Addiction

Paul Davis is a Consultant Clinical Psychologist in Addiction, and Teaching Fellow in Clinical Psychology at the University of Surrey, UK. He has contributed at a national level on substance misuse treatment guidelines, policies and service developments and has published widely in the field of psychosocial interventions for substance misuse. Bob Patton is a lecturer in Psychology at the University of Surrey, UK, Director of Short Term Solutions Ltd and Director of AdApped Ltd. He has previously worked as a consultant for the Home Office Drugs Prevention Initiative and as a Research Fellow in Addiction at Imperial College, King's College London and the Maudsley Hospital Hospital. Sue Jackson is a chartered psychologist specialising in the psychosocial impact and treatment of chronic health conditions. In addition to managing an extensive research portfolio, she is a teaching fellow on the Clinical Psychology Doctorate Programme at the University of Surrey and is the first psychologist to serve on the Medical Advisory Committee for the Pituitary Foundation.

• List of contributors xiForeword xiiiPreface xviiNotes on Contributors xixPART 1 Understanding the Psychology and Treatment of Addictions 1CHAPTER 1 Addiction: A Comprehensive Approach 3Jamie Brown and Robert West1.1 Introduction 41.2 Existing theories 51.3 The human motivational system 81.4 Internal and external sources of influence 111.5 The dynamics of the system 121.6 The unstable mind and chreods 131.7 Testing the theory 15Suggestions for further reading 16References 16CHAPTER 2 An Attachment-Informed Approach to Working with Addiction 20David B. Curran and Mani Mehdikhani2.1 Introduction to attachment 212.2 Attachment and psychopathology 232.3 Attachment and addiction 252.4 Attachment styles in clinical samples 282.5 Assessment and formulation through an attachment lens 292.6 Treatment implications 322.7 Conclusion 35Suggestions for further reading 35References 36CHAPTER 3 Families, Friends and Addiction: Impacts, Psychological Models and Interventions 42Alex Copello and Kathryn Walsh3.1 Introduction 433.2 The composition of alcohol and drug users’ social networks 433.3 Impacts of addictions on others 443.4 Theoretical models of addiction and the family: stress-strain-coping-support 473.5 From models to interventions 483.6 Conclusion 52Suggestions for further reading 53References 54CHAPTER 4 Working Systemically with Alcohol Misuse 57Arlene Vetere and Rudi Dallos4.1 Introduction 584.2 Family life 594.3 Family systems approaches 604.4 Working therapeutically with violence and abuse 644.5 Engagement and the therapeutic relationship 654.6 Conclusion 66Suggestions for further reading 66References 67CHAPTER 5 Dangerous Desires and Inanimate Attachments’: Modern Psychodynamic Approaches to Substance Misuse 68Martin Weegmann and Edward J. Khantzian5.1 Introduction 695.2 Primitive emotional states: Kleinian views 705.3 Comforting self-objects: Kohutian views 725.4 Inanimate attachments: Bowlbian views 745.5 Bringing it together: addiction as disorder of self-regulation 765.6 Reflective practice 785.7 Internal recovery 795.8 Conclusion 81Suggestions for further reading 82References 82CHAPTER 6 Mindfulness, Acceptance and Values in Substance Misuse Services 84Liz McGrath and Dominic O’Ryan6.1 Introduction: what are the principles and methods of mindfulness, acceptance and values? 856.2 How does ACT integrate with other approaches? 876.3 How does the service use these principles and methods of ACT? 906.4 How do mindfulness, acceptance and values support the resilience of staff in the face of seemingly relentless relapse and other behaviours? 926.5 What are the experiences of staff working with ACT? 946.6 What are the experiences of clients working this way? 966.7 Our experience of ACT 97Suggestions for further reading 98References 98PART 2 Clinical Applications of Addiction Psychology 103 CHAPTER 7 The Role of Clinical Psychology within Alcohol Related Brain Damage 105Fraser Morrison and Jenny Svanberg7.1 Introduction 1067.2 Clinical definition of alcohol-related brain damage and related syndromes 1067.3 Epidemiology of ARBD and related syndromes 1077.4 Cognitive function in ARBD 1087.5 Psychosocial and cognitive rehabilitation 1117.6 Legal framework: mental capacity 1177.7 Recovery 118Suggestions for further reading 119References 119CHAPTER 8 Trauma and Addiction 124David B. Curran8.1 Psychological trauma and PTSD 1258.2 The relationship between addiction and psychological trauma 1278.3 Assessment 1298.4 Treatment of co-existing trauma and substance use disorders 1318.5 Clinical implications 1358.6 Conclusion 139Suggestions for further reading 139References 139CHAPTER 9 Narrative Identity and Change: Addiction and Recovery 144Martin Weegmann9.1 Narrative theory 1459.2 Narrative therapy 1459.3 Narrative theory and addiction 1469.4 Client talk 1479.5 Generating narrative 1499.6 Narratives of recovery 1529.7 Varieties of recovery story 1529.8 Conclusion 154Acknowledgements 155Notes 155Suggestions for further reading 155References 156CHAPTER 10 Addiction and Mental Health 158Adam Huxley10.1 Introduction 15910.2 Association between substance misuse and psychosis 16010.3 Prevalence and epidemiology 16210.4 Outcomes associated with co-occurring disorders 16310.5 Treatment approach and effectiveness 16310.6 Evidence for effectiveness 16410.7 Conclusion 166Suggestions for further reading 167References 167CHAPTER 11 Substance Misuse in Older Adults 172Sarah Wadd and Tony Rao11.1 Introduction 17311.2 Definition of older adult 17311.3 Alcohol 17311.4 Illicit drug use 17611.5 Medication misuse 17811.6 Assessment of older people with substance misuse 17911.7 Psychosocial interventions 18411.8 Legal and ethical considerations 18511.9 Using and evaluating health and social outcomes 18611.10 Conclusion 187Suggestions for further reading 188References 188CHAPTER 12 Issues Arising in Hepatitis C Work: The Role of the Clinical Psychologist 193Jo M. Nicholson12.1 Introduction 19412.2 Hepatitis C background: the virus and treatment 19412.3 Social and clinical characteristics of the HCV patient population 19512.4 HCV treatment challenges 19612.5 Pegylated Interferon-related adverse psychiatric side-effects 19712.6 HCV-infected mental health populations 19812.7 So what is the role of the psychologist? 20012.8 Psychological stepped-care model in HCV treatment 20612.9 Future challenge 20812.10 Conclusion 208Suggestions for further reading 209References 209CHAPTER 13 The Psychology and Treatment of Gambling Disorders 213André Geel, Rebecca Fisher and Aska Matsunaga13.1 Introduction 21413.2 Definition 21413.3 Prevalence 21513.4 Demographic risk factors 21613.5 Treatment of gambling disorders 22213.6 Personal comment and reflections 22413.7 Conclusion 224Suggestions for further reading 225References 225CHAPTER 14 Alcoholics Anonymous and 12 Step Therapy: A Psychologist’s View 230Martin Weegmann14.1 Introduction: personal context 23114.2 History 23214.3 Philosophy 23314.4 How does it work? 23514.5 What can psychologist and helping professionals do? 23914.6 Criticisms of AA 24014.7 Postscript 241Notes 241Suggestions for further reading 242References 242CHAPTER 15 Relapse Prevention: Underlying Assumptions and Current Thinking 245Robert Hill and Jennifer Harris15.1 Introduction 24615.2 What is relapse prevention? 24615.3 Models of relapse prevention 25015.4 Addressing co-existing mental health 25415.5 Neuropsychological and associated difficulties when undertaking RP 25515.6 Conclusion 257Suggestions for further reading 258References 259CHAPTER 16 Working with Ambivalence about Change: Motivational Interviewing 262Lisa Dutheil and Alina Galis16.1 Introduction 26316.2 Definition 26316.3 Historical perspective 26416.4 Theoretical influences 26516.5 The spirit of MI 26616.6 Change talk, sustain talk and discord 26616.7 The four MI processes 26716.8 Core MI skills 26916.9 MI strategies more specific to particular processes 27116.10 Evidence for the efficacy of MI 27216.11 Integrating MI with other approaches 27416.12 Using MI in groups 27516.13 Learning MI 27716.14 Conclusion 278Suggestions for further reading 279References 279CHAPTER 17 ‘Beyond Workshops’: Turning Evidence for Psychosocial Interventions into Embedded Practice 284Luke Mitcheson, Christopher Whiteley, and Robert Hill17.1 Introduction 28517.2 What is implementation? 28517.3 Implementation science 28717.4 Consolidated Framework for Implementation Research (CFIR; Damschroder et al., 2009) 28717.5 Implement what? Evidence-based interventions versus evidence-based practices 29217.6 Case studies in Motivational Interviewing and treatment effectiveness (Mapping) 29417.7 Conclusion 298Notes 300Suggestions for further reading 300References 300Index 303