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Helping Students Overcome Substance Abuse: Effective Practices for Prevention and Intervention

James Roth, M.S., and Dilip Ramchandani, M.D.

This interesting book is a part of the "Guilford Practical Intervention in the Schools Series," which focuses on the psychosocial issues of at-risk youth. Although primarily aimed at school-based mental-health practitioners, it also provides information that could be useful to teachers and graduate-level students interested in the mental health field.

The book consists of seven chapters. The earlier chapters are devoted to an introduction to the problem, a very brief discussion of the theories of substance abuse, and descriptions of commonly abused substances. Chapters in the second half of the book address prevention programs, individual and group interventions, and, finally, issues of referral.

Some of the features that we feel are well done include the opening discussion of the medical terms and classifications of substance abuse and presentation of prevalence data. The authors avoid getting bogged down with the DSM-IV lists and go on to graphically illustrate the disturbing extent of substance use among school-age children. Although the data are limited to children who are currently attending school, they can still give the reader a picture of the enormous scope of the problem. Rounding out the background information is a chapter that gives concise descriptions of commonly abused drugs and their effects. This section provides convenient references and is written in a simple, jargon-free style.

On the spectrum of society’s response to the substance-abuse issue, prevention programming is, perhaps, the role most associated with the school system. This subject is covered, starting with an overview of various levels and core principles of prevention programming; the authors then move on to discuss specific programs. The most interesting part of the discussion was the evaluation of several research-based prevention programs. A universal prevention program, two programs specifically targeted at higher-risk groups, and a tiered program are discussed with regard to structure, content, and delivery. Although they provide some statistics for evaluation of program effectiveness at reducing targeted behaviors, we would have preferred to see a more detailed statistical analysis of the effectiveness of the programs.

The individual- and group-interventions chapters give an overview of approaches presently used in substance-abuse treatment and the settings in which patients receive therapy. Several decision-making tools, interviewing techniques, and motivational skills and approaches are discussed, both for individual and group interventions. Some of the significant obstacles faced in setting up and maintaining an effective school-based intervention are discussed in order to help school personnel determine where their program should fit into the continuum of care.

The closing chapter focuses on dealing with situations in which the level of care needed by a student exceeds that which can be provided in the school setting. The authors provide concise but informative coverage of treatment settings, spanning the full range from psycho-education to residential care. Their discussion incorporates the relative strengths and weaknesses of each mode of treatment. The chapter also describes a role for the school-based practitioner in building ties to community resources and coordinating and monitoring the student’s treatment. A convenient flow-chart outlines each phase of care and suggests steps for tracking progress and providing appropriate treatment.

Throughout the book, the chapters end with a case vignette and a list of web-based resources (with descriptions). We found the web-resources section useful and convenient for seeking further information; however, we would have liked to see a single, comprehensive, real-world case description of a school that was able to implement a successful substance-abuse prevention and intervention program, rather than the smaller case-examples for each chapter.

Overall, the book is informative and easy to read, with the subject broken down into manageable-sized chapters that convey the main points rather well. The book does a good job of laying out the daunting task faced by school-based practitioners in helping students dealing with substance abuse.

FOOTNOTES

 
Mr. Roth is a 2008 M.D. candidate at the Drexel University College of Medicine; he is planning a career in psychiatry. Dr. Ramchandani is Director of Undergraduate Psychiatric Education at the Drexel University College of Medicine and Book Review Editor of Psychosomatics.

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