This book is written by two US professors of social work and is aimed primarily at social workers who take a special interest in problems of addiction among their clients.
When reviewing US textbooks in the addictions field, it never ceases to surprise how far behind that great country is, in both practical and conceptual terms, compared with the way addiction is understood in the UK and some other European countries. For example, in the first sentence of the Preface, we learn that: The moderation versus abstinence controversy is easily the most hotly contested issue in substance abuse treatment today. In the UK, although pockets of misunderstanding may still be found, this issue was largely resolved in practice about 15 years ago. Similarly, the disease concept of addiction is said to be increasingly subjected to public and professional scrutiny in the USAthe kind of scrutiny apparently that occurred in the UK in the 1970s. Harm reduction is strangely defined here as an umbrella term for a set of practical strategies based on motivational interviewing but the European origins of the harm reduction movement are at least recognized by the authors. Needless to say, the US contains within its borders many of the scientists and scholars who have helped transform our understanding of addiction over the past 40 years but this paradigm shift has had far less influence at the grass roots level there than it has had in the UK and elsewhere.
The key characteristic of this book is eclecticism. Indeed, in the bio-psycho-social-spiritual model presented by the authors, it is difficult to think of any school of thought, any reasonable approach to treatment or prevention or any well-known point of view on addictions that has not been included. If there is any unifying theme to be found, it is the strengths perspective. This is defined by six elements said to be crucial to recovery: identity as a competent human being; the need for personal control or choice; the need for hope; the need for purpose; the need for sense of achievement; and the presence of at least one key person. Disregarding the possible vagueness of these prescriptions, there is little to disagree with there.
The book consists of four parts. The introductory Part 1 discusses the nature of addiction and various historical perspectives on it before presenting the elements of strengths-based helping strategies. Part 2 describes knowledge on the biology of addiction, including interventions related to these biological foundations. In Part 3 we find the psychology of addiction applied across the life-span, to various sorts of behavioural addictions and to comorbid disorders. Last, in Part 4, the social aspects of addiction are described under headings of family risks and resiliencies, racial, ethnic and cultural issues, gender and sexual orientation differences, mutual-help groups and public policy.
One should not appear too sniffy about this book. It is well written, contains a great deal of sound common sense and obviously derives from a warm and genuine concern for the plight of addicted persons. Nevertheless, I cannot recommend it for anyone wishing to further a scientific understanding of addiction; there are many other books far more suited to this aim. I am sure the book would be useful to social workers wanting to increase their knowledge of how to respond to addictions in their clients, if only because of the professional orientation of its authors. Finally, the book would be a useful read for anyone intending to visit the US and who wishes to get a feel for what goes on in the addictions field there, particularly for what is considered new and radical in US treatment circles.