Changing Substance Abuse and Criminal Behavior Through Therapeutic Relationships

223 Pages·2016·5.43 MB·English

by  Debra H. Benveniste (auth.)

Changing
Substance Abuse
and Criminal Behavior
through Therapeutic
Relationships
DEBRA H. BENVENISTE
Changing Substance Abuse and Criminal
Behavior Through Therapeutic Relationships

Debra   H .   Benveniste
Changing Substance
Abuse and Criminal
Behavior Through
Therapeutic
Relationships
Debra   H.   Benveniste
Dayville , Connecticut , USA
ISBN 978-1-137-53038-7 ISBN 978-1-137-53039-4 (eBook)
DOI 10.1057/978-1-137-53039-4
Library of Congress Control Number: 2016938716
© Th e Editor(s) (if applicable) and Th e Author(s) 2016
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with the Copyright, Designs and Patents Act 1988.
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Cover illustration: © Steven C. Ross
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Th is Palgrave Pivot imprint is published by Springer Nature
Th e registered company is Macmillan Publishers Ltd. London
Acknowledgments and Dedication
Although I am the author of this book, in many ways I have only been a
conduit for others. A great many of the people who contributed to this
book will have to go unnamed. I know that many of them had hoped
that there was something positive about themselves that they could
give to others to make up for the damage they have caused. Others are
deceased and never had the chance to realize their potential in life. I have
attempted to convey what was compelling, wise, and important about all
of them, so that those qualities can live on in some way.
I started out in this fi eld as a drug counselor, working without the
benefi t of a clinical degree. My fi rst clients, particularly Billy, Bobby, and
Jeff , patiently and thoroughly schooled me about the nature of heroin
addiction. Th ey helped me to be wise beyond my young age and lack of
experience. Many of those clients succumbed to the AIDS pandemic just
as it was beginning.
Th e Smith College School for Social Work provided me with an
excellent education in psychodynamic theory and therapy. Post master’s,
the incarcerated clients I worked with, particularly Marc and Ron,
allowed me into their internal worlds and helped me to understand the
complexity of violent crime. Since then in private practice, I have worked
with clients with substance abuse problems and those in secondary
desistance from criminal behavior. A thank you to Terry, Jeff , and Bill,
who helped me to understand the role of trauma in substance abuse.
v
vi Acknowledgments and Dedication
To all of my clients who have lost hard-fought battles with their demons,
may they rest in peace.
I am thankful to Simmons College School of Social Work and my
doctoral committee for supporting the dissertation which produced the
results used for this book. I am especially grateful to Dr Heith Copes for
his wisdom and availability. A very special thanks to Sam Williams, the
community advisor for the project, whose help with the pilot study was
invaluable. I am very grateful to the “group of 11,” my respondents who
gave of their time and of themselves to share their desistance process with
me. I thoroughly enjoyed meeting with them and wish them all the very
best in their journeys. Th ank you to Nicola Jones and Eleanor Christie
at Palgrave Macmillan for their support of this work. I am grateful to
Shannon Dohar for her reading of the manuscript and for her advice
and suggestions. Th is book is dedicated to my husband, Steve, who has
provided me with unfailing support and encouragement throughout all
of these endeavors.
Contents
Part I Overview 1
1 Introduction 3
Issues in Analyzing and Presenting the Data 5
Psychodynamic Th eory as a Framework
to Explore Relational Dynamics 6
Strange Bedfellows 8
Treatment Models Which Integrate CBT
and Psychodynamics 10
A Relational Analytic Practice Model for Desisters 12
References 13
2 Th e Men’s Stories 17
Overview of Study Methodology 18
Demographic Information 19
Narratives 22
Summary 39
References 39
vii
viii Contents
Part II Relational Analytic Th eory
and Desistance 41
3 Th eoretical Context 43
Relational Analytic Th eory 44
Dissociation and Its Impact on Identity
Formation: Th e Descent into Crime 49
Th e Developmental Formation of Identity 51
Trauma and Dissociation in Respondents’ Stories 56
Addiction 59
Turning Points 60
References 61
4 Pathways to Desistance 65
Primary and Secondary Desistance Pathways 66
Th e Role of Signifi cant Relationships in Desistance 68
Societal Obstacles to Secondary Desistance 85
Summary 86
References 88
Part III Practice 91
5 Diagnostic Considerations 93
Antisocial/Dissocial Personality Disorder 94
Substance Abuse 96
ASPD/DPD and Psychopathy 99
Treatability 101
Diagnostic Impressions of the Respondent Group 102
Applying for Treatment 109
Relational Diagnosis 110
References 112
Contents ix
6 Developing a Practice Th eory 115
Relationally Based Practice Th eory Goals 116
Attachment 119
Th erapeutic Confl ict: Impasses, Ruptures,
and Enactments 133
Capacity for Internal Confl ict 151
Personal Agency 158
Identity Change 161
Meaning Making 166
Conclusion 171
References 172
7 Relational Th erapy and the “Real World” 177
Societal Marginalization and Access to Treatment 178
Th e Beginning Stages 181
Integrating Relational Concepts into Longer
Term Group Th erapy 186
Partial Hospitalization or Day
Treatment Programs 188
Residential Treatment/Sober Houses 189
Treatment for Clients Approaching
or in Secondary Desistance 189
Conclusion: A Plea for Relationally
Informed Treatment 192
References 194
Appendix: Study Rationale and Methodology 195
Working Defi nitions of Variables 197
Data Sources 198
Study Design 198
Data Management 201
Data Analysis 202
Ethical Concerns 202