Dr. Arthur P. Ciaramicoli articulates a holistic model for cost-effective, outpatient treatment of clients whose multiple presenting problems include patterns of addiction following histories of abuse. Recognizing the interaction of intrapsychic, interpersonal, and societal dynamics, Dr. Ciaramicoli's design relies on both individual and group modalities to build self-esteem. Toward consolidating, stabilizing, and enriching the therapeutic gains, it endorses a spectrum of alternative tools from physical fitness and herbal medicine to spirituality. In conclusion, the model considers the managed care system, addressing negotiating strategies and also the need to balance the imperatives of cost with respect for quality care.

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