Motivating Substance Abusers to Enter Treatment - Working With Family Members PDF
Preview Motivating Substance Abusers to Enter Treatment - Working With Family Members
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 ©2004TheGuilfordPress ADivisionofGuilfordPublications,Inc. 72SpringStreet,NewYork,NY10012 www.guilford.com Allrightsreserved Paperbackedition2008 Exceptasnoted,nopartofthisbookmaybereproduced,translated,stored inaretrievalsystem,ortransmitted,inanyformorbyanymeans,electronic, mechanical,photocopying,microfilming,recording,orotherwise,without writtenpermissionfromthePublisher. LIMITEDPHOTOCOPYLICENSE Thesematerialsareintendedforuseonlybyqualifiedmentalhealthprofessionals. ThePublishergrantstoindividualpurchasersofthisbooknonassignable permissiontoreproduceallmaterialsforwhichphotocopyingpermissionis specificallygrantedinafootnote.Thislicenseislimitedtoyou,theindividual purchaser,forusewithyourownclientsandpatients.Itdoesnotextendto additionalcliniciansorpracticesettings,nordoespurchasebyaninstitution constituteasitelicense.Thislicensedoesnotgranttherighttoreproducethese materialsforresale,redistribution,oranyotherpurposes(includingbutnot limitedtobooks,pamphlets,articles,video-oraudiotapes,andhandoutsorslides forlecturesorworkshops).Permissiontoreproducethesematerialsfortheseand anyotherpurposesmustbeobtainedinwritingfromthePermissionsDepartment ofGuilfordPublications. PrintedintheUnitedStatesofAmerica Thisbookisprintedonacid-freepaper. Lastdigitisprintnumber: 9 8 7 6 5 4 3 2 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. ix
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