ABSTRACT
This chapter discusses the goals we set out to meet in the treatment of substance abuse. There are some goals that treatment accomplishes about which almost everyone agrees, but there are many goals for which there is widely held disagreement as to whether treatment attains them or not. When an abusing client first presents to a therapist for evaluation, the consultation is nearly always sought as a consequence of a single crisis or an accumulation of problems. The addict, the therapist, and often the family and employer have differing goals that they wish to see attained from the treatment, and often these goals are unrealistic and sometimes incompatible. For example, a bank teller performing well at his job consults you 3 days after an automobile accident. At the time of the accident cocaine was found in his car and in his blood. He was arrested on charges of possession of cocaine, driving while intoxicated, and abusive behavior. A great deal of newspaper publicity was given to his arrest, because his car destroyed a popular fountain. He is also experiencing major marital and financial difficulties.
