Psychotherapeutic interventions with substance abusers—The clinical context (original) (raw)
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The issue of addictions and treatment has been increasingly prioritized by policy-makers in recent years, yet the meaning of the concept remains ambiguous. Throughout the 22 chapters of his book Addiction Counseling Today, Kevin G. Alderson weaves together the most salient theories, research, and therapies from the field of addiction and from contemporary developments in policy and practice. The book examines what the tenets of recovery and treatment mean in terms of not only the professional involved in providing treatment but also what recovery looks like for each client. Chapters cover the influence of ethics in treatment, theories of addiction, the neurosciences, and the recognition of behavioural addictions, including the controversies attached to the use of particular labels. A notable strength involves the author's inclusion of the lived experiences of those who have dealt with various addictions. This book will be essential reading for practitioners, researchers, policy-makers, and students in the fields of addiction, social care, psychology, and criminal justice. résumé Au cours des dernières années, les décideurs politiques se sont beaucoup intéressés aux phénomènes de la dépendance et de son traitement, mais la signification de ce concept reste floue. Tout au long des 22 chapitres de son livre Addiction Counseling Today, Kevin G. Alderson regroupe et recoupe les points les plus saillants de la théorie, de la recherche, et des thérapies en lien avec le domaine des dépendances, ainsi que les progrès actuels en matière de politique et de pratique. Dans ce livre, on examine ce que signifient les grands principes du rétablissement et du traitement, non seulement en ce qui concerne le professionnel qui s'occupe de la prestation du traitement mais aussi ce qui constitue un rétablissement chez chacun des clients. Certains chapitres portent sur l'influence de l'éthique sur le traitement, les théories de la dépendance, et les neurosciences, en passant par la reconnaissance des dépendances comportemen-tales, notamment les controverses associées au recours à des étiquettes particulières. L'une des forces de l'ouvrage tient au fait que l'auteur inclut des expériences vécues 188 Canadian Journal of Counselling and Psychotherapy / Revue canadienne de counseling et de psychothérapie
Substance Use & Misuse, 2013
The most critical unresolved issue associated with psychoanalysis is whether its core precepts belong in today's substance use armamentarium. Psychoanalytic theories have resisted the criterion of falsifiability, putting them at odds with the current paradigm for treating addiction. However, Freud's earliest pronouncement on the subject, "making the patient a collaborator in his own treatment" (i.e., therapeutic alliance) not only holds up to scientific scrutiny, but is a robust determinant in improving treatment outcomes. Psychoanalytic constructs today appear as conjectures, but recognition of the primacy of the collaborative therapeutic relationship is one example of how psychoanalytic observations have influenced current research.
Integrative principles for treating substance use disorders
Journal of Clinical Psychology, 2006
This article, based on B. , provides guidance for the treatment of substance use disorders by identifying empirically based principles that underpin effective treatment systems and effective treatments. To promote the flexible application of empirically based principles to individual clients, the authors (a) integrate therapeutic, participant, and relationship factors (drawn from reviews by B.S. McCrady ) into a comprehensive description of treatment, (b) integrate common and specific principles of changes into articulated descriptions of treatment, and (c) identify directions for research to improve the sensitivity and specificity of treatment.
Brief Therapy Approaches in the Treatment of Substance Abuse and Addiction
2019
The use of brief intervention and brief therapy techniques that are focused on short-term, problem-specific approaches, has become an increasingly important part of the continuum of care in the treatment of substance abuse problems and addictive disorders. With the health care system changing to a managed model of care and with changes in reimbursement policies for substance abuse treatment, these short, problem-specific approaches can be valuable in the treatment of addictive disorders. They provide the opportunity for clinicians to increase positive outcomes by using these modalities independently as stand-alone interventions and, more commonly, as additions to other forms of substance abuse and mental health treatment. Furthermore, they can be used in diverse venues, including opportunistic settings (e.g., primary care, home health care) and specialized substance abuse treatment settings (inpatient and outpatient). Appropriate for a variety of substance abuse problems from at-risk use to dependence, brief interventions and brief therapies can help clients reduce or stop abuse, act as a first step in the treatment process to determine if clients can stop or reduce on their own, and/or act as a method to change specific behaviors before or during treatment. Currently, the psychotherapy of substance abuse utilizes a wide variety of treatment modalities based on diverse theoretical perspectives, including, cognitive-behavioral, strategic and interactional, humanistic and existential, psychodynamic, family systems and group therapy.
Self-Help Strategies Among Patients with Substance Use Disorders
American Journal on Addictions, 2001
The objective of this study was to determine (1) the type and extent of self-help efforts among patients presenting for treatment of substance use disorders, and (2) the association of self-help with demographic and clinical characteristics. A retrospective report of life self-help methods, current demographic characteristics, and current and lifetime clinical characteristics was used. Six hundred and forty-two patients in treatment for substance use disorder were interviewed at one of two university medical centers with Alcohol-Drug Programs located within departments of psychiatry. A research associate (RA) interviewed patients regarding seven types of self-help involving speci®c, mutually exclusive behaviors and rated the patient's lifetime self-help methods. The patient, RA, and addiction psychiatrists provided demographic, familial, and clinical information. Most patients (78%) had tried one or more types of self-help, with a mean of 2.7 methods per patient. They more frequently chose methods related to the substance (decreasing amounts or frequency, or changing substance type) or joining a self-help group than methods that involved changing friends, residence, or occupation/job/school. Certain patterns of self-help tended to occur together (eg, changing substance frequency and dose), whereas others appeared more independent (eg, joining a self-help group). Some self-help approaches occurred mostly in association with other methods rather than alone (eg, changing occupation/job/school). More self-help was associated with higher socioeconomic class, more relatives with substance use disorder, greater severity of substance use disorder, and more treatment for substance use disorder. Self-help tends to occur more often after exposure to addicted relatives or addiction treatment. Clinicians and public adult education should promulgate self-help methods in the general population. (Am J Addict
Re-envisioning Addiction Treatment: A Six-Point Plan
Alcoholism treatment quarterly, 2012
This article is focused on improving the quality of addiction treatment. Based on observations that patients are leaving treatment too early and/or are continuing to use substances during their care, the authors propose six actions that could help reorient and revitalize this kind of clinical work: (1) conceptualize and treat addictive disorders within a psychiatric/mental health framework; (2) make the creation of a strong therapeutic alliance a core part of the healing process; (3) understand patients' addictions and other problems using models based on multiple internal parts, voices, or modes; (4) make contingency management and the use of positive reinforcement systems a standard and central practice in all treatment settings; (5) envision long-term change and healing through the lens of identity theory; and (6) integrate the growing developments in recovery culture with formal treatment.
Discussion Harm reduction psychotherapy: Extending the reach of traditional substance use treatment
2014
Harm reduction is a paradigm-shifting idea that has the potential to significantly improve the treatment of problem substance users. The essence of harm reduction is the recognition that treatment must start from the client’s needs and personal goals and that all change that reduces the harms associated with substance use can be regarded as valuable. The paper presents harm reduction’s rationale, principles, treatment implications, and application to psychotherapy. The author describes his model of Integrative Harm Reduction Psychotherapy, an approach that integrates a strategic skills-building focus with an exploration of the multiple meanings of substance use and the importance of the therapeutic alliance. D 2003 Elsevier Inc. All rights reserved.