The political process and its relationship to the psychotherapy of substance misusers: an historical perspective

There are massive changes underway in the allocation of funds for health care in the United States which will impact upon services provided for users and misusers of intoxicating substances. Recent findings suggest that conditions in the marketplace and the development of professions have effected standards of care rather than a reasoned analysis of need and outcome. Psychologists question to what extent they will be involved in public policy issues including what is clinically and socially relevant. The goal of this paper was to determine if an historical perspective upon federal regulation of intoxicating substances (tobacco/alcohol/drugs) would enlighten the psychotherapy scientist in the pursuit of standards for service. The methodology included a review of the economic and social structure of colonial America which included tobacco plantations, breweries, and distilleries as well as a review of the formation of the federal government and political system in which men, women, and slaves were each assigned different performance standards/roles and economic rewards within the community. The implication is that potential for self-regulation and psychological development is based upon the legacy of our forefathers.