By: Trevor Gates, MSW
Book review of
Overcoming Your Alcohol or Drug Problem: Effective Recovery Strategies (2nd ed.)
Daley, D. C., & Marlatt, G. A. (2006). Overcoming Your Alcohol or Drug Problem: Effective Recovery Strategies (2nd ed.). New York: Oxford University Press. 240 pages, $35.00 (Therapist Guide). 192 pages, $19.95 (Workbook).
Social work education programs at both the BSW and MSW levels provide generalist knowledge about working in a variety of settings, including settings for working with people with chemical dependency and other addictions. Chemical dependency and other addictions affect people of all ethnic, gender, sexual orientation, cultural, economic, and other backgrounds. Regardless of the new social worker’s explicit desire to work specifically with persons with chemical dependency, there are hardly any settings in which substance abuse and dependence do not affect the client population.
Yet despite the prevalence of persons with substance addiction in our agencies, our generalist social work programs tend to only briefly address the topic, through portions of the human behavior component or perhaps through a single elective course on substance addictions. Chemical dependency remains the “elephant in the room,” yet our social work programs are providing only minimal knowledge for working with persons affected by substance addictions.
Fortunately, there are books available for the new social worker who wants to gain additional knowledge or specialize in working with substance addictions. Overcoming Your Alcohol or Drug Problem: Effective Recovery Strategies (2nd edition), Therapist Guide and Workbook, by Dennis C. Daley and G. Alan Marlatt, are effective tools for not only learning about the chemical dependency field as a therapist, but also learning about the disease model of alcohol and other substance addiction as a client. Daley and Marlatt assert that, while substance abuse and dependence are clinical diagnoses with specific diagnostic criteria, their focus is on the treatment of substance use problems. Substance use problems exist whenever clients experience social, economic, occupational, or role functioning as the result of the ingestion of substances, whether prescribed, legally obtained, or illicit street drugs.
Closely adhering to the motivational interviewing approach to working, the therapist guide and accompanying client workbook are linear and easy to follow. The authors begin with an overview of substance use problems, followed by treatment settings and approaches. A brief introduction to psychosocial therapies and pharmacological interventions is included. Next in the topics that are covered are change issues and strategies. The texts encourage the substance using client to examine their motivation toward recovery by weighing the positives and negatives of deciding to continue using or stop using. There are resources for goal planning, managing cravings, identifying distorted thinking (“stinking thinking,” as it is called in twelve-step fellowships), managing emotions, and refusing offers to use substances. Additionally, the topics of psychiatric co-morbidity, assessing progress, and relapse prevention, are covered.
While the writers clearly encourage the social worker or other clinician to modify the treatment program to fit the individual client’s needs, using the book as a resource rather than a prescription to be swallowed whole, a potential danger I see is that the book may be used as a one-size fits all approach to treating persons with addictions. Overcoming Your Alcohol or Drug Problem is an effective series, yet seems to be typical of the curriculum-based sobriety programs found in many intensive outpatient, offender education, or other treatment settings. Moreover, the books are a great resource, but I would caution against their use as the sole intervention for working with an individual, family, or group affected by chemical dependency.
A mentor in the area of treating substance addiction once told me that chemically dependent persons can benefit from treatment, regardless of the social worker’s theoretical orientation, and regardless of the treatment program’s quality or effectiveness. We should throw away the “hitting rock bottom” approach to treating chemical dependency and realize that persons who are addicted can receive help at any point in their addiction. With the help of a holistic treatment team, including social worker or other clinician, self-help fellowship, and family and significant others, addicted individuals begin to walk the road to recovery when they examine their motivation to change and recognize that substance use is causing problems. Overcoming Your Alcohol or Drug Problem is a useful tool, among many, to add to the social worker’s repertoire for walking with the chemically dependent person and family on their road to addiction-free living.
Reviewed by Trevor Gates, LMSW, ACSW.
This article appeared in the Fall 2006 issue of THE NEW SOCIAL WORKER. For permission to reprint, please contact Linda Grobman . Copyright 2006 White Hat Communications. All rights reserved.