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 xi Foreword xiii Preface xvii 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 The unstable mind and chreods 13 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 B. 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 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 ORyan 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 B. 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