Critical analysis Essay

‘THE FIRST SESSION WITH SUBSTANCE ABUSERS’ is one of the best books that give a clearer picture of the initial stages of substance abuse and how the clinicians can identify and easily eliminate them. It says that substance abuse is the over dependence on a drug or other chemical which in most cases lead to effects that are harmful to the persons physical and mental health. He argues that these in the initial stages the users may succeed to hide the addiction to the substance due to addiction and up to 80 per cent go undiagnosed. Therefore a better way of identifying the substance is needed. He says that the disorder is characterized by a continued use (pathological) of a substance which is not medically prescribed.

The author gives the clinicians with an innovative plan for conducting the first session this has come out successful in sighing drug abuse problems including the most resistant and manipulative patients. He believes that mental health professionals with the help of method outlined in this book can easily detect the depth and the period of which the substance has been used and the motive behind the use. All within the session the client can seek the most appropriate approach for treatment.

The authors believe that professionals in health can deal easily with issues pertaining to transference and counter transference how to cope with crisis in denial, establishing mutual goals and making the referrals necessary for the support of recovery. They have initiated classifications of drug abuse that bring together the physiological and the psychological and these can be applied to an extended variety of populations and individuals, these may include clients who are adult or teenager, men or women, employed or non employed.  The clinicians can therefore know very easily the kind of substance abuse likely to occur in a client or within a specific population.

He argues that when patients are in denial about the obviously self destructive behavior which they are very good at hiding, they in many instances survive an initial psychotherapeutic session virtually undetected. It is now clear that those who suffering and are are taken for clinical interview 80 percent of them go un-diagnotised. This has therefore led to clinicians being manipulated too often into recommending initial treatment instead of creating a deal with their clients that allows for acknowledgement and compassion for the addiction. This has been misguiding and inappropriate thereby assisting the patients in continuation of the denial.

Addiction is said to be a progressive primary chronic disease with genetic and factors of the environment affecting its development and manifestation. The substance addiction is always progressive and in many cases fatal if proper and immediate care is not taken. It mainly characterized by impaired control over use of the drug or preoccupied with the substance.

The author writing in an understandable language which includes proper use of humor, he give s directive clinicians need to choose the most appropriate modality of treatment. He says that the reason therapists have failed in detecting the underlying addictions is because they did not have a compelling model for assessing and treating the addiction. He illuminates this are which was previously murky to provide a way that can easily be followed by clinicians of all kind.

The instructions and models in this book if properly followed and adhered to then the users can dramatically increase their success in identifying substance abuse in patients who may otherwise go undiagnosed and most probably untreated. He says that this is an innovative approach in breaking the wall of denial and establishes an environment of trust that is very crucial in behavior changing.

This is one of the best books to be read by those trying to help substance abusers or the patients themselves. It states that when an individual or a group of individuals persist in use of drugs not regarding the problems related to it then the use can be said to be depending on the substance. This is done by following the criteria for diagnosis.

The author states a very definitive way of identifying the clinically significant distress manifested as follows.

Ø  Recurrent use of the substance leading to failure to perform major obligations mainly at work, home or at school. These may include absence or poor performance which directly relates to substance use.

Ø  Continued substance use may lead to interpersonal problems caused by the effects of the substance

This book is very helpful not only to clinicians but also to counselors to be more open minded in identifying the extent of the addiction or substance use. They will be in a position to know the way to handle different cases and a variety of patients depending on their level of addiction.

The author gives guidelines on how patients can be helped to get out of denial and face reality of their status and can be assisted in getting into a recovery program. This must be done with a lot of care since some patients are very hard to break into and cannot be convinced easily.

The book continues to inform the understanding and field’s knowledge and the understanding of a threat which is very dangerous to public health; this is substance abuse and dependence. It provides clinicians and researchers with necessary information used in creating more reliable and sophisticated ways of prevention and intervention.

Personally I have to admit that I have gained much as a counselor from this book. It helps me understand the kind of patient one is dealing with and their level of addiction. It has various examples of various kinds of addiction and how to handle every level of addiction. It gives a descriptive way of handling users of various substances.

Besides the merits of the book it has several demerits one of which is that the book emphasizes mostly to those who would want to identify new user, portraying denial to addiction as the major challenge in most cases is not true. It should have highlighted in details other challenges clinicians and professionals in health face in dealing with initial stages of dealing with substance abusers.


Cummings, N and Cummings, J. the first session with substance abusers.