Contemporary trends in substance abuse.

Abstract

A clinical consensus has evolved as to the specific areas to be addressed in a comprehensive clinical interview with substance abusers. Knowledge of specific psychopathology and associated comorbidities among addicts will refine this assessment. There are several reasonably reliable and valid objective psychological tests that can be used to provide supplementary information for diagnostic and treatment decisions. Etiological theories, including the disease concept, family systems theory, psychodynamic formulations, and behavioral approaches, have generated treatment interventions of clinical utility. Recent research suggests that psychotherapy, combined with traditional approaches, results in increased therapeutic benefits that were heretofore considered unlikely. EpidemiologyThe main data systems for assessing and monitoring the prevalence of drug abuse in the United States are survey indicators, particularly those sponsored by the National Institute on Drug ROBERT J. CRAIG received his PhD from Illinois Institute of Technology, Chicago in 1969. He is currently the Director of the Drug Abuse Treatment Program at West Side Veterans Affairs Medical Center and is a member of the faculty at the Illinois School of Professional Psychology, where he teaches in the area of substance abuse. He is a Fellow of the Society for Personality Assessment and Consulting Editor to the Journal of Personality Assessment, and he does ad hoc reviews for several other journals. He has published four books and over 60 papers in professional journals, and is a Diplomate of the American Board of Clinical Psychology.

A Family Perspective for Substance Abuse: Implications from the Literature

“…The need to address family issues in a comprehensive treatment program is becoming widely recognized (Craig, 1993;Kelley & FalsStewart, 2002;McIntyre, 2004;Straussner, 2004). Family involvement is often sought because of the critical role it has in getting addicts into treatment, participating in aftercare, and preventing relapse and maintaining recovery (Costantini, Wermuth, Sorenson, & Lyons, 1992;Gruber & Fleetwood, 2004;Gruber, Fleetwood, & Harding, 2001;Knight & Simpson, 1996;Margolis & Zweben, 1998;McCrady et al, 1998;Ossip-Klein & Rychtarik, 1993;Stevens-Smith, 1998).…”

“…Children who grow up in substance-abusing dysfunctional families often learn maladaptive role expectations that impair their relationships later in life. They have unrealistic expectations of themselves, difficulty with accepting authority and problems with intimacy, trust, and emotional balance (Craig, 1993). Murray (1989) noted that parental alcoholism is probably disruptive to family life, but measuring the disruption and linking it to specific behavior is problematic.…”

Adolescent Substance Abuse and Family Therapy Outcome

“…In the clinical literature, the importance of family-based interventions for substance abuse has remained widely accepted (Craig, 1993), and family therapy is frequently implemented with adolescent abusers (d. Selekman & Todd, 1991). As in the broader family therapy literature, however, treatment approaches have been derived primarily from theories of family functioning and clinical experience, rather independently from research (Bry, 1988), and with little attention to systematic evaluation.…”

The Relationship Between Parental Chemical Abuse and Children's Behavior Disorders

“…Because of their physical and psychological chemical addiction parents' moods may be unpredictable, they fail to assert consistent discipline, and they are less able to console and comfort young children (Woititz, 1985). However, research (Craig, 1993;Joanning, Quinn, Thomas, & Mullen, 1992;Jones & Houts, 1992;Turner et al, 1993) indicates that children raised in chemically abusive homes are rarely, if ever, exposed to nurturing and supportive human interactions that lead to taking responsiblity. Thus, children raised in chemically dependent families "lack emotional support to develop an accurate self perception" (Jones & Houts, 1992)-for example, having never been given top priority, they do not give themselves top priority, and they subse-156 PREVENTING SCHOOL FAILURE sponsibility for themselves.…”