Search

Objectives: The research aimed to evaluate an exploratory Compassion Focused Group Psychotherapy Programme and the impact on participants' experiences of self‐criticism, usage of services and general wellbeing. Participants included patients with a history of complex attachment and relational trauma (A&RT), who might attract a diagnosis of personality disorder. Design: This study utilised a quasi‐experimental non‐randomised within subject controlled design for the evaluation of the efficacy of the programme. Methods: Participants were recruited from tertiary care services. The programme consisted of a 12‐week Preparation and Engagement intervention (PEG) which was Compassionate Mind Training and Psychoeducation, followed by a 40‐week Compassion Focused Trauma Group intervention. The cohort was then followed up after 12 months during which period they received treatment as usual. A comprehensive selection of self‐report measures was administered at various points during the therapeutic process and following completion of the group interventions. Results: The results of the research showed that the provision of a long‐term, slow‐paced, Compassion Focused Group Psychotherapy intervention, resulted in significant changes across all measures which were maintained at 12‐month follow‐up. These significant results were maintained following intention to treat and reliable change analyses. These data were supported by a significant reduction in service usage and a significant increase in engagement in employment and education. Conclusions: This study has identified that within Compassion Focused Group Psychotherapy, there is a therapeutic process of establishing group‐based safeness as a necessary precursor to cultivating compassion and reworking early shame‐based trauma memories. [ABSTRACT FROM AUTHOR]

This article is based upon the collective findings of a number of studies conducted in a number of countries during the past 20 years. Female partners and mothers are the family members who have been most represented in the study samples, but the latter also included sizeable numbers of male partners, fathers, sisters, brothers and adult sons and daughters. Citing examples taken from the studies, the article describes some of the most prominent elements of the stressful experience of living with a relative who is drinking or taking drugs excessively, notably: the relationship with a relative becoming disagreeable and sometimes aggressive; conflict over money and possessions; the experience of uncertainty; worry about the relative; and home and family life being threatened. The reasons why family members may put up with substance misuse are described, and the ways in which family members may either withdraw and gain independence or stand up to substance misuse, as alternative ways of coping, are outlined. Examples of the strain experienced by family members are given. The kinds of social support valued by family members are explained, as is the finding that good quality social support for family members is often lacking. The article concludes by offering an integrated view highlighting the disempowered position in which family members usually find themselves and the importance of good social support for family members in their coping efforts. Although the picture is coloured by factors such as sociocultural group and the ages and genders of family members and their relatives, we believe the core experience for affected family members is a universal one. (Contains 2 tables and 3 figures.)

This article outlines the stress-strain-coping-support (SSCS) model which underpins the whole programme of work described in this supplement. The need for such a model is explained: previous models of substance misuse and the family have attributed dysfunction or deficiency to families or family members. In contrast, the SSCS model assumes that having a close relative with a substance misuse problem constitutes a form of stressful life circumstances, often longstanding, which puts affected family members at risk of experiencing strain in the form of physical and/or psychological ill-health. Coping and social support are the two other central building blocks of the model. Affected family members are viewed as ordinary people faced with the task of coping with such stressful life circumstances. It is an assumption of the model that, difficult though the coping task is, family members need not be powerless in maintaining their own health and helping their relatives. Good quality social support, in the form of emotional support, good information and material help, is an invaluable resource for affected family members, supporting their coping efforts and contributing positively to their health. The 5-Step Method, to be described later in the supplement, is based on the SSCS model. It can be seen as a way of increasing the positive social support available from professional sources. (Contains 1 table and 1 figure.)

This article includes a description of the 5-Step Method. First, the origins and theoretical basis of the method are briefly described. This is followed by a discussion of the general principles that guide the delivery of the method. Each step is then described in more detail, including the content and focus of each of the five steps that include: listening non-judgementally; providing relevant information; exploring ways of coping; discussing social support and establishing the need for further help. Finally, issues of training, supervision and on-going support are discussed. It is concluded that the 5-Step Method offers a flexible response that can be delivered to family members affected by addiction problems by a range of helpers and in a range of settings and health systems. (Contains 5 tables and 2 figures.)

In this article we describe our work in trying to influence whole service teams to move their practice towards greater involvement of affected family members. Work with five teams is described. The process varied but in all cases it included recruitment of the team, training, continued support and evaluation of results. Use of a standard questionnaire for assessing attitudes towards working with affected family members showed significant changes in team members' knowledge, confidence and team support for working with family members. Records of all project events and meetings suggested that change takes time but that a "cultural change" can take place whereby earlier misgivings are dispelled and positive attitudes towards involving family members become embedded in a team's approach. Diary audit indicated that the frequency of involvement of family members in sessions can be increased three- to five-fold, with teams beginning to carry out work with a diversity of family members, in diverse ways and with diverse positive outcomes. In a number of cases, teams were encouraged to institute new family-friendly procedures, for example changes to appointment letters, assessments and design of waiting and counselling rooms. Lessons have been learnt, including the need to accommodate different levels of initial experience of working with family members, and the need to be clear about project aims and objectives. Sustainability of change remains an issue. A general conclusion is that the capacity of services to take on work with family members affected by substance misuse of close relatives varies greatly. Where organizations already have a mission to involve family members, capacity is good. Where alcohol and drug services have previously been focused on individuals who are misusing substances, change is difficult but can be achieved. For most non substance-specialist organizations, such as primary care health centres and most non-statutory organizations, capacity is very limited. In addition to training and continued support for practitioners, explicit commissioning of work with family members combined with management support is necessary. (Contains 5 tables and 1 figure.)

Twenty of the 24 drug users receiving prescribed injectable methadone from a citywide drug treatment service agreed to participate in a semi-structured interview about their drug use and treatment. Participants reported that they were originally prescribed injectable methadone to replace street purchases because they could not tolerate oral methadone or because of an inability to stop injecting. The experience of injectable methadone was reported as having led to significant improvements in drug use and life stability and reductions in risk behavior, but several participants compared injectable methadone unfavorably to injectable heroin, either in the form of street heroin or prescribed diamorphine. Although a number of the respondents reported sufficient stability to contemplate employment and relationships, few spoke about abstinence as a viable goal in the short-term and many participants reported considerable ambivalence about the experience of receiving injectable methadone prescriptions.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.addbeh.2005.06.005 Byline: Alex Copello (a)(b), Emmie Williamson (c), Jim Orford (a)(b), Ed Day (a)(d) Keywords: Addiction; Substance abuse treatment; Social environment; Intervention; Social influences Abstract: This paper reports on the implementation and preliminary evaluation of Social Behaviour and Network Therapy (SBNT) within drug treatment services. SBNT was initially developed and evaluated as part of a trial for alcohol treatment in the UK (UKATT). For the study reported in this paper SBNT was adapted for application with drug users. Therapists (N =20) from community drug services in Birmingham, UK, were trained to deliver the intervention. Training methods were supported by a treatment manual and included a two-day workshop followed by video supervision and monitoring. Following training therapists were asked to implement the treatment within the services in which they worked. Twelve of the therapists that were trained delivered SBNT to 24 clients within the study period of 8 months. Baseline and 3-month follow-up measures were administered using both quantitative and qualitative methods. This paper reports the quantitative results including drug use, levels of dependence, drug users' social network variables and family environment. Results suggest that it was feasible to train a number of therapists to deliver SBNT, and preliminary outcome results are encouraging. Further evaluation is needed in order to continue developing this promising social intervention. Author Affiliation: (a) Substance Misuse Services, Birmingham and Solihull Mental Health NHS Trust, UK (b) School of Psychology, The University of Birmingham, Edgbaston, Birmingham B15 2TT, UK (c) Department of Clinical Psychology, Bristol University, Bristol, UK (d) Academic Department of Psychiatry, The University of Birmingham, UK

Research has highlighted the benefits of professional substance misuse treatment workers facilitating their clients' involvement in 12-step self-help groups such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA). This study used a cross-sectional survey design to explore the attitudes of substance misuse treatment stall' working in the English West Midlands region toward AA and NA and the 12-step philosophy. A total of 346 treatment workers responded (71%). Fewer than 10% used the 12-step model in their treatment work, and only a third fell that their clients were generally suited to AA or NA. Fewer than half (46%) said that they were likely to recommend that their clients attend a self-help group meeting. Staff with nursing qualifications were more likely to have a positive attitude toward AA/NA than their nonnursing colleagues, and there was a statistically significant association between the level of reported spirituality of the workers and the likelihood of them recommending to clients that they attend AA or NA meetings. These results highlight differences in the role of AA/NA within the substance misuse treatment system in the United Kingdom and that in the United States: possible explanations are discussed. Keywords: Substance use disorders: Staff attitudes: Alcoholics anonymous; Narcotics anonymous: 12-Step treatment

Keywords * substance abuse * alcohol and alcoholism * health promotion These keywords are based on the subject headings from the British Nursing Index. This article has been subject to [...]

This article discusses and evaluates the social aspects of group alcoholism therapy. Topics include social support, family intervention, and relapse prevention.