Book review

Counselling for Alcohol Problems

Richard Velleman, Sage Publications, London, 2001.

202 pp.; ISBN 0 7619 6579 3

This, the second edition of Counselling for Alcohol

Problems , is an updated version aimed at keeping pace

with developments in research and practice. The author

maintains the focus on providing evidence-based gui-

dance for counselling interventions that he successfully

developed in the earlier edition. The purposive and

functional role fulfilled by problem drinking in the life

of a given individual is emphasised. This perspectiveprovides a framework for the counsellor to enhance

motivation for change and, if necessary, to foster the

skills needed to initiate and to maintain this in the

longer term. This essentially cognitive-behavioural,

motivational and client�/centred approach is outlined

early on, and the reader is left in no doubt as to the

allegiances of the author. Professor Velleman is above

all a pragmatist, however, and acknowledges the posi-tive influence Alcoholics Anonymous has had in the lives

of many, while at the same time recognising the

difficulty for some in learning to drink in a controlled

way.

The book continues with sections on Helping People

with Alcohol Problems, using both individual and

group-based formats. This, the main section of the

book, covers the various stages from assessmentthrough intervention and relapse prevention and man-

agement. Within the constraints of a short text, issues

such as Relapse Prevention Training are dealt with

relatively briefly but the essence is revealed. Throughout

this section, the author describes the most appropriate

counselling strategy. Thus, initially the counsellor

adopts an eliciting, exploratory stance, moving towards

a more structured approach when called to teachcontrolled drinking or assertiveness skills. Inevitably

perhaps, there are some omissions. No reference is

made, for instance, to the neuropsychological deficits

associated with excess alcohol. While a counsellor would

not generally be equipped to assess this aspect of

alcohol-related harm, the possibility that their clients

are even subtly impaired in terms of problem solving orcognition needs at least to be borne in mind, especially

where there are high levels of recent or current alcohol

involvement.

The third section, entitled ‘Other Important Topics’,

covers areas such as dealing with resistive or aggressive

clients, co-morbidity and the family dimension. A

chapter on ‘Myths and Facts’ systematically refutes

many myths that have gained public currency by defaulte.g. ‘Alcoholics will always deny their problems’. Even

the most experienced practitioner will find this catalogue

instructive, and maybe find that aspects of some of these

myths might lurk somewhere in their own implicit

assumptions! The book ends with a list of resources

for those affected by problem drinking and some useful

addresses. Overall, this is a very practical and accessible

guide. It should be of considerable benefit to genericcounsellors, in particular due to the manner in which the

utility of core counselling skills is emphasised in

responding to problem drinking. For practitioners

more familiar with the themes covered in this text, it

should also provide a pertinent, up-to-date overview

and a reminder that counselling problem drinkers, or

indeed users of other drugs, should be based on credible

evidence of the efficacy of such endeavours.

Frank Ryan

Consultant Clinical Psychologist,

Central and

North West London Mental Health NHS Trust,

5 Wolverton Gardens,

Hammersmith,

London W6 7DY,

UK

E-mail: frank.ryan@cnwl.nhs.uk

International Journal of Drug Policy 13 (2002) 513

www.elsevier.com/locate/drugpo

0955-3959/02/$ - see front matter # 2002 Elsevier Science B.V. All rights reserved.

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