Social Work Practice in the Addictions

273 Pages·2013·2.09 MB·English

by  Matthew O. Howard

Contemporary Social Work Practice
Series Editor
Christina E. Newhill
For further volumes:
http://www.springer.com/series/8853

Michael G. Vaughn Brian E. Perron
●
Editors
Social Work Practice
in the Addictions
Editors
Michael G. Vaughn Brian E. Perron
Saint Louis University University of Michigan
St. Louis, MO, USA Ann Arbor, MI, USA
ISBN 978-1-4614-5356-7 ISBN 978-1-4614-5357-4 (eBook)
DOI 10.1007/978-1-4614-5357-4
Springer New York Heidelberg Dordrecht London
Library of Congress Control Number: 2012950336
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Preface
Several important developments motivated us to pull together a volume on social
work practice in the addictions. First, social workers represent the largest body of
addiction and mental health service providers in the USA and many other countries.
Consequently, a growing interest in issues of addiction in schools of social work
throughout the USA and abroad is being observed. This is exempli fi ed by an
increased number of addiction-related courses, certi fi cate programs, fi eld place-
ments, research projects, and peer-reviewed articles. Despite these developments
and the impact that addictive behaviors have on client populations, the fi eld of social
work lacks authoritative resources to help ensure social workers receive training
based on the best available knowledge and interventions in addictions. Quite sim-
ply, social workers are not being exposed to the most current developments in the
fi eld of addiction research. Existing texts are not suf fi ciently comprehensive and not
based on the cutting-edge information. As such, the fl owering of evidence-based
science in this domain is inhibited.
The absence of an authoritative book on addictions speci fi cally written for social
workers is critically needed. Thus, this volume fi lls the gap by providing a compre-
hensive evidence-based guidebook that can serve as the cornerstone for courses in
the addictions at schools of social work. Cutting-edge yet user- friendly, this book
can be used by not only graduate and undergraduate students in social work but also
researchers and practicing social workers who seek to update their knowledge. This
volume is designed to provide state-of-the-art information that can be used as a
reference guide that will facilitate the advancement of knowledge in social work and
beyond.
Several issues bear mention that pertain to terminology and the future of diag-
nostic systems. We use the term addictions as an umbrella term in this volume to
include substance use, abuse, and substance-related problem behaviors and not
solely dependence. The reason for this is substance dependence is intimately con-
nected to these other categories either by prior progression and relapses or by the
myriad behavioral consequences of dependence. Thus, several chapters discuss
and present information pertaining to the use and abuse of intoxicants and related
v
vi Preface
behaviors. Although we realize that many behaviors such as compulsive video
game playing and exercise dependence can be considered under the general rubric
of addictions, our focus is on alcohol and other drugs. However, much of what is
covered in this volume is applicable to these emerging areas of addiction. At the
time this volume was completed DSM-V has not been implemented. As is the case
with the classi fi cation of mental health disorders we realize that the revisions to
substance use disorders are projected to be signifi c ant. In order to maintain rele-
vance especially to information consistent with DSM-V we will add updated sup-
plemental materials to the web site for this book. This will be especially useful for
instructors who adopt the volume for their courses and wish to remain current.
Contributing authors represent many of the leading social work addiction
researchers. Additionally, we include researchers from other allied fi elds, including
psychiatry, psychology, and epidemiology, to ensure a strong interdisciplinary
focus. In short, this is an impressive lineup of distinguished scholars and rising
stars. Unlike other texts on addiction outside of the fi eld of social work, this book is
infused with content relating to social justice and practice with diverse communities
to represent the knowledge base of social work. Further, we add chapters on the
etiology and epidemiology of addiction and alcohol and drug policy, elements typi-
cally not included in social work books on addictions. We include these elements
because in our view social workers bene fi t from an understanding of the causes of
addiction, their prevalence, and patterns, and the policy context in which alcohol
and illicit drug use, abuse, and dependence occurs. Thus, this volume is comprehen-
sive, social work friendly, and interdisciplinary.
The structure of the volume is divided into four major parts. Part I covers foun-
dational material related to the various perspectives on addiction, epidemiology, and
explanatory theories. In Chap. 1 , “Historical and Contemporary Perspectives,”
Howard, Garland, and Whitt document the rise of perspectives on addictions includ-
ing important developments that formed addictions as a professional and academic
fi eld. They also describe the various models of addiction and substance abuse such
as the moral, educational, spiritual, psychological, sociocultural, biological, public
health, and neurocognitive. The distribution of addiction and its mental health
comorbidities particularly with respect to services for af fl icted persons is taken up
by Michael Fendrich in Chap. 2 , “Epidemiology.” In Chap. 3 , “Etiology,” Michael
Vaughn uses a cell-to-society framework to provide an explanation of the genetic
and environmental causes of substance abuse and addiction.
Part II brings together the major components of assessment, diagnosis, and treat-
ment. In Chap. 4 , “Assessment Strategies for Substance Use Disorders,” Michael
Mancini elucidates the assessment process as acquiring and synthesizing informa-
tion but most importantly establishing a productive therapeutic alliance in order to
engage them in treatment and to develop an understanding of the role substances
play in a person’s life across multiple psychosocial domains. In Chap. 5 , “The
Language of Diagnosis,” Ahmedani and Perron focus on using the Diagnostic and
Statistical Manual (DSM) as a basis for diagnosis in social work practice. They
provide an overview of the DSM, including basic information on the multiaxial
assessment and diagnostic coding including making distinction between substance
Preface vii
use disorders (i.e., abuse and dependence) and substance-induced disorders
(i.e., intoxication, withdrawal, and substance-induced mental disorders). Recent
years have witnessed the rise of briefer motivation-based interventions in the
addictions’ fi e ld. In Chap. 6 , “Brief Motivational Interventions to Change
Problematic Substance Use,” Ilgen and Glass examine the empirical evidence sup-
porting brief motivational interventions and explain the essence of motivational
interviewing. They argue that s ocial workers employed in a variety of practice set-
tings (e.g., substance abuse treatment, mental health or medical settings) are well
positioned to identify individuals who could be appropriate for brief motivational
interventions. In Chap. 7 , “Cognitive Behavioral Therapy with Substance Use
Disorders: Theory, Evidence, and Practice,” Granillo, Perron, Jarman, and
Gutowski tackle the cognitive behavioral therapy (CBT) paradigm as applied to
substance use disorders. CBT represents a broad class of interventions that take
into account how learning processes are involved in developing and maintaining
maladaptive thought patterns, emotional reactions, and behavioral responses. The
fi nal chapter i n Part II examines the recovery process. In Chap. 8 , “Philosophy and
Practice of AA and Related Twelve-Step Programs,” Pickard, Laudet, and Grahovac
discuss the often misunderstood 12-step programs that are voluntary, nonprofes-
sional, self-directed groups that use peer support to promote recovery from an
addiction. As these authors astutely point out social workers possess minimal train-
ing in the philosophy and practice of 12-step programs, preventing them from
maximizing the benefi ts of this important resource.
Part III is unique in providing cutting-edge information on speci fi c populations.
In Chap. 9 , “A Framework for Integrating Culture, Diversity, and Social Justice in
Addictions,” Castro and Gildar recognize the important role that culture and diver-
sity plays in addiction. They outline a multidimensional framework for integrating
culture into addiction. Next, in Chap. 1 0 , “Empirical Status of Culturally Competent
Practices,” Marsiglia and Booth examine effective prevention and treatment pro-
grams that are rooted in each individual client, their families, and their larger social
and cultural networks. This chapter considers the role of culture of origin in relation
to resiliency and protection from substance abuse and addiction processes. Substance
use and abuse during adolescence is the focus on Chap. 1 1 , “Adolescents,” by
Bender, Tripodi, and Rock. These researchers survey the empirical literature and
highlight numerous concerns during this developmental period vis-à-vis substance
abuse. These concerns include psychosocial problems, cognitive de fi cits, and
reduced motivation to succeed academically. In Chap. 1 2 , “Women and Families,”
Bonnie Carlson draws comparisons between males and females with respect to
alcohol and drug use problems with particular attention to treatment admissions,
stressful life events, childhood and/or adult interpersonal victimization, pregnancy
issues, and impaired parenting. Carlson outlines and discusses available best prac-
tice guidelines for providing services for women who abuse or are dependent on
substances. Finally, in Chap. 1 3 , “Older Adults,” Sacco and Kuerbis point out that
greater numbers of older adults will need treatment for substance-related condi-
tions. To prepare practitioners for these trends, this chapter speci fi es the unique
viii Preface
challenges and age-speci fi c risks regarding assessment and treatment of unhealthy
substance use, including prescription drug use, among older adults.
Social work practice in the addictions occurs within a de fi nite policy context.
Thus, Part IV focuses on key developments in alcohol and drug policy. Building a
bridge between policy and practice is the overall goal of this section. In Chap. 14 ,
“Alcohol Policy,” Jennifer Price-Wolf and Lorraine Midanik provide a critical
appraisal of policies surrounding the use, abuse, and dependence of alcohol includ-
ing biomedicalization, prevention, and harm reduction. Importantly, these authors
demonstrate the links between these larger social issues and how they impact social
work practices such as assessment. In Chap. 1 5 , “Drug Control Policies: Problems
and Prospects,” Maayan Schori and Eli Lawental confront issues of drug policy.
More speci fi cally, Schori and Lawental place special emphasis on historical, eco-
nomic, legal developments as well as treatment and rehabilitation policies. These
authors conclude, among other things, that real change in drug policy is dif fi cult
without a major shift in public perceptions about drug use.
In sum, this volume is designed to p rovide and enhance the knowledge and skill
set of social workers about the addictions’ arena. Given the enormous number of
persons affected by substance use disorders and substance-related problem behav-
iors it is our hope that this volume contributes to increased effectiveness by social
workers in this often neglected domain of practice.
St. Louis, MO, USA Michael G. Vaughn
Ann Arbor, MI, USA Brian E. Perron
Contents
Part I Overview and Foundations
1 Historical and Contemporary Perspectives .......................................... 3
Matthew O. Howard, Eric L. Garland, and Ahmed Whitt
2 Epidemiology ........................................................................................... 23
Michael Fendrich
3 Etiology .................................................................................................... 35
Michael G. Vaughn
Part II Assessment, Diagnosis, and Treatment
4 Assessment Strategies for Substance Use Disorders ............................ 49
Michael Mancini
5 Language of Diagnosis ............................................................................ 73
Brian K. Ahmedani and Brian E. Perron
6 Brief Motivational Interventions to Change Problematic
Substance Use .......................................................................................... 87
Mark A. Ilgen and Joseph E. Glass
7 Cognitive Behavioral Therapy with Substance Use Disorders:
Theory, Evidence, and Practice ............................................................. 101
M. Teresa Granillo, Brian E. Perron, Christopher Jarman,
and Sarah M. Gutowski
8 The Philosophy and Practice of Alcoholics Anonymous
and Related 12-Step Programs .............................................................. 119
Joseph G. Pickard, Alexandre Laudet, and Ivana D. Grahovac
ix