Addictions: Concepts and Strategies for Treatment.

Lewis JA, ed. Gaithersburg, MD 20878, Aspen Publishers Inc, 1994, hardback, 393 pp, $49.

Judith Lewis pulled together the writings of more than 50 mental health specialists for this cohesive, readable text with the Purpose of linking theory to practice in the field of addictions. The book clearly shows how past and present theories of addiction shape treatment approaches used to manage addictive behaviors. It is written for professional counselors who specialize in treating addictions. Counselors with other specialties, however, will find the book helpful, as addictive behaviors often occur concurrently with other adjustment problems.

The book is divided into six sections: part 1 is an overview of the addictions field, parts 2 through 5 deal with various treatment approaches and models, and part 6 is an annotated bibliography of current resources.

"Treating Addictions," part 2, has separate chapters that deal with alcohol problems, drug abuse, eating disorders, smoking, and pathological gambling. Each chapter in this part examines the effectiveness of current treatment strategies and the emerging trends in treatment approaches. The influence that biological, psychological, and social factors have on the successful outcome of treatments is emphasized. Chapter 11, "Maintaining Change in Addictive Behavior," is the most thought provoking. it explores the need for counselors to relinquish control over their client's behavioral changes. It is proposed that, in order to maintain change achieved through direct therapeutic interventions, counseling goals should become the development of a healthy reliance on family members, friends, other support groups, and on the client's own personal strengths.

"The Pharmacology of Addictions," part 3, is well written and easy to understand. It covers the pharmacology of alcohol, abused drugs, and nicotine. This section adds meaning to the information that precedes and follows it in the other sections of the book.

Part 4 is entitled "Family Therapy and Addictions." As stated in the introduction, family therapy has become the choice of treatment for addictions. The six chapters in this section cover a wide range of topics, including role behavior, denial, special issues for addicted women, and the problems of adult children of addicted parents. Chapter 16, "The `Taking Charge' model of Recovery for Addictive Families," discusses strategies that could be used with families struggling to adjust to life with a disabled family member.

Part 5, "Innovations in Thought and Practice," reviews seven distinct treatment models. The fact that so many alternative approaches are being piloted and studied for therapeutic value and cost-effectiveness attests to the impact that persons who are addicted have on our society. This part further highlights the fact that there is no universal method for managing the diverse populations who engage in debilitating addictive behaviors. Case studies found in parts 4 and 5 help the reader understand how different counseling approaches are applied to treatment models for addictions.

Whether read in its entirety, by section, or by chapter, Addictions: Concepts and Strategies for Treatment should be a useful book for all types of counselors. Addictions, especially substance abuse, are often associated with accidents, disease, or disability; therefore, the book is also relevant for professionals in the field of physical rehabilitation who frequently deal with clients who have multiple problems.

Marylou Ingles, PT Sullivan County BOCES Liberty, NY

Ms Ingles is director of physical therapy at the Sullivan County BOCES, specializing in school-based therapy. She bas worked extensively with patients with dual diagnoses of psychiatric disorders and individuals with developmental disabilities.