Abstract
Any clinician working with young people with psychosis has to deal with cannabis use and its effects. This book, written by clinicians at the Early Psychosis Prevention and Intervention Centre (EPPIC), aims to provide the reader with skills in the assessment and management of cannabis use in this population.
The material is drawn from the Cannabis and Psychosis Project (CAP), a program in which EPPIC patients are eligible to receive weekly individual counselling with a CBT flavour from specialized staff in addition to their usual management.
There is much to recommend in the book. The most useful elements are the practical exploration of assessment and motivational interviewing, with sample scripts of clinician/client interactions. The sections on harm minimization and relapse prevention are helpful. I particularly liked the feedback tools, such as the personalized cannabis feedback summary. The appendices provide samples of the tools mentioned in the texts, with some worked-up examples. The on-line resources are also valuable (my favourite being the on-line calculator to tote up the cost of a substance use habit). There is a short video provided which could be used in individual or group counselling to stimulate discussion.
The text has limitations, in large part stemming from the fact it grew from a specialized program. The session structure is aimed at the clinician who is doing time-limited work with this population focused only on cannabis use. This is evident in statements such as ‘emphasize that CAP sessions will be devoted exclusively to discussion of cannabis use’ (p.29). Clearly, most clinicians have to balance general review, crisis management and specific counselling about substance use. The next edition would benefit from a tweaking of emphasis to accommodate this reality. The other gap is a section on families and substance use. My experience is that cannabis use causes great anxiety and uncertainty among families; tips on education and advice would be most welcome.
I would recommend this book to those working with young people with psychosis, who can incorporate its guidelines in a flexible way in their practice. As the authors quote: ‘any time discussing the client's concerns about cannabis use “is time well spent …”’ (p. 42). This text will undoubtedly enhance the clinicians's confidence to do so.