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Rehab: A Comprehensive Guide to Recommended Drug-Alcohol Treatment Centers in the United States.

This book represents the author's personal visits to many chemical dependency treatment centers during a 2-year journey through the 48 contiguous states. It lists 145 centers: 111 are recommended and given detailed descriptions, and the remaining 34 are briefly described in two separate sections. Six of these earned his respect," but are listed separately because they serve women only, and 28 are listed as "honorable mention." The book implies that some centers were visited and not listed, but does not say how many.

Detailed descriptions take four to five pages each (111 centers, 488 pages), and constitute the major section of the book. These descriptions are organized according to a consistent format. Major headings include individual(s) interviewed, brief description, location-accessibility, length of treatment, cost, insurance, residential accommodations, detox unit, age limitations, physical limitations, leaving the premises, gym & recreational program, chapel on premises, treatment, primary therapeutic staff, therapy, relapses, smoking, coffee, food, spacial unit or program for women, AA & NA meetings, family program, aftercare, hospital on premises, admitting hours, key personnel, telephone use, radios/stereos/ cassettes, visitation, author's comments, and rating. Two of these sections are subdivided. Primary therapeutic staff comprises subheadings of patient/therapy staff ratio, percentage of recovering alcoholics/addicts on staff, percentage of counselors certified, psychiatrist or psychologist on staff, and clergy on staff. The therapy section is subdivided into individual therapy and group therapy. Consistent with its heading, the author's comments section contains Hart's opinions and impressions of the facility under discussion; the rating is excellent," very good," or "good." The other sections contain mostly facts about the center's staff, physical facilities and policies.

Facilities listed in the women only and honorable mention categories are each described in one paragraph, emphasizing the author's impressions and opinions.

In the main section of the book, facilities are grouped by states. Forty-one states are represented by at least one treatment center each. States are arranged alphabetically. When a state has more than one center listed, they are arranged alphabetically by name. The honorable mention listings follow the same pattern. The most heavily represented state is California with 18 listings, and Florida is second with 13. Eight states are represented by one center each.

In the introduction, Hart openly acknowledges his perspective as a recovering alcoholic. If he had not, I would still find this viewpoint evident in many of his descriptions. In my view, this perspective adds to the book's value. Recovering people strongly influence the psychosocial climate of most treatment programs.

Hart's introduction also includes a discussion of the criteria he used in deciding whether a facility should be listed. Many of these clearly represent judgment calls, such as love," "simplicity," "inspiration" and "an overall sense of wellness." Other criteria are easier to objectify, such as "solid, tight treatment schedules that emphasized group therapy." Though I found no attempt to quantify any of these criteria, I found this fact more refreshing than troubling for two reasons. First, the writing leaves no doubt about what is opinion and what is fact. Second, the book's mission is not to provide evidence supporting a research hypothesis, but to help people choose treatment programs. To this end, much helpful information is presented quantitatively in the descriptions of the individual centers, such as costs, treatment schedule and staff composition.

Hart is to be commended for including the physical limitations section in which he discusses each center's physical accessibility to people with mobility impairments, and its policies regarding admission of people with severely impaired vision or hearing. Almost a decade after Alcohol Health and Research World devoted an entire issue to the combination of chemical dependencies and other disabilities, I find this matter given less than optimal attention in both the rehabilitation literature and the chemical dependency literature.

The book contains more thorough and useful information about the treatment centers it lists than is offered in most service facility directories with which I am familiar.

In context of my overall favorable impression of this book, I wish to discuss a few remaining concerns. First, large areas of the contiguous 48 states are not represented, and the book offers no suggestions for readers in these areas. I think it would be more useful to these readers if it suggested (a) how to find treatment facilities in one's local area (e.g., offices of the National Council on Alcoholism in most major cities), and (b) how to use the descriptions in the book as a model for evaluating locally available treatment resources.

Second, I wonder how Hart decided which treatment centers to visit. There are many more in the 48 contiguous states than any one person could possibly visit in two years and examine thoroughly enough to provide the descriptions Hart gives for his listed programs. If a particular center in my locality is not in the book, how am I to interpret its absence? Did Hart visit it and find it did not meet his criteria for inclusion? Did he bypass it for a practical reason such as inconvenience to his itinerary?

Third, the data the book provides about treatment facilities can become obsolete very rapidly. Staff turnover, board decisions, and population changes in the surrounding community can all profoundly affect a treatment program. So can the health of one person in a prominent position. Though the book does not say when each listed center was visited, I do not miss this information. The time usually required to bring a book to print offers ample opportunity for even the most recently visited program to undergo important changes. Therefore I recommend that users routinely verify the current status of any information about a treatment facility before making a referral.

These considerations lead me not to criticize the book for omitting information about staff qualifications to serve people with sensory and motor disabilities. When referring a client with a disability, I like to know how well staff understand the implications of the disability, and what attitudes they have toward it. Unless such matters are part of agency policy, they may change and are therefore better left to users' current inquiry than included in a book's descriptive information. A recommendation that users make this inquiry would have strengthened the book.

In sum, I think this book belongs on the desk of any practitioner likely to refer clients for recovery services. Its price is quite modest in comparison with other books of similar size and quality. Considering the prevalence of chemical dependency problems in the U.S. population, I think any human service practitioner should be prepared to make such referrals. Robert G. Hadley, Ph.D., CRC, CIRS, professor emeritus, Rehabilitation Counselor Education Program, California State University, Los Angeles.
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Author:Hadley, Robert G.
Publication:The Journal of Rehabilitation
Article Type:Book Review
Date:Jan 1, 1990
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