A History of Addiction and Recovery in the United States. (Reviews).
What helps individuals break from heir addictions? What programs have been tried? Which ones work?
For answers, read this book. In it, Michael Lemanski (who has written on the addiction treatment field for the Humanist), traces the history of addiction treatment in the United States and explains why things are the way they are.
He shows, for instance, that the recovery movement over the past 250 years has been more of a religious than a scientific enterprise. He charts the path of the early temperance movement, which began in the late-1700s, to the mid-1800s group the Washingtonians to the Woman's Christian Temperance Union (WCTU), which started in 1874. All of these offered recovery programs requiring acceptance of religious dogma.
Not much changed in the early twentieth century. Organizations to help people struggling with alcohol addiction remained firmly religious. The Salvation Army, a Christian group, offered food and shelter along with "nine steps" to help problem drinkers find a new life. (Compare these nine steps to Alcoholics Anonymous' twelve steps.) Then there was another Christian-based program, the Emmanuel Movement, which interestingly included some Freudian psychoanalysis in its otherwise spiritual approach. In addition, there were the religious and moral activists who pushed for, and helped to bring about, Prohibition, the U.S. ban on the sale and consumption of alcoholic beverages which lasted from 1920 to 1933.
The immediate predecessor to AA was the Oxford Group Movement/Moral Re-Armament, a Christian-based program--complete with regular meetings --designed to help people turn their lives around by finding God and "becoming moral." Both Bill Wilson and Dr. Bob Smith were members of Oxford Groups when they founded what was to become AA.
Lemanski describes these early recovery programs with great precision. He then covers the entire history of the monopoly by AA of addiction care--from the organization's origin in 1935, through its heyday in the 1970s and 1980s, to its leveling off in the mid- to iate-1990s, and the beginning decline in the present day.
He also covers the origination and development of the disease concept of addiction and demonstrates how it parallels the growth of--and, indeed, is wedded to--AA. Lemanski analyzes the reasons for the broad-based acceptance of the disease model and also the many inconsistencies in its application.
For instance, he poses, if addiction is a disease with obvious physical origins, then why would one recommend as treatment a religious or spiritual program that encourages addicts to make a connection with God and revamp their moral lives? Lemanski describes this obvious mismatch and shows how addiction treatment in the United States evolved, in spite of this, into an AA-dominated industry.
He also analyzes AA's efficacy as a treatment program. This analysis alone should be required reading for every treatment professional working in the addiction field today. It would help therapists, counselors, and program managers to realize, first, that AA does not work for everybody (indeed it works for a surprisingly small percentage); and, second, that they can help clients achieve more lasting recovery by offering a broader array of treatment modalities and matching each client to the modalities that work best for him or her.
This latter approach, called client-treatment matching, is likely to become the gold standard of addiction treatment. As scientific research demonstrates the efficacy of more and more therapies and treatment modalities in treating addiction, an increasing number of treatment professionals will begin offering these as part of the standard fare.
What are some of these alternative treatments? Lemanski provides snapshot reviews of various treatment modalities, types of therapies, and self-help groups--all of which have been proven successful with some significant percentage of clients.
Today, every treatment professional needs to know these alternative treatments and be prepared to offer them directly to clients or to make referrals so that clients can access these treatments elsewhere. Sadly, few addiction professionals do this currently. But when they become more savvy to the alternatives, then the addiction treatment field will compare favorably with, for example, the field of psychology. Within the past hundred years, psychology grew from one primary psycho-therapeutic intervention, Freudian psychoanalysis, to the dozens upon dozens of successful interventions which are used today.
With this book, Lemanski offers not only a remarkably exciting read but an immensely important work on this topic. Everyone associated with the addiction treatment industry can benefit by reading it. As Goethe said, "Those who do not understand the past are doomed to re-live it." We need not relive the nightmares of addiction treatment past. We can move ahead.
Jerry Dorsman, B.A.C., is the author of two books on addiction, How to Quit Drinking without AA (revised edition, 1994) and How to Quit Drugs for Good (1998). He works as an addictions therapist for Upper Bay Counseling and Support Services in Elkton, Maryland.
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|Article Type:||Book Review|
|Date:||Mar 1, 2002|
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