Alcohol and Alcoholism Vol. 38, No. 3, pp. 289, 2003
© 2003 Medical Council on Alcohol
BOOK REVIEW
Chemical Dependency Counseling, A Practical Guide.
By Robert R. Perkinson. Sage Publications, Thousand Oaks, CA. 2nd edn: 2002, 544 pp., £39.00. ISBN: 0-7619-2388-8.
The book’s author, Robert R. Perkinson, is a licensed psychologist and a certified alcohol and drug counsellor who is Clinical Director of the Keystone Treatment Centre in South Dakota. The book is intended as a standard training text for those in the addiction field, which in America, is 12-step orientated. The author describes treatment as a ‘spiritual journey’ and examines the importance of the ‘higher power’ in supporting patients through steps 1–5 of the AA Programme.
The opening chapter looks at welcoming, assessing, and negotiating treatment with clients. The language is perhaps somewhat exuberant for the less emotionally forthright British therapist, e.g. ‘your job as a chemical dependency counsellor is to love the patients in truth, knowing the truth will set them free from the slavery of lies’. However, the importance of engaging the client and offering them hope that they can be helped is sincerely conveyed.
The next section examines treatment approaches, including individual and group therapy, the use of contracts, i.e. patient exercises to increase insight, exploration of the first five steps of AA and suggestions on educational lectures. The author illustrates his descriptions with examples of interventions and makes the distinction between spirituality and religious dogma.
Later chapters focus on other relevant issues in dependency treatment, including assessment and treatment of mental health problems, special considerations with adolescents and family involvement. There is a chapter on clinical staff, which describes a multi-disciplinary team, which is very different from its counterpart in Britain. It does, however, tackle issues pertinent to any team, including respecting each other’s roles and the importance of good communication. The last chapters describe discharge and aftercare, the action of different addictive drugs and the qualities of a good counsellor.
These sections make up only half of the book, with the other half being made up of a huge number of appendices. These include rating scales, screening tests and a series of practical exercises to use at every stage of a treatment programme.
Overall, the book provides insight into a disease-based treatment model, which augments research-based interventions, such as relapse prevention and motivational enhancement with a spiritual element.
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