Choice Theory with Addicted Populations: A Diverse Approach for the Treatment of Addictions

‘‘Choice Theory With Addicted Populations—A Diverse Approach for the Treatment of Addictions’’ as its name implies, is a book specifically written for the application of Choice Theory and Reality Therapy to substance abuse and dependence. This book is not only directed to counselors certified on these therapies, but also to friends, spouses, and family members of addicts and alcoholics. It is worded in such comprehensive way, that it can easily be read and understood by someone without an expertise on these topics. This book is based on the work of Dr William Glasser at the William Glasser Institute on Choice Theory and Reality Therapy. The book begins by explaining the relationship between the addict and their closest contacts, explaining their behaviors, setting the stage for the basis of Choice Theory. Rice puts in plain words his theory, explaining how we cannot make anyone do anything that they do not want to do, and how building trust is the cornerstone of treatment. He then guides us through different approaches to consolidate trust with the patient, keeping always in mind that we need to take in consideration the basic needs of the patient. The author notes how these needs can be completely opposite, giving the example of how, ‘‘when you want them to stop drinking, they want you to go to hell. ’’ This exemplifies how, in the Choice Theory and Reality Therapy, providing information and dialogs to help the patient realize how unhappy they are is essential. Useful examples of dialogs are provided for application during sessions. The book transitions into a very useful format, in which applicable exercises on Choice Theory and Reality Therapy are explained in detail. The author provides literature and video resources, outlines of lectures to present to the patients, activities and exercises to perform during group sessions, and suggestions on how to structure them. Mr Rice concludes the book with sections on how to work through relapses from the counselor’s perspective and, very importantly, on how the friends or family members should deal with certain situations that will arise during and after the interventions. It also emphasizes how loved ones must adapt to changes once the treatment has been completed. This book offers many positive aspects; however, we also need to consider some issues mentioned throughout the book that should not be ignored. For instance, the author mentions in Chapter 6 how the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition-Text Revised (DSM-IV-TR) does not have a scientific base. Also, that not all the substances drug addicts use are considered addictive by the DSM-IV-TR, and that psychiatrists use the DSM-IV-TR as a check list to diagnose mental illness, labeling it ‘‘the most dangerous book ever written. ’’ Certainly, there are many weaknesses in the DSM-IV-TR and, for that reason, a workforce has been assigned to revise and develop a new DSM-V. Some of the proposed DSM-V changes, among many others, include adding Cannabis withdrawal symptoms to the list of substance-related disorders and changing the way mental illness is diagnosed, by using dimensional assessments. This hopefully will help the clinician capture the symptoms and severity of the disorders in a more global way, and will help prevent the ‘‘DSM’’ from being used as a check list. All of these adjustments stay very close to what Mr Rice proposed in his book. In Chapter 11, the author writes: ‘‘No one can say under any specific terms that alcoholism is genetic. There is no proof. Until that alcohol gene is discovered, we cannot blame genes for addiction. ’’ Regarding these statements about the absence of a genetic role in alcoholism, there are currently excellent research efforts that clearly demonstrate how alcohol addiction is a complex condition influenced by genetic and environmental factors, and that several genes are related to this condition. In addition, there is a wide array of family, twin and adoption studies which have shown how the ADDICTIVE DISORDERS & THEIR TREATMENT