Clinical Textbook of Addictive Disorders 3rd ed - R. Frances, S. Miller, A. Mack (Guilford, 2005) WW

3. Psychological Evaluation 53Social AdjustmentSocial adjustment is defined as the individual’s success at fulfilling age-appropriateroles according to expectations (Barrabee, Barrabee, & Finesinger, 1955). Themeasurement domains encompass social support, social roles, social skills, peeraffiliations, school and vocational adjustment, and recreation and leisure activities.Social Functioning/Social SupportAs previously discussed, the Addiction Severity Index (McLellan et al., 1980)profiles the individual’s problems, including social support, along with psychological,legal, family, and vocational status. The Substance Abuse ProblemChecklist (SAPC; Carroll, 1983) assesses social functioning in relation to treatmentplanning. An especially useful feature of the SAPC is its capacity todetermine the client’s readiness to initiate substance abuse treatment. TheSAPC evaluates health status, personality, social relationships, vocational status,use of leisure time, religious orientation, and legal status. The Social RelationshipScale (SRS; McFarlane, Neale, Norman, Roy, & Steiner, 1981) is oneof only a few instruments developed with the specific intention to measuresocial support. It assesses three facets of social support: (1) total number of individualswho make up the social support network, (2) type of relationships, and(3) quality of relationships. These facets of social adjustment are integral toprognosis following treatment for substance use disorders (see McLellan, 1986;Woody et al., 1983).Peer AffiliationsA social network in which drug use is commonplace increases the likelihoodthat the individual will adopt this behavior. Ameliorating a substance abuseproblem may thus require abandoning long-standing peer affiliations. Whetherthe quality of peer relationships is embedded in an antisocial behavior dispositionneeds to be evaluated. Antisociality impedes work, school, and familyadjustment. One self-report measure, the revised Drug Use Screening Inventory(Tarter, 1990), described earlier, quantifies deviancy in both the individual andfriendships.Because the social environment is a major source of reinforcement, it isessential to identify the reward contingencies, role models, and contextual factorsassociated with alcohol or drug use. It should be recognized that the individualnot only responds to the particular social environment but also seeks out an environmentthat has reinforcing value. Hence, during the course of the psychologicalassessment, an attempt should be made to learn why the substance abusing clientseeks out social interactions that have maladaptive consequences.