their practitioners lack effective, innovative strategies for this unique client base who remain part of a revolving-door syndrome. Now, Certified Alcohol and Drug Addictions Counselor Mark Sanders, LCSW, offers specific strategies to assist therapists and counselors who work with difficult and at-risk populations, including those with:

• multiple addictions
• co-occurring disorders
• adolescents; rural methamphetamine users
• antisocial personality disorder, criminality, and addiction
• trauma or grief and chemical dependency
• history of chronic relapse and recidivism

Slipping Through the Cracks is a encyclopedic handbook to specific traits of the difficult-to-reach client, as well as a concise guidebook to effective strategies that will be useful to anyone working with clients in private practice or in treatment programs who have both mental health and substance abuse issues.