Clinical Work with Substance-Abusing Clients, Second Edition (The Guilford Substance Abuse Series)

511 Pages·2004·1.88 MB·English

by  Shulamith Lala Ashenberg Straussner

CLINICAL WORK WITH
SUBSTANCE-ABUSING CLIENTS
THE GUILFORD SUBSTANCE ABUSE SERIES
Howard T. Blane and Thomas R. Kosten, Editors
Recent Volumes
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Clinical Work with
Substance-Abusing Clients
Second Edition
Edited by
Shulamith Lala Ashenberg Straussner
THE GUILFORD PRESS
New York London
© 2004 The Guilford Press
A Division of Guilford Publications, Inc.
72 Spring Street, New York, NY 10012
www.guilford.com
All rights reserved
No part of this book may be reproduced, translated, stored in a
retrieval system, or transmitted, in any form or by any means,
electronic, mechanical, photocopying, microfilming, recording,
or otherwise, without written permission from the Publisher.
Printed in the United States of America
This book is printed on acid-free paper.
Last digit is print number: 9 8 7 6 5 4 3 2
Library of Congress Cataloging-in-Publication Data
Clinical work with substance-abusing clients / edited by Shulamith Lala
Ashenberg Straussner.—2nd ed.
p. cm. — (The Guilford substance abuse series)
Includes bibliographical references and index.
ISBN 1-59385-067-0 (hard)
1. Substance abuse—Treatment. 2. Social work with alcoholics. 3. Social
work with narcotics addicts. I. Straussner, Shulamith Lala Ashenberg.
II. Series.
RC564.C57 2004
616.86′06—dc22
2004005221
About the Editor
Shulamith Lala Ashenberg Straussner, DSW, CSW, CEAP, BCD,
CAS, is Professor at the Shirley M. Ehrenkranz School of Social Work at
New York University and Director of their Post-Master’s Program in the
Treatment of Alcohol- and Drug-Abusing Clients. She was a Fulbright Se-
nior Scholar to Israel in 2003; Distinguished Visiting Professor at Ben-
GurionUniversityoftheNegevinBeer-Sheva,Israel,inJanuary2002;and
Visiting Professor at the Omsk State Pedagogical University in Siberia,
Russia, in the spring of 2000.
Dr. Straussner has written numerous publications dealing with sub-
stance abuse. Among her 13 books are International Aspects of Social
WorkPracticeintheAddictions(coeditedwithLarryHarrison;2003,Ha-
worth Press), Understanding Mass Violence: A Social Work Perspective
(coedited with Norma Phillips; 2003, Allyn & Bacon), The Handbook of
Addiction Treatment for Women (coedited with Stephanie Brown; 2002,
Jossey-Bass), Ethnocultural Factors in Substance Abuse Treatment (2001,
Guilford Press), and Gender and Addictions: Men and Women in Treat-
ment (coedited with Elizabeth Zelvin; 1997, Jason Aronson). She also is
the founding editor of the new Journal of Social Work Practice in the
Addictions.
Dr. Straussner has served on the National Center on Substance Abuse
Treatment panel on workforce issues and is a founding board member of
the New York State Institute for Professional Development in Addictions.
Sheservesasaconsultanttovarioushospitals,agencies,andotherorgani-
zations in New York and lectures on a variety of topics throughout the
United States and abroad. She also has a private therapeutic and supervi-
sory practice in New York City.
v

CCoonnttrriibbuuttoorrss
Contributors
Armin R. Baier, JD, CSW, Parallax Center, New York, New York
Insoo Kim Berg, MSSW, Brief Family Therapy Center, Milwaukee,
Wisconsin
Edgar E. Coons, PhD, Department of Psychology, New York University,
New York, New York
Jenna Davis, CSW, private practice, Newtown, Pennsylvania
Nabila El-Bassel, PhD, School of Social Work, Columbia University,
New York, New York
Kathleen J. Farkas, PhD, LISW, ASCW, Mandel School of Applied
Social Sciences, Case Western Reserve University, Cleveland, Ohio
Christine Huff Fewell, CSW, CASAC, Ehrenkranz School of Social
Work, New York University, New York, New York
Audrey Freshman, CSW, CASAC, Tempo Group, Inc., Woodmere, New
York, and Graduate Department of Family Studies, Hofstra
University, Hempstead, New York
Ellen Grace Friedman, PhD, CSW, CASAC, Greenwich House, New
York, New York, and Ehrenkranz School of Social Work, New
York University, New York, New York
Larry M. Gant, CSW, PhD, School of Social Work, University of
Michigan, Ann Arbor, Michigan
Sandy Gibson, PhD, private practice, Morrisville, Pennsylvania
Eda G. Goldstein, DSW, Ehrenkranz School of Social Work, New York
University, New York, New York
Muriel Gray, PhD, School of Social Work, University of Maryland,
Baltimore, Maryland
vii
viii Contributors
Meredith Hanson, DSW, Graduate School of Social Service, Fordham
University, New York, New York
Roberta Markowitz, MSW, CSW, Oakwood Center, White Plains, New
York
Jeffrey R. McIntyre, CADAC, CGP, LMHC, LMFT, Hawley–McIntyre
Associates, Cambridge, Massachusetts
David Ockert, DSW, Parallax Center, New York, New York
Philip O’Dwyer, EdD, CSW, CAC, Brookfield Clinics, Garden City,
Michigan
Margaret O’Neill, PhD, private practice, Riverdale, New York
Lois Orlin, CSW, CASAC, private practice, New York, New York
Patricia A. Pape, MSW, Pape & Associates, Wheaton, Illinois
Shelley Scheffler, PhD, CSW, University Behavioral Health Care,
University of Medicine and Dentistry of New Jersey, Union City,
New Jersey
Belinda Housenbold Seiger, CSW, School of Social Work, University of
South Florida, Tampa, Florida
Evan Senreich, CSW, ACSW, CASAC, Ehrenkranz School of Social
Work, New York University, New York, New York
Kathryn C. Shafer, PhD, LCSW, CAP, School of Social Work, University
of South Florida, Tampa, Florida
Betsy Robin Spiegel, MSW, CSW, private practice, New York, New
York
Diane Pincus Strom, MSW, ACSW, Department of Medicine and AIDS
Program, Bronx Lebanon Hospital Center, Bronx, New York
Shulamith Lala Ashenberg Straussner, DSW, CAS, Ehrenkranz School of
Social Work, New York University, New York, New York
Elena Vairo, CSW, New York City Department of Education and private
practice, New York, New York
Robin Wilson, LCSW, CSW, ACSW, Addiction Treatment Services,
Catholic Community Services/Behavioral Health, Union City,
New Jersey
Elizabeth Zelvin, MSW, CSW-R, CASAC, LZcybershrink.com, New
York, New York
PPrreeffaaccee
Preface
M
uchhaschangedinthefieldofsubstanceabuse(oraddiction)
since1993,whenthefirsteditionofthisbookwaspublished.Asindicated
in the final chapter of this book, the field is constantly evolving as new
substances,newpopulations,andnewtreatmentapproachesdevelopwith-
in ever-changing political and organizational climates. This second edition
is an attempt to cover the main issues in this changing field.
Like the previous edition, this book is organized into five main sec-
tions, with an additional chapter that takes a brief look at the future.
However, updating the state of knowledge required a major reconceptual-
ization of the organization of this book and the addition of a number of
new chapters. Chapters on the motivation of substance-abusing clients,
harm reduction, working with involuntary clients, and treatment of older
adults and of gay and lesbian clients have been added, whereas others—
interventionwithsubstanceabusersinmedicalsettings,theworkplace,and
private clinical settings, and on the use of family “intervention”—had to
be eliminated due to space limitation. When possible, many of the core is-
sues of the omitted chapters have been incorporated into other chapters.
Additional important topics, in particular, ethnocultural issues, have been
omittedbecausetheyareaddressedelsewhere(seeEthnoculturalFactorsin
Substance Abuse Treatment [Straussner, 2001]).
As was true in the first edition, this book is aimed at both beginning
and experienced clinicians, and all of the chapters are written by people
who have front-line experience working with the substance-abusing popu-
lation.
Part I provides an overview of the impact of alcohol and other drugs
on individuals and discusses basic clinical practice issues.
Part II offers varying perspectives on intervention with substance
abusersandincludeschaptersonmotivationalinterviewing,thepracticeof
harm reduction, the use of a solution-focused approach with involuntary
ix