Anthropological Perspectives on Money Management: Considerations for the Design and Implementation of Interventions for Substance Abuse

Abstract

Background: There remains a long-standing argument regarding the need for money management strategies to control poor spending habits among people with substance use disorders. Objective: The objective was to review issues relevant to the design and implementation of money-management-based interventions for substance abuse. Methods: Using a comparative, cross-cultural framework of anthropology, this manuscript examines three challenges for the design and implementation of money management interventions for substance abuse: (i) clients may not trust mental health centers to manage their money, (ii) clients may have different economic perspectives from clinicians and researchers, and (iii) clients may obtain substances through informal networks of exchange. Results: This article clarifies the inherently complex symbolic and social dimensions of money and addiction and illustrates the need for researchers and clinicians to be mindful of the cultural assumptions that underlie money management interventions for substance abuse. Conclusions and Scientific Significance: Using an anthropological approach toward understanding the issues surrounding money management for individuals struggling with addiction and mental illness has the potential to strengthen the design and implementation of money-management-based interventions in a manner that is acceptable and meaningful for this target population.

• money management
• substance abuse
• anthropology
• cultural assumptions

ACKNOWLEDGMENTS

Several people generously provided guidance as I prepared this article. I thank Hoyt Alverson, Ph.D., professor of Anthropology at Dartmouth College, who offered keen insights from economic anthropology, including very helpful reading suggestions. Also, Marc Rosen, M.D., associate professor of Psychiatry at Yale University School of Medicine, read and commented on several drafts of this article; his careful reading and thoughtful comments greatly strengthened the main arguments.

Declaration of Interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Notes

1. In this regard, this intervention is unique in that it aims to resonate with recovery-oriented services, countering associations of money management as coercive and antithetical to client autonomy (5). ATM is a promising treatment modality, having been found to be efficacious for the treatment of cocaine abuse or dependence among individuals with a co-occurring psychiatric condition (5).