List of Contributors xi
Forewordxiii
Prefacexvii
Notes on Contributors xix
Part 1 Understanding the Psychology and Treatment of Addictions 1
Chapter 1 Addiction: A Comprehensive Approach 3
Jamie Brown and Robert West
1.1 Introduction 4
1.2 Existing theories 5
1.3 The human motivational system 8
1.4 Internal and external sources of influence 11
1.5 The dynamics of the system 12
1.6 Changing dispositions 14
1.7 Testing the theory 15
Suggestions for further reading 16
References 16
Chapter 2 An Attachment-Informed Approach to Working with Addiction 20
David Curran and Mani Mehdikhani
2.1 Introduction to attachment 21
2.2 Attachment and psychopathology 23
2.3 Attachment and addiction 25
2.4 Attachment styles in clinical samples 28
2.5 Assessment and formulation through an attachment lens 29
2.6 Treatment implications 32
2.7 Conclusion 35
Suggestions for further reading 35
References 36
Chapter 3 Families, Friends and Addiction: Impacts, Psychological Models and Interventions 42
Alex Copello and Kathryn Walsh
3.1 Introduction 43
3.2 The composition of alcohol and drug users' social networks 43
3.3 Impacts of addictions on others 44
3.4 Theoretical models of addiction and the family: stress-strain-coping-support 47
3.5 From models to interventions 48
3.6 Conclusion 52
Suggestions for further reading 53
References 54
Chapter 4 Working Systemically with Alcohol Misuse 57
Arlene Vetere and Rudi Dallos
4.1 Introduction 58
4.2 Family life 59
4.3 Family systems approaches 60
4.4 Working therapeutically with violence and abuse 64
4.5 Engagement and the therapeutic relationship 65
4.6 Conclusion 66
Suggestions for further reading 66
References 67
Chapter 5 'Dangerous Desires and Inanimate Attachments': Modern Psychodynamic Approaches to Substance Misuse 68
Martin Weegmann and Edward J. Khantzian
5.1 Introduction 69
5.2 Primitive emotional states: Kleinian views 70
5.3 Comforting self-objects: Kohutian views 72
5.4 Inanimate attachments: Bowlbian views 74
5.5 Bringing it together: addiction as a disorder of self-regulation 76
5.6 Reflective practice 78
5.7 Internal recovery 79
5.8 Conclusion 81
Suggestions for further reading 82
References 82
Chapter 6 Mindfulness, Acceptance and Values in Substance Misuse Services 84
Liz McGrath and Dominic O'Ryan
6.1 Introduction: what are the principles and methods of mindfulness, acceptance and values? 85
6.2 How does ACT integrate with other approaches? 87
6.3 How does the service use these principles and methods of ACT? 90
6.4 How do mindfulness, acceptance and values support the resilience of staff in the face of seemingly relentless relapse and other behaviours? 92
6.5 What are the experiences of staff working with ACT? 94
6.6 What are the experiences of clients working this way? 96
6.7 Our experience of ACT 97
Suggestions for further reading 98
References 98
Part 2 Clinical Applications of Addiction Psychology 103
Chapter 7 The Role of Clinical Psychology within Alcohol Related Brain Damage 105
Fraser Morrison and Jenny Svanberg
7.1 Introduction 106
7.2 Clinical definition of alcohol-related brain damage and related syndromes 106
7.3 Epidemiology of ARBD and related syndromes 107
7.4 Cognitive function in ARBD 108
7.5 Psychosocial and cognitive rehabilitation 111
7.6 Legal framework: mental capacity 117
7.7 Recovery 118
Suggestions for further reading 119
References 119
Chapter 8 Trauma and Addiction 124
David Curran
8.1 Psychological trauma and PTSD 125
8.2 The relationship between addiction and psychological trauma 127
8.3 Assessment 129
8.4 Treatment of co-existing trauma and substance use disorders 131
8.5 Clinical implications 135
8.6 Conclusion 139
Suggestions for further reading 139
References 139
Chapter 9 Narrative Identity and Change: Addiction and Recovery 144
Martin Weegmann
9.1 Narrative theory 145
9.2 Narrative therapy 145
9.3 Narrative theory and addiction 146
9.4 Client talk 147
9.5 Generating narrative 149
9.6 Narratives of recovery 152
9.7 Varieties of recovery story 152
9.8 Conclusion 154
Acknowledgements 155
Notes 155
Suggestions for further reading 155
References 156
Chapter 10 Addiction and Mental Health 158
Adam Huxley
10.1 Introduction 159
10.2 Association between substance misuse and psychosis 160
10.3 Prevalence and epidemiology 162
10.4 Outcomes associated with co-occurring disorders 163
10.5 Treatment approach and effectiveness 163
10.6 Evidence for effectiveness 164
10.7 Conclusion 166
Suggestions for further reading 167
References 167
Chapter 11 Substance Misuse in Older Adults 172
Sarah Wadd and Tony Rao
11.1 Introduction 173
11.2 Definition of older adult 173
11.3 Alcohol 173
11.4 Illicit drug use 176
11.5 Medication misuse 178
11.6 Assessment of older people with substance misuse 179
11.7 Psychosocial interventions 184
11.8 Legal and ethical considerations 185
11.9 Using and evaluating health and social outcomes 186
11.10 Conclusion 187
Suggestions for further reading 188
References 188
Chapter 12 Issues Arising in Hepatitis C Work: The Role of the Clinical Psychologist 193
Jo M. Nicholson
12.1 Introduction 194
12.2 Hepatitis C background: the virus and treatment 194
12.3 Social and clinical characteristics of the HCV patient population 195
12.4 HCV treatment challenges 196
12.5 Pegylated Interferon-related adverse psychiatric side-effects 197
12.6 HCV-infected mental health populations 198
12.7 So what is the role of the psychologist? 200
12.8 Psychological stepped-care model in HCV treatment 206
12.9 Future challenge 208
12.10 Conclusion 208
Suggestions for further reading 209
References 209
Chapter 13 The Psychology and Treatment of Gambling Disorders 213
Andre Geel, Rebecca Fisher, and Aska Matsunaga
13.1 Introduction 214
13.2 Definition 214
13.3 Prevalence 215
13.4 Demographic risk factors 216
13.5 Treatment of gambling disorders 222
13.6 Personal comment and reflections 224
13.7 Conclusion 224
Suggestions for further reading 225
References 225
Chapter 14 Alcoholics Anonymous and 12 Step Therapy: A Psychologist's View 230
Martin Weegmann
14.1 Introduction: personal context 231
14.2 History 232
14.3 Philosophy 233
14.4 How does it work? 235
14.5 What can psychologist and helping professionals do? 239
14.6 Criticisms of AA 240
14.7 Postscript 241
Notes 241
Suggestions for further reading 242
References 242
Chapter 15 Relapse Prevention: Underlying Assumptions and Current Thinking 245
Robert Hill and Jennifer Harris
15.1 Introduction 246
15.2 What is relapse prevention? 246
15.3 Models of relapse prevention 250
15.4 Addressing co-existing mental health 254
15.5 Neuropsychological and associated difficulties when undertaking RP 255
15.6 Conclusion 257
Suggestions for further reading 258
References 259
Chapter 16 Working with Ambivalence about Change: Motivational Interviewing 262
Lisa Dutheil and Alina Galis
16.1 Introduction 263
16.2 Definition 263
16.3 Historical perspective 264
16.4 Theoretical influences 265
16.5 The spirit of mi 266
16.6 Change talk, sustain talk and discord 266
16.7 The four MI processes 267
16.8 Core MI skills 269
16.9 mi strategies more specific to particular processes 271
16.10 Evidence for the efficacy of mi 272
16.11 Integrating MI with other approaches 274
16.12 Using MI in groups 275
16.13 Learning mi 277
16.14 Conclusion 278
Suggestions for further reading 279
References 279
Chapter 17 'Beyond Workshops': Turning Evidence for Psychosocial Interventions into Embedded Practice 284
Luke Mitcheson, Christopher Whiteley, and Robert Hill
17.1 Introduction 285
17.2 What is implementation? 285
17.3 Implementation science 287
17.4 Consolidated Framework for Implementation Research (CFIR; Damschroder et al., 2009) 287
17.5 Implement what? Evidence-based interventions versus evidence-based practices 292
17.6 Case studies in Motivational Interviewing and treatment effectiveness (Mapping) 294
17.7 Conclusion 298
Notes 300
Suggestions for further reading 300
References 300
Index 303
