Addiction Treatment: A Strengths Perspective

by Katherine Stuart van Wormer

ADDICTION TREATMENT covers the biological, psychological, and social aspects of alcoholism, eating disorders, compulsive gambling, and other addictions. First-person narratives about the experience of addiction provide you a realism and depth of study not commonly found in textbooks. In addition, you will study topics that interest you, such as the case against so-called underage drinking laws, to show you the importance of reducing the harm of any addictive behavior.

Genres: Psychology, Nonfiction, Addiction, School, Counselling, Textbooks, Grad School

592 pages, Paperback

First published July 9, 2002

Reviews

[Matthew · Rating 4 out of 5]

This book gives a brief overview of the various substance misuse issues related to addiction treatment. It offers a harm-reduction example for nearly each type of addiction. It was severely lacking on information related to sexual addiction. At times, it was difficult to determine what the authors believed to be an addiction or a compulsive behavior. Nevertheless, this should be a read for every addiction specialist.

[Katty · Rating 4 out of 5]

Excellent overview of the main issues surrounding addiction and harm-reduction treatment. It was a bit light on addictions outside of substance use (especially those related to sex). I understand the concentration on substance use, but I wish books like this would focus on other addictions that can be equally harmful and in need of treatment. Still, this is a good place to start for anyone interested in substance use treatment since it explores the strengths and weaknesses of different models (e.g., abstinence, harm-reduction, ect.). As expected, it's more in favor of harm-reduction methods, but it covers abstinence treatments such as AA fairly. A solid introduction to the subject.

[Morgan Blackledge · Rating 4 out of 5]

Good balanced view of the biological, psychological and social factors contributing to substance use and behavioral addiction.

Nice coverage of harm reduction models and public health perspective.

Correctly opposed to incarceration of addicted individuals.

This edition is from 2016, i.e. the ‘before times’ when Obama era public health and police reforms were changing the game in the good way.

It’s such a sad contrast to what we have now.

My guess is the edition prior to this one is more applicable to the shit show we’re currently living in.

[John Kennedy · Rating 4 out of 5]

Well-researched with many anecdotal accounts. A primary drawback is that only one page is devoted to sexual addictions.

[Frrobins · Rating 3 out of 5]

A thorough overview of addiction and addiction treatment. I think it says a lot that, though this was published in 2003, the movement to adopt strength based treatment has been so slow that a lot of this information is still rather relevant in 2017. This also introduced me to the view of addiction as a brain injury, which is a lot more accessible and understandable than disease, something my clients would struggle with. Brain injury seems to make more sense to people, and also helps take the stigma away.

I noticed several reviewers had the complaint that so little attention was paid to behavioral addictions, particularly sex addiction, yet I held the opposite view that too much attention was paid to them. Only gambling addiction is recognized by the DSM, and Van Wormer spent a bit of time on it, and there are good reasons that the other supposed behavioral addictions aren't included. I was also baffled as to why so much time was spent on anorexia and bulimia, which are classified as eating disorders, not addictions. I guess given how much debate the topic of behavioral addictions incites, to people who believe they are true addictions they will see this book as skimming over them while people who are skeptical will see that too much time was paid attention to them.

The societal challenges presented here are accurate, and I liked the models of treatment Van Wormer presented, even if it is frustrating the only a fraction of it is being implemented (or at least in the small, rural area I was practicing in).

I did take issue with her chapter on 12 step programs. Many people are forced to attend 12 step programs or go to prison, which seriously undermines her claim that only people who want to stop using go there. And despite the claims that the higher power can be secular, I've worked with nonreligious clients who are rightfully angry that when they went they were told that their higher power had to be the Christian god. Further, there is nothing grounded in science about the idea that recovery involves surrendering oneself to a higher power. And nevermind the fact that a lot of clients report that the parking lot of NA is the best place to score drugs. Van Wormer tended to use idealized situations to defend the 12 steps, at the expense of ignoring the reality.

Then to me there is the incongruous and unscientific stance that while addiction is a disease, any medicine to treat it is replacing one addiction with another. And harm has come from this (which Van Wormer acknowledged) when sponsors have told people to stop taking anti-psychotics or other anti-depressants. Further, there are promising medical treatments for alcoholism that involve medicine, that are fought against by AA, which ultimately advocates for self control. Trying to spin 12 step groups as science based and strengths based is a hard sell.

Some people do find 12 steps helpful and effective, but it seems that it's more about building a community around not using, and if you fit in demographically with that community, it will help, if not, it won't. Current estimates put that 12 steps only help about 5-10% of people who attend maintain sobriety, which is only slightly better than no treatment.

That aside, this is a good book and overview of the field.

[Georgia · Rating 4 out of 5]

The key for most treatment programs in the United States is to stop viewing addiction as a criminal offense and to start treating it as a public health crisis. Harm reduction is the basis of the foundational approach that works the best and if we implement that we will begin to see changes in death tolls from abuse.

[Natasha · Rating 3 out of 5]

There is a lot of helpful information in this textbook, but often it read more like an OpEd rather than a responsible description of the multiple sides of certain issues. There was plenty I agreed with the authors on, but it would have been nice to have a more complete view of the "other" side to better understand multiple perspectives.

[Steve · Rating 3 out of 5]

Very well written, full of research results, and very thought provoking. The down side of this book is its extremely liberal worldview. The authors, in giving an example of their harm reduction philosophy, suggested giving clean razor blades to a person who cuts him/herself. Their extreme liberal bias obstructs their conclusions.

[Andrea · Rating 5 out of 5]

I used this book for one of my college classes. It is very interesting and approaches addiction from many different aspects and opinions.

[Josh · Rating 5 out of 5]

An excellent strength based perspective on the treatment of addictions.