Walk the Walk and Talk the Talk: An Ethnography of a Drug Abuse Treatment Facility.

Walk the Walk and Talk the Talk is a book written by Geoffrey R. Skoll after studying "the culture" vis-a-vis a participant-observer of a Drug Treatment Facility (DTF) in the Midwest. He was introduced to the DTF after starting work there as a counselor and wrote this ethnography after three years of work in it. This book represents a case study of a residential therapeutic community for drug abuse treatment. It provides an interesting close up of the sociopolitical make up of a DTF. It is composed of an introduction, seven chapters, and a notes, reference, and index section.

In the Introduction the author orients the reader to the nature of DTF and compares it to group homes which he had previous work experience in. Worth noting is the fact that DTF is based on the synanon model of treatment; and for those readers unfamiliar with this treatment approach, it is explained in detail. The author continues to introduce the reader to "The Case Study," and gives a description of the DTF and its historical perspective. In Chapter 2 he describes the primary inhabitants, "residents," of the DTF. He takes the reader through the process of how the residents arrive at DTF, enters the facility, and the stages of treatment they go through. He explains "who's who" in the social structure of the residence, and what a typical treatment day consists of. In the DTF a typical treatment day begins with a morning meeting followed by morning groups, a noon day meal and loosely structured activities. The evenings are more for the residents' discretion. Next, he reveals how the "residents" survive the program's "moral commitment" and experience successful or unsuccessful egress from it. After this, Chapter 3 looks at "The Counselors." It outlines how to become a drug counselor, what counselors do, and the contradictions and conflicts common to counselors in this DTF.

Chapter 4-begins to look at the working socio-political dynamics common to most DTF's, thus the chapter title, "The Political Economy." The political economy is examined from three perspectives: from the inside, the outside, and the historical. This chapter reveals to the reader how the DTFs are funded at local and state levels and how residents provide environmental support to the DTF as part of their "treatment." The ideology of DTF is explained in Chapter 5. In DTF the idea is for the resident to attain a level of functioning which will promote group format which maintains a centrality for the resident and keeps them trapped within it. In Chapter 6, the author describes the different types of discourse common in the treatment program. They are as follows: coffee talk, cigarette talk, aspirin talk, drug talk, ceremonial talk, discourse of identity, gender talk, race talk, and talk about class. These forms of discourse appear to be primary in forming social order and framing interactions between residents and counselors and residents and other residents.

In the author's conclusion of Chapter 7, he makes some very interesting points on the overt and covert dynamics of day to day interactions of the staff and residents. But most striking is how he reveals "hegemony" as the primary dynamic at work in the DTF. A dynamic which is enacted by the staff and outside social forces. One who is knowledgeable in residential treatment of alcohol and drug use disorder knows why the synanon model is less desirable and ineffective. But for those who are not and want to learn about the basic structure and function of one, then this book will be instructive. However, keep in mind that the treatment approach and philosophy is not representative of most residential treatment centers.

Chapters 5 and 6 do seem to be representative of most residential treatment programs that I have worked in, and it is felt the author hits the bulls-eye with his typing of discourse utilized by staff and residents.

Hopefully, further study will be given to this essential ethnographic part of residential treatment by the author. Also in closing, this book can provide insightful and objective observations to those of us who do work in the field of alcohol and drug treatment, and give pause for reflection on our own interactions with clients.

H. Andy Williams, M.S., C.R.S. North Aurora, Illinois