Book Review
Addiction 
Psychosocial Treatments Elinore F McCance-Katz, H Westley Clark, editors. New York: Brunner-Routledge; 2004. 173 p. US$34.95.
Reviewer
rating*: Excellent
Review by: Nady el-Guebaly, MD
Calgary, Alberta
The American Academy of Addiction Psychiatry, a professional membership organization of some 1000 members, has over the last 3 years provided an annual quick guide to selected treatment approaches and research studies in the addiction field. The Key Readings in Addiction Psychiatry series seeks to advance the knowledge of those committed to the field as well as to introduce newcomers to recent advances.
The series began with a summary of the pharmacotherapy of addictions, followed by a volume on the treatment of dual disorders; it now addresses psychosocial treatments supported by selected clinical trials. No information is provided about the editors, but they are both well-respected scholars in addiction psychiatry. One would like to know more about the scope of their review and the selection criteria for inclusion in the Series.
This book essentially compiles selected reprints from various sources. There are 6 recent articles from the American Journal on Addictions (the Society’s journal, also published by Brunner-Routledge), an article from the Journal of Substance Misuse (same publisher), an article from the Archives of General Psychiatry, one from Addiction Behaviors, and 2 from Alcohol, Research and Health.
The first article, by ME Larimer and colleagues, presents an overview of Marlatt’s relapse prevention approach. Specific interventions, such as identifying high-risk situations, as well as global strategies, such as balancing one’s lifestyle, are described. An outline of recent research and potential modifications to the original model conclude the article.
The second review article, by WC Noonan and TB Moyers, summarizes the tenets of motivational interviewing aimed at assisting individuals to explore and resolve their ambivalence and thereby increase motivation for change. The evidence supporting the efficacy of this approach is detailed through 9 studies; in addition, 2 studies that did not lend support to the intervention’s efficacy are included. Again, future research directions conclude the review. An additional effectiveness study by KM Carroll and colleagues supplements the review.
The fourth selection, by M Galanter and colleagues discusses an application of his network therapy to the treatment of cocaine dependence. Network therapy is an interesting approach for solo practitioners, employing a cognitive-behavioural orientation in sessions with individuals as well as with family and peers.
The fifth chapter, by WR Miller and colleagues, describes the community reinforcement approach aimed at eliminating positive reinforcement for drinking and enhancing positive reinforcement for sobriety. This approach’s flexibility has allowed its integration with a range of diverse strategies, such as family therapy, motivational interviewing, and the treatment of special populations, such as Native Americans.
The sixth chapter, by ST Higgins and colleagues, describes the voucher-based incentives approach originally developed to improve the retention of cocaine-dependent patients and now extended to the treatment of a wide range of populations and substance abuse problems, including smoking among pregnant women.
In the next selection, RA Rawson and colleagues offer a clinical comparison of contingency management (CM) and cognitive-behavioural therapy (CBT) approaches during methadone maintenance treatment for cocaine dependence; the effect of CM is found to be significantly greater during treatment, whereas CBT produces comparable long-term outcomes.
A study of self-help strategies by J Westermeyer and colleagues forms the eighth chapter. Most patients tried one or more types of self-help, either by employing methods related to the substance (such as decreasing amounts or frequency) or by joining a self-help group. Methods involving changing friends, residence, or occupation were used less frequently.
The ninth selection, by WJ Kasprow and colleagues, compares reports from residential treatment facilities for homeless veterans with dual diagnoses. Although differences were modest, integrating substance abuse and psychiatric treatment may promote a faster return to community living for this population. The benefits of integration were not furthered by the presence of a psychotic disorder.
The tenth chapter, by Y Kaminer and JA Burleson, describes a 15-month follow-up study of adolescents randomized into out- patient CBT and interactional treatment (IT). At 3 months, the CBT group demonstrated significantly reduced substance abuse, compared with the IT group, but the difference disappeared at 15 months, with significant gains for both groups.
The last selection, by SE Martin, outlines the links between alcohol, crime, and the criminal justice system. Environmental intervention strategies, as well as individual treatment strategies for offenders, are noted. This last selection seems to blend less well with the other topics.
In summary, editors from the American Academy of Addiction Psychiatry have highlighted several recent articles reviewing the evidence underpinning various psychosocial approaches. In the absence of clear selection criteria, some bias may be construed toward articles published in the Academy’s journal. Any selection is open for debate, and I am left to wonder why, in this series on psychosocial treatment, there were no publications selected about the evidence underpinning group therapy or therapeutic communities.
I would recommend the series to members of the Academy and other professional associations specializing in addictions who wish to benefit from the editors’ selection effort. This should not replace the use of a broader text for those who want to acquaint themselves with the field. For those specializing in the treatment of addictions who do not subscribe to the American Journal on Addictions, the cost is particularly appropriate.
*Reviewer
Rating Scale/ Échelle d’évaluation du réviseur
Excellent / Excellent
Very Good / Très bon
Good / Bon
Fair / Passable
Not recommended / Pas recommandé
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