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Key Readings in Addiction Psychiatry: Psychosocial Treatments

Curtis N. Adams, M.D.

The series Key Readings in Addiction Psychiatry aims to keep readers current with the existing literature on addictions. Psychosocial Treatments is the third book in this series. Each of its 11 chapters is an article, ranging from the presentation of pilot data to a series of review articles. Most of the articles focus on adults, but one article addresses addicted teens. In addition to articles describing interventions, a policy article is included.

One of the strengths of Psychosocial Treatments is that it presents material to which people who focus on the psychiatric services literature may not be exposed. That's because most of the book's articles are written from an addictions perspective. A few touch on dual diagnosis, but the primary emphasis is on the addictions literature.

The book does not dictate what to do but describes which psychosocial treatments are available. After that, it is up to the reader to examine a particular area that might be of interest.

Some of the interventions that are detailed can be easily adapted to an already existing program, as demonstrated in the third chapter, "Motivational Interviewing to Enhance Treatment Initiation in Substance Abusers: An Effectiveness Study." This chapter shows how motivational interviewing can be incorporated into a standard interview and result in increased enrollment in substance abuse treatment.

Other interventions, such as the one described in "Relapse Prevention: An Overview of Marlatt's Cognitive Behavioral Model," seem to require much more of a culture shift if they are to be introduced in their entirety to a clinic or a community mental health center. This being said, one can choose elements of relapse prevention and integrate them into one's current practice to enhance it, without adopting the entire approach. For example, the authors of the chapter on relapse prevention break relapse into multiple discrete entities as opposed to one event. With such a breakdown, the reader can easily see how many points of intervention there actually are between abstinence and full-blown relapse. And each element offers an opportunity for the person with the addiction to learn about his or her particular addiction at a more specific and individualized level. For service providers who are involved in the management of funds for patients, the voucher and contingency management elements described in several articles may be very helpful.

Psychosocial Treatments hits its target. It offers an array of interventions that one can use and that can restore the morale of the practitioner who thinks he or she has tried everything. It's particularly useful for those of us who have become wedded to one particular strategy and have missed or ignored others.

Footnotes

Dr. Adams is affiliated with the Department of Psychiatry, University of Maryland, Baltimore.

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