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Book Reviews   |    
Circles of Recovery: Self-Help Organizations for Addictions
Reviewed by Judith Faberman, L.I.C.S.W.
Psychiatric Services 2005; doi: 10.1176/appi.ps.56.4.499
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by Keith Humphreys; Cambridge, England, Cambridge University Press, 2004, 228 pages, $85

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Millions of people across the globe participate in self-help groups to address problems of addiction to alcohol, drugs, food, gambling, and sex. Many recover from addiction without the help of professional treaters at all. Yet there still exists a bias among addiction and mental health professionals in their belief that self-help organizations are the less effective and less preferred alternative to treating addictions. Considering increasingly managed health care systems and the multiple obstacles to obtaining professional addiction treatment—never mind long-term treatment—it may behoove us to seriously consider self-help groups as a preferred treatment for addictions.Circles of Recovery: Self-Help Organizations for Addictions, by Keith Humphreys, does just that.

Humphreys begins by illustrating the nature of self-help group organizations, highlighting their universal characteristics—the shared problems and change goals of participants, self-directed leadership, voluntary association, reliance on experiential knowledge, and norms of reciprocal helping. Beginning with Alcoholics Anonymous (AA), the most widely researched and understood of the self-help organizations, Humphreys describes 19 international groups in terms of their origins, philosophy and approach, and membership and attendance patterns. Humphreys nicely illuminates why traditional AA groups are not culturally appropriate or viable in all parts of the world and uses AA as the comparison group for the other organizations. The reader is certain to gain useful knowledge of differences in practices among groups' rules for anonymity, inclusion of family and significant others, and spirituality.

After his world tour of self-help groups, Humphreys explores the question of whether such groups are effective. Does involvement in self-help groups reduce members' substance abuse? Do members benefit from increased psychiatric, social, and physical well-being? Are there other benefits to involvement in self-help groups? Although such questions are admittedly difficult to assess, the author concludes that involvement in self-help groups correlates with better outcomes, not only in terms of reducing substance abuse and improving well-being but also in terms of spiritual changes, life-story transformation, increasing friendship networks, and overall empowerment of members.

The author's encouraging findings bring the reader to the last portion of the book, which explores how clinicians and health care organizations should interact with self-help groups to make them optimally effective. He suggests tailoring clients' referrals to self-help groups by improving professional treaters' working knowledge of the various groups available. He recommends that referrals to self-help groups occur before, during, and after treatment, with the most obvious solution of inviting self-help groups to conduct meetings at treatment facilities. Finally, he encourages professional treaters to change their attitudes toward self-help and to recognize the reality that these groups have the advantage of being available over the lifespan to clients with addiction.

Circles of Recovery provides a general introduction to addiction-related self-help organizations in the developed world. The goals of the book are clearly stated and met: to describe addiction-related self-help organizations; to empirically evaluate how involvement in self-help groups affects members; to provide guidelines for clinical and policy interaction with self-help groups; and to bring science to bear on controversial issues in the field. I highly recommend this book.

Ms. Faberman is director of the alcohol and drug abuse partial hospital treatment program at McLean Hospital in Belmont, Massachusetts.

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