Motivating Substance Abusers to Enter Treatment: Working with Family Members

305 Pages·2004·1.57 MB·English

by  Jane Ellen Smith

MOTIVATING SUBSTANCE ABUSERS TO ENTER TREATMENT

MOTIVATING
SUBSTANCE ABUSERS
TO ENTER TREATMENT
Working with Family Members
Jane Ellen Smith
Robert J. Meyers
THE GUILFORD PRESS
New York London
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LibraryofCongressCataloging-in-PublicationData
Smith,JaneEllen.
Motivatingsubstanceabuserstoentertreatment:workingwithfamily
members/byJaneEllenSmith&RobertJ.Meyers.
p. cm.
Includesbibliographicalreferencesandindex.
ISBN-13:978-1-59385-646-5(pbk.) ISBN-10:1-59385-646-6(pbk.)
ISBN-13:978-1-59385-052-4(hbk.) ISBN-10:1-59385-052-2(hbk.)
1. Substanceabuse—Treatment. 2. Substanceabuse—Patients—
Rehabilitation. 3. Motivation(Psychology) I. Meyers,RobertJ. II. Title.
RC564.S566 2004
362.29—dc22
2004009472
To my parents, Gloria and John (Bud) Smith,
for the many years in which they have
exemplified respect, love, hard work, and humor;
and to my #1 brother, David J. Smith,
for living his own life in this same rich tradition.
—J. E. S.
To my father, Charles J. Meyers (The Big “C”),
for his love and support.
—R. J. M.

About the Authors
Jane Ellen Smith, PhD, is a Professor in the Psychology Department at
theUniversityofNewMexicoinAlbuquerque,wheresheisalsotheDirec-
torofClinicalTraining.ShereceivedherdoctorateinClinicalPsychology
from the State University of New York at Binghamton. Specializing in
both alcoholism and eating disorders, Dr. Smith has written numerous
articlesandchaptersonthesetopics.SheisthecoauthorofClinicalGuide
toAlcoholTreatment:TheCommunityReinforcementApproach,alsowithRob-
ert J. Meyers. She has received federal grants from the National Institute
on Alcohol Abuse and Alcoholism to test the Community Reinforcement
Approach with homeless individuals. Dr. Smith is the newest recipient of
the University of New Mexico’s highest teaching award: the Presidential
Teaching Fellowship (2007–2009).
Robert J. Meyers, PhD, is the Director of Robert J. Meyers, PhD, and
Associates,andanAdjunctResearchAssociateProfessorofPsychologyat
the University of New Mexico, where his primary affiliation is with the
Center on Alcoholism, Substance Abuse, and Addictions (CASAA). Dr.
Meyers is the recipient of the 2002 Dan Anderson Research Award from
the Hazelden Foundation, and the 2003 Young Investigator Award from
theResearchSocietyonAlcoholism.Hehaspublisheddozensofscientific
articles and several books, including Get Your Loved One Sober: Alternatives
to Nagging, Pleading and Threatening. Dr. Meyers has been in the addic-
tions field since 1976. He was recently featured prominently for his work
inO,TheOprahMagazineandintheHBOdocumentaryseries,Addiction.
vii

PPrreeffaaccee
Preface
It seems as though everybody knows somebody who absolutely refuses to get
professional help for a serious substance abuse problem. Once the
nonabusing family members have tried everything conceivable on their
own to convince the addict to seek treatment, they often place desperate
phone calls to clinics, hospitals, and substance abuse centers. Sadly, these
agencies typically have not had much to offer. Alternatively, other family
members enter therapy themselves in an effort to cope with the anxiety
anddepressionthatresultfromlivinginthemidstofachronicalcoholor
drugcrisis.Wheneventuallytheypointedlyasktheirtherapistsforhelpin
getting a resistant individual into treatment, many counselors have found
themselvesintheuncomfortablepositionofnotknowinghowtorespond.
In the past, the only options for therapists or agencies were either to rec-
ommendthehighlyconfrontationalJohnsonInstituteIntervention,orfor
the client to be sent to an Al-Anon meeting in order to learn how to
“detach” from the substance abuser. Perhaps not surprisingly, many cli-
ents found these choices unacceptable, and thus were forced to resort
again to their old patterns of begging, threatening, or nagging the sub-
stance abuser to quit using and to get professional help.
Thisbookwaswrittensothattherapistscouldprovideascientifically
supported program that is neither confrontational nor advocates detach-
ment. Instead, CRAFT (Community Reinforcement and Family Training)
teaches these family members (Concerned Significant Others) how to
changetheirownbehaviortowardthesubstanceabuserwiththeobjective
of getting the person with the alcohol or drug problem to enter treat-
ment. Importantly, CRAFT never makes Concerned Significant Others
(CSOs) feel responsible for the substance abuse problem, but simply
offersamethodforfosteringasolution.CRAFTalsoaddressestwoother
goals: getting the substance abusers to reduce their substance use in the
meantime, and helping CSOs increase their own happiness by targeting
problems in various other aspects of their lives.
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