I remember in the 1980s being told by a seasoned counselor that “clients” should not be educated about addiction, because it would allow them to feel like they could understand and “control” their drug use and this would interfere with their surrendering to their disease. For many years, addicted individuals in treatment programs were repeatedly told that they should shut up and just do what they were told. More recently, we hear celebrity endorsements for luxury treatment programs and quasi-religions which suggest that if you simply pay lots of money to these organizations and follow their science fiction or their narcissistically-inspired formulas, it is very possible to become “cured” and avoid the hard work of recovery. This is an attractive and seductive message, but an inaccurate one—it creates false hopes, but great profit margins. Both of these messages have been detrimental to the recovery efforts of many people.
In the development of effective, evidence-based treatments for people with health problems, including substance use disorders, a few fundamental principles have emerged. First, it is important to educate individuals with scientifically accurate information about their illnesses and about the steps they can take to improve their health. Second, it is important to empower these individuals to take action and become active participants in improving and maintaining their own health. Third, it is critical that information is conveyed to these individuals in a respectful way, not by talking down to them or being preachy or judgmental. Finally, to get people to use treatment materials, those materials need to be relatable, interesting, and realistic. All of these principles are important in giving people the tools they need to improve their health and make positive changes in their lives.
The Addiction Recovery Workbook reflects a sophisticated knowledge of how to effectively communicate to people struggling with substance use disorders. The workbook has been developed with a keen awareness of the scientific literature on the nature of addiction and the information and skills that are useful in helping people to stop using alcohol or drugs and develop a positive and sustainable recovery. The material in the workbook is presented in a way that shows a true understanding of how confusing, frightening, and discouraging addiction can be to individuals struggling with excessive alcohol or drug use. The book communicates its message in a respectful way, giving the readers credit for investing time and effort, for taking responsibility for their own lives, and for seriously wanting to make changes, while at the same time avoiding a condescending or paternalistic tone. In short, this book approaches readers as adults who are responsible for their own lives—who recognize they want to improve their lives, but are not sure exactly what to do or how to do it.
The reader is invited to join in the process of recovery, but, at the same time, it is clearly acknowledged that there may be ambivalence about taking on this job of recovery. Is this whole recovery thing really necessary? Do I really have a problem with drugs or alcohol? Why does my intention to occasionally use slide into compulsive, sometimes catastrophic, out-of-control, excessive use? Am I crazy? Do I have self-destructive tendencies? Am I a bad person? I just want to be able to drink alcohol or use like a normal person—why does this go “sideways” when I try? How can I tell if I am addicted? What does it mean to be addicted?
The first section of the workbook addresses many of the confusing and apparently paradoxical elements of addiction and how good, intelligent people can be drawn into a pattern of alcohol and drug use that can wreak havoc with their lives, resulting in damage to themselves and the people they love. This section contains current, accurate information about what addiction is, why some people get addicted and others don’t, how to know if you do have a serious alcohol or drug problem, and what steps can be taken to begin to address this problem. The clear message is that there are many pathways and approaches to addressing problem alcohol and drug use. The workbook helps the reader understand that many people may need treatment with professional therapy, addiction medications, and 12-step support, and that the book can be used together with these other recovery tools and approaches.
All of this information is given with a recognition that the reader is in a state of ambivalence, which is natural and normal. Rarely do people dive into a program of recovery with a burning desire and deep commitment to changing their lives and giving up a set of behaviors that, at one point in their lives, was a great source of pleasure (and, at times, still is). As addiction is explained, many case examples and conversations are used to illustrate the salient points and to show readers that the workbook was written for people like themselves.
The heart of the workbook is a set of chapters that address the major aspects of the recovery process. Each chapter gives an overview of its main theme, using clear explanations of the scientific principles and processes involved, as well as lots of examples of how the issues it presents may relate to the reader’s current situation. And each chapter has a wonderful collection of worksheets and written exercises to give readers a vehicle for expressing their own version of these issues and helping to personalize the concepts. These chapters cover an amazing array of the most current set of knowledge, principles, and skills that are considered either evidence based or extremely promising and under active study.
Included in these chapters are concepts of self-directed behavior change; all kinds of tools to help people modify thoughts and beliefs; ways to build rewards and positive new behaviors into a life in recovery; strategies for managing negative mood states and coping with cravings for alcohol or drugs; relapse prevention approaches and skills; and a format for creating a clear, simple, and practical recovery plan. The approaches and strategies in these chapters come from well-established clinical research literature. Included are concepts and skills from motivational interviewing, cognitive behavioral therapy, community reinforcement therapy, relapse prevention, contingency management, and the matrix model. In addition, other approaches are included that are currently considered to hold great promise in the addiction field but with more limited evidence. These include behavioral activation therapy, mindfulness meditation, dialectic behavioral therapy, and physical exercise.
Throughout the workbook, the principles and skills are illustrated with excellent case examples and scripts of conversations that help bring the information to life and make it useful. It is a very challenging task to communicate about the scientific literature on addiction and addiction treatment in a way that is accurate, understandable, and engaging. These case examples are written in such a way that they illustrate challenges, concepts, and solutions in a very readable style. What could otherwise be a litany of dry, clinical research is transformed into a collection of very relevant and applicable skills that readers can use and apply to their own situations. The sample conversation scripts help pull the readers into situations and allow them to vicariously get a sense of how it feels to manage these commonly experienced recovery scenarios.
The Addiction Recovery Workbook is an important new resource for individuals struggling with alcohol and drug use problems. It is an active document, not a textbook to be put on a shelf. The book has been written to enrich and empower the reader. For people who struggle with repeated failures to self-manage their alcohol and drug use, it is a refreshingly positive and hope-inducing resource. The overarching message is that there has been a great deal of knowledge amassed about the problem of addiction and there are many ways to make progress in achieving recovery. There is no one school of thought that has all the answers, and there is no “right way” to recovery.
The author clearly has great affection for the individuals she has worked with in her clinical practice and her research, who struggle with addiction. Her commitment to, and personal interest in, their well-being is conveyed on every page. The Addiction Recovery Workbook is her way of giving a gift of hope and assistance to others who struggle with alcohol and drug problems.
—RICHARD A. RAWSON, PH.D.
Professor and Co-Director
UCLA Integrated Substance Abuse Programs
Semel Institute of Neuroscience and Behavior
David Geffen School of Medicine
University of California, Los Angeles