Addiction Treatment: a Strengths Perspective.

Addiction Treatment: a Strengths Perspective. ADDICTION TREATMENT: A STRENGTHS PERSPECTIVE Katherine van Wormer Katherine van Wormer, a professor of social work at the University of Northern Iowa and a writer on addiction treatment, claimed in an Irish Times article on May 6 2003 that U.S. president George W. Bush seems to display "all the classic patterns of addictive thinking".Dr. and Diane Rae Davis, Pacific Grove Pacific Grove,residential and resort city (1990 pop. 16,117), Monterey co., W central Calif., on a point where Monterey Bay meets the Pacific Ocean; inc. 1889. , CA:Wadsworth, 2002. 456 pp. $57.95 paperback. ISBN ISBNabbr.International Standard Book NumberISBNInternational Standard Book NumberISBNn abbr (= International Standard Book Number) → ISBN m: 0-534-59670-3. Katherine van Wormer and Diane Rae Davis's AddictionTreatment: A Strengths Perspective (2003) presents a dilemma. Inclusionof the term "strengths perspective" in the title of any bookintended for a target audience of social workers imposes on a reviewerthe dilemma of whether to respond only to its strengths. Must we beconstrained to a critique that only addresses the strengths of the textunder consideration, focusing solely on its merits, eschewing mentionsof any deficits or shortcomings? If a text purports to espouse a"strengths perspective," are the "strengths goneawry" or limitations of the book still within the purview The part of a statute or a law that delineates its purpose and scope.Purview refers to the enacting part of a statute. It generally begins with the words be it enacted and continues as far as the repealing clause. of thereviewer (personal communication with R. Nooe, August 23, 2003)? The complexity of this dilemma is further amplified by theambiguity of what actually constitutes a strengths perspective andwhether the strengths perspective is in fact an efficacious or effectiveapproach to treatment, either in substance abuse or more broadly insocial work. Staudt and colleagues (2001) reviewed the empiricalliterature on the strengths perspective and concluded that "thestrengths perspective is a value stance, but there is little support forit as a distinct and uniquely effective practice model" (p. 1). Inthe substance abuse treatment literature there is evidence thatstrengths-focused approaches to treatment, such as motivationalinterviewing, which avoids pathologizing, supports self-efficacy, andpersonal choice, are efficacious in substance abuse treatment. The dilemma of whether to be bound by a strengths perspective inreviewing a book espousing a strengths perspective is less acute in thecase of the work of Wormer Wormer is a town in the Dutch province of North Holland. It is a part of the municipality of Wormerland, and lies about 13 km northwest of Amsterdam.In 2006, the town of Wormer had 12566 inhabitants. The built-up area of the town is 16.88 km2 (of which water: 4.19 km2). and Davis as there is much to recommend inthis book and very little that necessitates critique. AddictionTreatment: A Strengths Perspective (2003) is a presentation of the majorissues in substance abuse treatment germane to social workers and othersinvolved in the field of addictions treatment. The authors use abiopsychosocial model The biopsychosocial model is a general model or approach that posits that biological, psychological (which entails thoughts, emotions, and behaviors) ,and social factors (abbreviated "BPS") all play a significant role in human functioning in the context of disease or illness. to frame their presentation of this broad-rangingfield of practice. It is the breadth of topics associated withaddictions treatment that challenges any text on the subject to besufficiently comprehensive in its exploration of a particular topic andyet necessarily inclusive of inclusive ofprep.Taking into consideration or account; including. the array of interrelated in��ter��re��late?tr. & intr.v. in��ter��re��lat��ed, in��ter��re��lat��ing, in��ter��re��latesTo place in or come into mutual relationship.in topics in thefield, van Wormer and Davis's 13 chapters and epilogue ep��i��loguealso ep��i��log ?n.1. a. A short poem or speech spoken directly to the audience following the conclusion of a play.b. The performer who delivers such a short poem or speech.2. cover thetopics likely most important to social workers and other addictiontreatment professionals. The first three chapters provide an introduction to the nature ofaddiction, a historical overview of addiction across time and cultures,and a review of strengths-based strategies in substance abuse treatment.Of particular note in the third chapter is the inclusion of a discussionon harm reduction in substance abuse treatment. Harm reduction is widelyused in European countries and unfortunately has received limitedattention and application to date in the United States United States,officially United States of America, republic (2005 est. pop. 295,734,000), 3,539,227 sq mi (9,166,598 sq km), North America. The United States is the world's third largest country in population and the fourth largest country in area. , especially inmainstream treatment facilities. The authors present both a compellingrationale for the use of harm reduction strategies and describe thenumber of implementations of this approach. Also in chapter 3 theauthors introduce motivational interviewing, an approach to substanceabuse treatment supported by an extensive body of evidence of itsefficacy. The second section of Addiction Treatment: A Strengths Perspectiveis devoted to the biology of addiction. In chapter 4 of this section,the authors address the pharmacology, metabolism, neurology, and healthconsequences of addiction. Chapter 5 describes interventions, includingmedical interventions that address biological factors manifest inaddictions treatment. The substance of these two chapters is extremelyimportant to addiction treatment and too often neglected in mostsubstance abuse treatment texts. It is to the authors' credit thatthey present the essential elements of these topic areas, some of whichare complex and not readily conveyed in the confines of a singlechapter. However, readers would benefit from additional content inchapter 4 on basic pharmacology, metabolic mechanisms, and druginteractions. There are numerous resources on the Web related to thesetopics available from U.S. government agencies. A listing of a these Websites at the end of the chapters would help readers seeking moredetailed information about the biology of addiction. The third section of the book addresses the psychology ofaddiction. The chapters in this section cover addiction across the lifespan; other behavioral addictions, including eating, gambling, andshopping; and substance abuse with coexisting disorders anddisabilities. Chapter 6, entitled "Addiction across the LifeSpan" does a particularly effective job of reviewing adolescentsubstance abuse from the perspective of psychological development,gender, and social factors. The authors deserve praise for theirinclusion of motivational enhancement strategies for adolescents. On theother end of the life cycle, the authors address substance abuse byelderly people, a subject all too often neglected in social workeducation and practice. The authors' coverage of other behavioraladdictions in chapter 7 provides a solid introduction to the spectrum ofcompulsive addictive behaviors with particular focus on the use ofcognitively based interventions. The coverage of these topics isinsufficient for practitioners engaged in the treatment of individualswith one or more of these behavioral addictions. However, the content ofchapter 7 is a sufficient and orienting introduction to the topics toallow readers to seek out more detailed information. Chapter 8,"Substance Misuse with Coexisting Disorder or Disability,"addresses the challenges of substance abuse treatment with individualswho have historically been referred to as duly diagnosed or havingcoexisting disorders. The strengths of this chapter include itsdiscussion of integrated treatment practices, case management teams,strengths-based interventions, and the inclusion of case studies. Theauthors' discussion of coexisting disorders was rathercursory--lacking in sufficient detail of the etiology, clinicalmanifestations, or specialized interventions for this difficult-to-treatpopulation. The fourth section of Addiction Treatment: A Strength'sPerspective covers the social aspects of addiction, thereby completingthe presentation of the biopsychosocial model. The risks andresiliencies of families to addiction are covered in chapter 9. Theauthors present family systems therapy and role theory and describefamilial adaptation to addiction. Of particular note in this chapter isthe authors' application of the Stages of Change Model to familytreatment. They provide an innovative and original adaptation of theStages of Change Model for working with families struggling with one ormore addictive family members. Chapter 10, "Racial, Ethnic, andCultural Issues," offers a particularly strong discussion of thenecessary understanding and adaptation of intervention approachesnecessary in substance abuse treatment with diverse populations coveredin the chapter. The authors' discussion of each population group isframed from the perspective of prevalence patterns, socioeconomicfactors, cultural factors, and treatment issues. Chapter 11 is concernedwith the successful adaptation of substance abuse treatment services toaccommodate gender and sexual orientation sexual orientationn.The direction of one's sexual interest toward members of the same, opposite, or both sexes, especially a direction seen to be dictated by physiologic rather than sociologic forces. differences. The section ofthis chapter on substance abuse counseling and sexual orientation isboth particularly welcome because it has been insufficiently addressedin many substance abuse texts and sufficiently comprehensive in itscoverage of the topic. Chapter 12 is devoted to offering a strengthsperspective on mutual-help groups. The major portion of this chapter isdevoted to a rather charitable description of Alcoholics Anonymous Alcoholics Anonymous(AA), worldwide organization dedicated to the treatment of alcoholics; founded 1935 by two alcoholics, one a New York broker, the other an Ohio physician. andthe roles it can play in the substance abuse treatment process. Theauthors devote some attention to self-help groups that did not promote aspiritual orientation such as Women for Sobriety Women For Sobriety (WFS), Inc., is a non-profit support group for alcoholic women, founded in 1976. The mutual support groups of WFS work to increase the self-esteem of members. , SMART Recovery, andModeration Management. Finally, chapter 13 addresses current U.S. publicpolicies that affect substance abuse on a societal and individual level,oftentimes with deleterious effect. The authors clearly advocate forpublic policies that offer a "reasoned compassionate approach"for those seeking to extricate themselves from a life of substanceabuse. Over the course of the 12 years I have been teaching substanceabuse treatment, I have been looking for a textbook that providessufficient depth and detail in its presentation of the spectrum oftopics necessary to prepare graduate social work students for practicein substance abuse treatment settings. Typically, substance abusetextbooks focus on counseling and intervention skills with presentationof this information under-informed by recent research in effectiveinterventions. Furthermore, substance abuse texts commonly eitherexclude or give scant attention to historical, pharmacological, social,and cultural content, and usually provide only limited coverage onissues of cultural diversity, gender, and sexual orientation.Thankfully, van Wormer and Davis's contribution to the literaturehas not neglected these important topics that provide context andperspective to the endeavor of substance abuse treatment. This bookmight be improved with additional content on the process of diagnosisand assessment, an enhanced discussion of intervention strategies, andgreater use of linkages to substance abuse treatment content on theWorld Wide Web. Despite these reservations, Addiction Treatment: AStrengths Perspective is a very well-written, accessible, andempirically informed text that will likely be useful to both graduatestudents and substance abuse treatment professionals. I certainly planto give it strong consideration the next time I order books for mysubstance abuse treatment class. REFERENCES Staudt, M., Howard, M. O., & Drake, B. (2001). Theoperationalization, implementation, and effectiveness of the strengthsperspective: A review of empirical studies Empirical studies in social sciences are when the research ends are based on evidence and not just theory. This is done to comply with the scientific method that asserts the objective discovery of knowledge based on verifiable facts of evidence. . Journal of Social ServiceResearch, 27(3), 1-21. David A. Patterson For other persons of the same name, see David Patterson.David A. Patterson has been Professor of Computer Science at the University of California, Berkeley since 1977, after receiving his A.B. (1969), M.S. (1970), and Ph.D. (1976) from UCLA. College of Social Work University of Tennessee The University of Tennessee (UT), sometimes called the University of Tennessee at Knoxville (UT Knoxville or UTK), is the flagship institution of the statewide land-grant University of Tennessee public university system in the American state of Tennessee. Knoxville