Book Review
Substance Abuse 
Clinical Work with Substance-Abusing Clients Shulamith Lala Ashenberg Straussner, editor. New York (NY): The Guilford Press; 2004. 494 p. US$55.00.
Reviewer
rating*: Excellent
Review by: Ewa Swoboda, MD
Saskatoon, Saskatchewan
Working with substance-abusing clients is not an easy task, it is a challenge that can be successfully addressed with specific knowledge, skills, realistic expectations, and awareness of one’s own countertransference reactions (p 304).
This short quote from Clinical Work with Substance-Abusing Clients describes the essence of this book remarkably well.
Recent years have brought many new publications about issues relevant to substance abuse and its treatments. They present the topic from various angles and perspectives as the field rapidly develops and new trends in treatment constantly emerge.
The book, edited by Dr Straussner and published in 2004, is a comprehensive, informative, and well-written review. It targets mostly front-line addiction and mental health clinicians, such as social workers, clinical psychologists, family therapists, psychiatric nurses, addiction counsellors, general psychiatrists, psychiatry residents, and medical students. It can also be used by other health professionals, including family physicians who deal with substance abusing patients only occasionally, or by those simply interested in addictions. The strength of this text is its versatility: beginners will see this publication as a rich source of information with numerous clinical vignettes, while experienced readers will find it a good refresher and update.
Dr Straussner is a respected scholar and lecturer in the field of substance abuse and has authored many publications and books related to the topic. Her thorough understanding of the field of addictions comes from years of work as a clinician and lecturer, as well as service on various boards and advisory panels. The contributors to this publication include many renowned writers, such as Insoo Kim Berg and Audrey Freshman.
The first edition was published in 1993 and the new 2004 edition provides an updated review of crucial issues in substance abuse, shedding new light on previous perspectives and treatment approaches. The material is well organized and clearly written. The main focus is practical aspects of working in different areas of addiction. The concise and straightforward manner in which information is presented allows the editor to make the book simple and readable while covering an extensive range of theoretical material. The book can be read in its entirety by students and newcomers to the field or selectively by those interested in particular chapters. Its concise style and simple format should encourage teachers to use it as a scholastic textbook.
The book consists of 6 main parts. Parts 1 and 4 are written by Dr Straussner and provide a general overview and conclusion for the book, respectively. Parts 2 to 5 are dedicated to different aspects of the substance abuse field and are organized in a similar fashion. Each part starts with a brief forward explaining the content of that particular section and contains several chapters, each written by a different author.
Part 2 (Chapters 2 to 7) provides a review of different models of intervention with substance abusers, including a 12-step program, a structured relapse-prevention model, motivational interviewing, a solution-focused approach, and a harm-reduction model. The presentation of different models is nonjudgmental and honest while emphasizing that “there is no single ‘correct’ model of intervention” (p 37) and that the clinician is free to choose any technique, depending on the clinical situation. In Part 3 (Chapters 8
to 10), the reader finds the description of different therapeutic approaches to treatment of dependence on alcohol, opiates, and stimulants. Part 4 (Chapters 11 to 13) is the review of interventions with couples and families. Finally, Part 5 (Chapter 14 to 20) deals with unique issues of treatments for special populations: adolescents, older adults, women, the homeless, patients with dual diagnosis of substance abuse and borderline personality disorder, substance abuse patients infected with HIV, and gay, lesbian, and bisexual patients. The chapters are written in an easily readable and professional manner and contain updated epidemiologic and demographic information as well as samples of assessments and screening tools, tables, DSM IV-TR diagnostic criteria where applicable, numerous clinical case scenarios and vignettes, and exhaustive lists of references.
This book is an excellent resource for front-line substance abuse and mental health clinicians and a good-quality basic textbook for other professionals. It is concise, informative, and clear, with a wide selection of mostly American references. It would have been nice to see the addition of a few chapters addressing the treatment of aboriginal populations and ethnic communities as well as the use of groups and therapeutic communities in long-term substance abuse treatments. Otherwise, it is an excellent textbook.
The book comes in hardcover with an unassuming, but appropriate, front layout. It is reasonably priced, although it may be too expensive for students. I have no hesitation recommending this book to psychiatrists, mental health workers, addiction clinicians, and especially psychiatry residents and medical students as an informative, comprehensive, and clearly and concisely written textbook.
*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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