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An Holistic Approach to Substance Abuse Treatment
Abstract
The purpose of this article is to describe a model outpatient substance abuse treatment program. This program is designed to provide patients with not only traditional modalities of treatment such as individual, group, and family therapy, but also to provide an opportunity for patients to express thoughts and feelings through holistic modalities. These modalities include dance/movement therapy, Tai Chi, art therapy, leisure and recreational skills, spiritual growth and development, cultural awareness and appreciation, vocational services, psychiatric care and physical health. The authors describe features of this program that they believe to be unique and that focus on ways to help patients develop a stronger sense of self-identity, self-esteem and self-confidence.
... The holistic approach to substance abuse treatment focuses on all aspects of the person, including emotional, physical, and social well-being, by encouraging growth through self-exploration and expression. By learning personally modified ways to cope and ease the mind, body, and spirit, a holistic approach shifts from the chaos surrounding addiction into a healthy lifestyle (Breslin, Reed, & Malone, 2003). These areas are often unexplored in traditional treatment programs. ...
... An integrated holistic approach would allow for a tailored treatment plan, based on the client's strengths, and would offer the most hope for recovery (Atkinson, 2009). Holistic interventions for adults in substance abuse treatment are necessary to facilitate the development of a self-identity, self-esteem, and self-confidence (Breslin et al., 2003). ...
... A holistic approach is essential in substance abuse treatment based on the complexity of the disease and the diversity of individual needs (Amodia, Cano, & Eliason, 2005;Atkinson, 2009;Breslin et al., 2003;Thornton, Gottheil, Weinstein, & Kerachsky, 1998). There is an urgent need in the substance abuse field for integrated treatment models that deal more effectively with individuals' etiological, biological, psychological, social, spiritual, and cultural considerations. ...
Holism is regarded as an effective means of alternative treatment, and there has been an increase in the number of innovative holistic treatment interventions in diverse fields of practice. Holistic practices in substance abuse treatment programs encompass therapies such as expressive therapy, art therapy, spiritual, or religious interventions; osteopathic treatment; acupuncture; and more. Although there is limited research on the effectiveness and use of holism in the field of substance abuse, there is consistent evidence of its success in other areas of treatment or counseling. A holistic perspective explains the necessity of treating all aspects of the self to improve success in treatment and altered lifestyles. A review of the benefits and types of holistic interventions in substance abuse treatment is provided, along with suggestions for future research.
... In China, most of the behaviors of taking new drugs are group behaviors (57). Collective exercise in sports can establish contact with peers, form a mutually restrained group, and reduce the tendency to use drugs due to self-isolation (58), which is often very meaningful for those who depend on it to quit illegal drugs. In particular, sports can screen and optimize communication groups and reduce the possibility of contact with illegal drugs. ...
Addiction has been attributed to development of habit-based neural circuits that promote continued substance use despite a conscious wish to abstain. The goal of this study was to determine if physical exercise could serve as an alternative habit to replace habitual substance use, and whether this exercise intervention methods differed for opioid vs. amphetamine Dependents. A total of 14 randomized controlled experimental literatures on exercise intervention in people with opioid and amphetamine use disorder were screened, the 14 literature included 4 opioids and 10 amphetamines. From the 14 literature, the information of intervention program elements were counted, respectively. Independent sample t-test was used to compare the similarities and differences between the two intervention methods, and intervention mechanism of dependents were discussed. All rehabilitation exercises for opioid dependents use aerobic exercise, while most rehabilitation exercises for amphetamine dependents use aerobic exercise, and a few use aerobic and anaerobic mixed exercise. There is no significant difference in exercise time, exercise frequency and cycle between the two intervention schemes (P > 0.05). The rehabilitation indicators of opioid and amphetamine dependents generally include psychological indicators and physiological indicators, and most of the tests mainly focus on measuring psychological indicators such as mood and drug craving of dependents. The goal of exercise intervention for opioid and amphetamine dependents is similar, the first is to improve mood, reduce craving, improve sleep, and the second is to enhance physical fitness. In the treatment of Substance use disorder, exercise intervention can be used as an auxiliary treatment. Exercise intervention emphasizes low intensity and high frequency. Exercise intervention tends to cultivate long-term exercise habits or exercise lifestyle. Based on this “habit” mechanism, exercise can complete the substitution of material dependence.
... I say probably, Allah Almighty did not give up on this servant, but we suffered a calamity, we are trying to move forward on the right path (Selim,52) how spiritual values and religious practices work in the addicted counselee's recovery from addiction (DiClemente, 2013) is the key element of our model. Breslin, Reed, and Malone (2003) explain the importance of gaining insight into the addict's spirituality in the addiction treatment process as follows: Evaluating how spiritual orientation relates to one's substance abuse helps treatment providers understand how each individual views himself or herself in terms of individual worth. From this point of view, questions were asked to determine the boundaries of the spiritual world as well as the substance abuse history in the pre-interview step. ...
This study aims to develop, implement, and test the effectiveness of a model prepared with a crossdisciplinary approach, which includes religious and spiritual elements that could be applied in the treatment of alcohol and substance addiction, especially in the rehabilitation process. The study adopts a mixed method research design. In the qualitative part, phenomenological analysis was used. In the quantitative section, scales were used to measure the participants’ dependence. The study group included alcohol and substance addicts who were in the rehabilitation process at the Green Crescent Consultancy Center (YEDAM) and aged between 24 and 56. Initially, the participants were given Addiction Profile Index (BAPI) to determine their demographic information, addiction level, and clinical chart, which is followed by Addiction Outcome Assessment Index (AOAI) during the interview process. Within the scope of the Spirituality-Based Addiction Counseling (MTBD) model, eight different interview sessions were held with each participant for an average of 45 minutes. Then, the data were discussed and evaluated in the light of the relevant literature. Quantitative findings indicated a slow but steady improvement in the participants, with slight fluctuations, from the pre-interview to the final interview (altruism) in MTBD Model. With regard to qualitative findings, the data showed that during the first steps of the model, the participants developed an awareness of how addiction affected them psycho-socially and spiritually, and during the following steps, this awareness was significantly effective in transforming their lives. It could be claimed that the model is a motivational element that reinforces the basic treatment and rehabilitation processes in the struggle to get rid of addiction and adds religious and spiritual meaning to this process.
... 39 In addition, both modalities help patients achieve relaxation, and reconnect with their mind, body, and spirit, making them more mindful and internally focused. 64 Finally, practicing Taijiquan and Qigong exercises in a group can promote social interaction in interpersonal relationships, providing social support, and benefiting patients' physical and mental health. 63 Cognitive behavioral therapy and other non-drug therapies, such as exercise, acupuncture, and psychotherapy, have become important complementary modalities in treating SUD patients. ...
Previous studies have shown that Taijiquan and Qigong exercise can effectively reduce depression and anxiety in healthy and clinical populations. At present, only a few reviews have elaborated on the premise of different types of interventions, and there is still a lack of studies that systematically summarize the clinical evidence of patients with substance use disorders. The purpose of this meta-analysis was to assess the impact of the Taijiquan and Qigong exercise on the mood of individuals with substance use disorders (SUD); Articles were searched in Pubmed, Embase, Cochrane Library, Web of Science, and CNKI from their inception to the May 24, 2021. All randomized controlled trials (RCT) using Taijiquan and Qigong intervention were included. With the Review Manager software to determine the effect (standardized mean difference, SMD), subgroup analysis was conducted to intervention type, exercise time, and exercise duration. Nine studies totaling 823 participants were included in the study. Overall results indicated that Taijiquan and Qigong exercise had significant benefits in reducing depression (SMD = −0.35, 95% CI: −0.53 to −0.18, Z = 4.00, p < 0.01) and anxiety (SMD = −0.31, 95% CI: −0.50 to −0.11, Z = 3.06, p
... W procesie tym powinien uczestniczyć lekarz podstawowej opieki zdrowotnej (POZ), z którym pacjent ma styczność najczęściej i do którego niejednokrotnie ma największe zaufanie. Często konieczne jest wsparcie psychologa, psychoterapeuty lub psychiatry [13][14][15]. W pracy podjęto próbę opisania właściwego modelu postępowania z pacjentem uzależnionym od leków nasennych i uspokajających, skupiając się na roli lekarza POZ oraz psychologa. ...
Uzależnienie od chemicznych środków psychoaktywnych to stan psychologicznej albo psychicznej i fizycznej zależności od takich substancji przejawiający się okresową lub stałą koniecznością ich przyjmowania. Z problemem uzależnienia spotyka się w swojej pracy zawodowej większość praktykujących lekarzy, psychologów oraz psychoterapeutów. Lekarz podstawowej opieki zdrowotnej, do którego pacjent ma zazwyczaj najłatwiejszy dostęp i nierzadko największe zaufanie, powinien koordynować proces wychodzenia z uzależnienia. Jeśli to wskazane, powinien pokierować pacjenta do psychologa lub psychiatry. W leczeniu uzależnienia od leków podkreśla się w pierwszej kolejności duże znaczenie psychoedukacji dotyczącej działania zażywanych substancji i ich działań niepożądanych. Wartościową metodą wykorzystywaną w leczeniu tego nałogu oraz mogącą służyć podtrzymaniu motywacji do kontynuowania abstynencji jest terapia poznawczo-behawioralna. Ma ona za zadanie poprawić jakość życia pacjenta dzięki modyfikacji jego zachowań i sposobu myślenia. Kluczowa jest właściwa relacja pacjent–psychoterapeuta. W leczeniu farmakologicznym należy stopniowo zmniejszać dawki przyjmowanych leków i zamienić benzodiazepiny o krótkim czasie półtrwania na inne, ale o długim czasie półtrwania, a także leczyć przyczynowo inne niż uzależnienie zaburzenia psychiczne.
... Drug abuse has a holistic aspect because it impacts biologically, emotionally, psychologically, and spiritually [9]. Therefore, the rehabilitation procedure for drug users must also use a holistic approach [10]. The approach referred to is not only limited to efforts to eliminate user addiction from various aspects, but also includes multi-stakeholder involvement [11]. ...
Laksamana Sub-district located in 2 nd ring of Pertamina RU II Dumai operational area. In the last two years, a series of community development programs have been carried out in this district, as part of Pertamina RU II Dumai's commitment to participate in overcoming social problems. However, drug abuse is not a simple problem. There are many parties who have interests, especially from local government such as the BNN, BKKBN and Detention Centre. This study focuses on Pertamina RU II Dumai's CSR strategy to deal with rampant drug abuse in Dumai City generally, especially LaksamanaSub-district through a multi-stakeholder approach. As a result, premier and tertiary interventions were carried out on vulnerable groups such as children, youth, housewives and even former drug abusers. Meanwhile, CSR programs are synergized with local government and community groups programs. These programs focus on (1) developing child-friendly open spaces, (2) increasing education through reading corners, (3) increasing the competence of prisoners, (4) and developing economic center.
... To understand one's spirituality (defined at this time as one's values, beliefs, experiences, and a sense of drive in the world) is critical to any recovery program. The valuation of spiritual arrangement (and how it relates to one's substance support treatment providers) comprehends how each individual views him/herself in terms of personal means and value (Breslin, Reed, & Malone, 2011). Procedures of change characterise the internal and external practises and experiences that permit individuals to transfer from phase to phase. ...
This paper examines the role of spirituality in a recovery context by drawing on qualitative research conducted at a residential recovery community in North Wales, United Kingdom. The study aimed to examine perceptions of spirituality among exprisoners and people identifying as in recovery from addiction. The researchers explored ideas of “spiritual coping” and “spiritual wellbeing” in terms of meaning, purpose, connectedness, forgiveness, and peace in addiction treatment programs influenced by 12-Step models, for instance, Alcoholics Anonymous (AA). Also, this paper focuses on both spiritual counseling services shaped by pre-determined meanings and values and secondly, on individuals’ perceptions about spirituality through the language of desires, needs, and expectations. The data for this research produced from five semi-structured interviews with male individuals who had recovered from their addiction and had practised some custodial life. To discover the common context of different perceptions of the language spirituality, the data was coded by the first and second loop encodings from the data analysis methods used. The central schemes that appear as “Spirituality in Experiences, Spirituality in Values, Spirituality as Meaning/Purpose of Life, Spirituality as Attachment, Spirituality as Coping Mechanism” have been evaluated within the framework of the concept of spirituality. In the conclusion of this study, it was observed that spirituality was used as a coping mechanism for buffering the sensation of hopelessness and powerlessness often experienced by people in active addiction.
... To understand one's spirituality (defined at this time as one's values, beliefs, experiences, and a sense of drive in the world) is critical to any recovery program. The valuation of spiritual arrangement (and how it relates to one's substance support treatment providers) comprehends how each individual views him/herself in terms of personal means and value (Breslin, Reed, & Malone, 2011). Procedures of change characterise the internal and external practises and experiences that permit individuals to transfer from phase to phase. ...
This paper examines the role of spirituality in a recovery context by drawing on qualitative research conducted at a residential recovery community in North Wales, United Kingdom. The study aimed to examine perceptions of spirituality among ex-prisoners and people identifying as in recovery from addiction. The researchers explored ideas of "spiritual coping" and "spiritual wellbeing" in terms of meaning, purpose, connectedness, forgiveness, and peace in addiction treatment programs influenced by 12-Step models, for instance, Alcoholics Anonymous (AA). Also, this paper focuses on both spiritual counselling services shaped by predetermined meanings and values and secondly, on individuals' perceptions about spirituality through the language of desires, needs, and expectations. The data for this research produced from five semi-structured interviews with male individuals who had recovered from their addiction and had practised some custodial life. To discover the common context of different perceptions of the language spirituality, the data was coded by the first and second loop encodings from the data analysis methods used. The central schemes that appear as "Spirituality in Experiences, Spirituality in Values, Spirituality as Meaning/Purpose of Life, Spirituality as Attachment, Spirituality as Coping Mechanism" have been evaluated within the framework of the concept of spirituality. In the conclusion of this study, it was observed that spirituality was used as a coping mechanism for buffering the sensation of hopelessness and powerlessness often experienced by people in active addiction.
... YP with a substance-related disorder are more likely to have a co-morbid psychiatric illness and are more likely to report a history of trauma than YP without a substance-related disorder (Deas, 2006). As such, the multidisciplinary nature of the outpatient setting is ideal for care planning and holistic service delivery (Breslin et al., 2003). ...
Background:
Systematic reviews and meta-analyses (reviews) conflict regarding the efficacy and feasibility of substance disorder treatments for young people (YP). This overview of reviews, synthesizes, and methodologically assesses reviews examining substance disorder interventions for YP in outpatient settings.
Methods:
Reviews published between 1990 and March 2018 were searched using EBM Reviews, PsycINFO, Embase, Ovid Medline, and Campbell Collaboration. Reviews investigating efficacy and/or feasibility of YP substance disorder treatments in outpatient settings were included.
Forty-three reviews met all inclusion criteria:
To appraise methodological biases, 40 reviews were assessed using A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR2) and 3 were narratively assessed. One reviewer (NS) extracted study data and evaluated all 43 reviews. For inter-rater reliability, 13 (30%) reviews were extracted and appraised in duplicate by a second reviewer (JA, RC or ES). Agreement on AMSTAR2 ratings reached 100%. Agreement was moderate; κ = .52 (p < .05), 95% CI (.20, .84).
Results:
All high quality methodological reviews (n = 6) focused on intervention efficacy and none on treatment feasibility. One (n = 1) high quality review reported evidence for an intervention. Multidimensional Family Therapy (MDFT) has possible efficacy in reducing YP substance use when compared to treatment as usual, Cognitive Behavior Therapy, Adolescent Community Reinforcement Approach and Multifamily Educational Therapy.
Conclusions:
Methodological and reporting quality of reviews require improvement. High quality reviews focused on intervention efficacy but treatments commonly lacked evidence. One high quality review found MDFT demonstrated promising outcomes. Reviews examining feasibility of interventions were of low methodological quality.
... 7,8 In addition, anecdotal reports from SUD treatment programs using mind-body therapies indicate that the experiential focus of these therapies is instrumental in facilitating sensory and emotional awareness through nonverbal processes, management of stress and craving, sense of meaning, and increased satisfaction with SUD treatment. [9][10][11][12][13][14] This study examined the issues of implementation and acceptability of a novel mind-body intervention Mindful Awareness in Body-oriented Therapy (MABT) in women's substance use disorder treatment. This is the first known study of a mind-body intervention involving a manual (touch-based) therapy as an adjunct to SUD treatment. ...
Purpose: To study Mindful Awareness in Body-oriented Therapy (MABT), a novel adjunctive approach to women's addiction treatment. A high proportion of women entering treatment report a history of interpersonal violence. Risk of relapse is associated with vulnerability to interpersonal stress. MABT is designed to facilitate emotional regulation, reduce avoidant coping and trauma symptoms, outcomes important for relapse prevention. The primary two aims of the study examined: 1) recruitment and retention feasibility, and 2) MABT acceptability. Sample and Methods: Eligibility required attendance in inpatient program and continued outpatient treatment. A 2-group RCT repeated measures design involved randomization to MABT plus usual care or usual care (UC) only. Eight weekly MABT sessions (1.5 hrs) spanned inpatient and outpatient programs. Assessments administered at four time-points. To measure MABT acceptability, survey and written questionnaire were administered. Analysis involved descriptive statistics and content analysis. Results: Sixty women were screened, 46 were eligible and 45 enrolled. Thirty assigned to MABT and 15 to UC. Twenty-five percent screened positive for PTSD; 80% reported sexual or physical assault. In MABT group, 12 were discharged from, or ended, outpatient program. Of remaining 18, 16 completed 75-100% MABT sessions; a typical retention rate for behavioral interventions in addiction research. Results indicated MABT was perceived to increase emotional awareness and provide new tools to cope with stress; these were perceived to reduce relapse risk. In conclusion, it is feasible to recruit and implement MABT in women's addiction treatment, and MABT acceptability and perceived benefit is high. (NIH-NIDA- R21DA024771)
... The emergence of mind-body approaches in substance use treatment, 9 in combination with the inclusion of emotional regulation in conceptual models of psychopathology, has led to increased interest in the role of emotional regulation in the treatment of problematic substance use. 10 Mind-body therapies, in general, address the relationships among somato-emotional awareness, coping, and emotional regulation and teach integrative strategies that may help individuals react more effectively to stress and negative emotions. [11][12][13] Clinical studies have shown that for individuals in substance abuse treatment, emotion regulation difficulties as measured by the Difficulties in Emotional Regulation Scale (DERS) 14 are significantly higher compared to community controls. 15,16 Due to the high prevalence of PTSD and reported trauma among individuals seeking treatment for a substance use disorder (SUD), recent studies have examined the PTSD-SUD relation to emotional regulation difficulties. ...
Individuals in substance use disorder (SUD) treatment have shown high levels of difficulty with emotion regulation, as well as a high prevalence of reported trauma and symptoms of post-traumatic stress (PTS). Dissociation from the body is a common clinical experience among women with a history of sexual trauma. Research has shown promising effects of mind-body approaches in SUD treatment, as well as the importance of emotional regulation in conceptual models of psychopathology. The current study examines the mediating role of bodily dissociation and emotion regulation on PTS symptoms in a sample of women enrolled in substance use disorder treatment. Results indicate that bodily dissociation and emotion regulation had significant direct effects on PTS symptoms from baseline to a 6-month follow-up, and that bodily dissociation also may indirectly operate to reduce PTS symptoms through its effect on emotion regulation difficulties. These results suggest the importance of addressing bodily dissociation and emotion regulation difficulties in women's substance use disorder treatment.
... A multimodal theory of recovery was most beneficial to suit those individuals that do not fit within the parameters of a single therapy type. Breslin, Reed, and Malone (2003) reviewed a list of holistic approaches to substance abuse treatment, including dance movement therapy, tai chi, and leisure or recreational skills therapy. These approaches integrated the spiritual aspect of an individual into the treatment, as well as physical movement. ...
Chemical dependency addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Addiction interferes with an individual’s physical, mental, emotional, and spiritual development. This qualitative study focused on women who have relapsed from previous attempts at sobriety and investigated how art may allow for deeper personal exploration and emotional expression. Each participant was given the opportunity to express her concerns about her multiple attempts in recovery and the use of art for clarification of her needs. The women were interviewed regarding their ideas of harm reduction, relapse prevention, and motivation in recovery. Using a heuristic philosophy for the collection of data and materials, this study profited from empirical information acquired through observation, inquiry, and content analysis of daily journals. Using a grounded theory approach, the interview style changed according to the individual’s needs and as additional material and responses was collected. These interviews, discussion of personal art, observations made during the session, and content analysis of journals from both therapist and client were triangulated to find common themes about these women’s ideas about the recovery process from addictions. The benefits of art therapy with people with chemical dependency addictions were gleaned from the nine weeks of qualitative research.
... There is evidence that healthy behaviors, that is, behaviors encouraging recovery and incongruent with behaviors leading to relapse, improve abstinence rates (e.g., LePage & Garcia-Rea, 2008). To enhance these behaviors treatment programs frequently provide ancillary therapies such as recreational therapy (Breslin, Reed, & Malone, 2003) and exercise/kinesiotherapy (e.g., Brown et al., 2009). These therapies are viewed as improving the skills used to avoid boredom, loneliness, and frustration-factors associated with the return to substances (e.g., Levy, 2008). ...
Objective:
Behaviors and activities consistent with "healthy" lifestyles (i.e., leisure and recreational activities, social and family interactions, coping behaviors) have been shown to be related to prolonged substance dependence recovery. However, there has been little focus on systematically capitalizing on this association in treatment to improve relapse rates. The goal of this study was to determine if the inclusion of healthy lifestyle coaching, that is the encouragement of specific behaviors in a therapeutic setting, could impact time to relapse.
Methods:
Fifty-six veterans who were recently discharged from a Veterans Administration (VA) homeless Domiciliary Residential Rehabilitation and Treatment Program and were substance dependent were evaluated over a 6-month follow-up period. Using a partially randomized design, three groups were evaluated: 1) those followed by a therapist and coached to increase healthy behaviors, 2) those followed by a therapist and receiving only emotional support, and 3) those not followed by a therapist. Survival analyses and nonparametric evaluations were performed.
Results:
Coached consumers had longer latency to relapse than noncoached and relapsed at a lower rate than those not followed by a therapist.
Conclusions and implications for practice:
Therapeutic interventions which focus on increasing healthy behaviors chosen by the consumer can be an important component of sustained recovery from substance dependence.
... Mindfulness-based approaches have generated growing interest as one such set of strategies that may address the neurobiological and cognitive-emotional substrata of maladaptive stress responses in SUDs (Brewer, Bowen, Smith, Marlatt, & Potenza, 2010). Mind-body therapies, in general, address the relationships among somato-emotional awareness, coping, and emotional regulation and teach integrative strategies that may help individuals react more effectively to stress and negative emotions (Breslin, Reed, & Malone, 2003;Kosakoski, 2003;Wesa & Culliton, 2004). However, such therapies have not been evaluated in the context of women's addiction treatment. ...
This study examined mindful awareness in body-oriented therapy (MABT) feasibility as a novel adjunct to women's substance use disorder (SUD) treatment. As an individual therapy, MABT combines manual and mind-body approaches to develop interoception and self-care tools for emotion regulation. A 2-group randomized controlled trial repeated-measures design was used, comparing MABT to treatment as usual (TAU) on relapse to substance use and related health outcomes. Sixty-one women were screened for eligibility, and 46 enrolled. Participants randomized to MABT received 8 weekly MABT sessions. Results showed moderate to large effects, including significantly fewer days on substance use, the primary outcome, for MABT compared with TAU at posttest. Secondary outcomes showed improved eating disorder symptoms, depression, anxiety, dissociation, perceived stress, physical symptom frequency, and bodily dissociation for MABT compared with TAU at the 9-month follow-up. In conclusion, it is feasible to implement MABT in women's SUD treatment, and results suggest that MABT is worthy of further efficacy testing.
Knowing the patient's personality can assist the clinician in improving their relationship and tailoring the interventions for the patient. Several studies reported that treatment and prevention programs must be tailored to an individual's social and cultural attributes to facilitate continuous recovery and prevent relapse. This study aims to develop a deeper understanding of the personality typology, clinical features, and risk for relapse of Filipinos with substance use problems in rehabilitation centers. We used a sequential-explanatory mixed-method approach, with two phases (Phase 1: descriptive, cross-sectional design; Phase 2: phenomenological design) to provide an evidence-based framework to tailorfit treatment according to the personality of individuals with substance use problems. Phase 1 results revealed only one cluster of personality for Filipinos with substance use problems, Neurotic-Extravert. Participants also had high scores on different scales in the MCMI-III and displayed high chances of reusing illicit substances. Phase 2, on the other hand, revealed the four themes: Avoidance coping, Unwillingness to Change, Preference for Social Activities and Perceived lack of support. Integrating the findings of our two phases led to the development of the proposed treatment framework for Filipinos with substance use problems, including activities focused on developing positive coping mechanisms, increasing the motivation of Filipinos with substance use problems, having social activities, fostering support systems and a post-treatment program. Our study’s findings may aid mental health professionals engaged in substance use prevention and recovery in creating better treatment programs and reducing relapse tendencies post treatment.
The topic of raving has not yet been addressed in dance/movement psychotherapy (DMP) literature, despite being a meaningful activity shown to facilitate personal transformation. Whilst studies on rave culture have highlighted its therapeutic benefits, none of them focus on recovering substance abusers. This research identifies links between raving and DMP, looking at what each practice can offer this client group. Three key commonalities were identified whilst reviewing the literature on raving, DMP and substance abuse: strengthening spirituality, enhancing one’s sense of self, and creating a sense of belonging. Through analysing data from participant interviews, my embodied responses and my own experiences, five more were revealed. Findings from this study were considered for their relevance in DMP clinical practice.
Sexual minority women (SMW) engage in higher rates of substance use treatment than their heterosexual counterparts, yet little is known about how treatment can target the unique needs of SMW. This systematic review identified twelve articles that focused on testing or developing substance use interventions for SMW. Adaptations to meet the needs of SMW focused on sexual orientation, gender, minority stress, and mental health. Only four interventions were empirically evaluated. Behavioral interventions had the greatest empirical support, and results were mixed for the inclusion of partners in treatment. Future research should empirically evaluate proposed identity-focused substance use interventions for SMW.
Present study examined effectiveness of Integrative Body Mind Spirit (I-BMS) intervention among individuals with alcohol dependence. A 2-group single blind RCT design was used, comparing I-BMS to treatment as usual (TAU) on drinking and psychological outcomes. One hundred participants diagnosed with alcohol dependent syndrome were randomly assigned to receive 7 sessions of I-BMS or TAU. Measurements done by a registered nurse who was blinded to the experimental design used standardized questionnaire on wellbeing, readiness to change, craving, quantity and frequency of drinking before and up to 6 months after the intervention. With respect to the within group effects, the I-BMS group demonstrated significant improvement in all outcome measures with large effect size. Compared to TAU, I-BMS participants showed lesser relapse rates and quantity of drinking at 3-month follow-up, reduction in craving and drinking days at 2-month follow-up. At 6 months follow-up, participants in I-BMS group reported significant improvement in wellbeing and motivation compared to TAU. Results of binary logistic regression showed that number of previous attempts and living in urban area positively predicted participant’s relapse possibility at 6-month follow-up. Results suggest that I-BMS is worthy of further efficacy testing. In conclusion, it is feasible to implement I-BMS intervention for individuals with alcohol dependence.
Abstract Background Methamphetamine (MA) is a highly addictive psychostimulant used by approximately 52 million people worldwide. Chronic MA abuse leads to detrimental physiological and neurological changes, as well as increases in anxiety and depression, and decreases in overall fitness and quality of life. Exercise has been reported to possibly reverse physiological and neurological damage caused by previous MA use, and to reduce anxiety and depression in this population. The aim of this systematic review was to identify, clinically appraise and synthesise the available evidence for the effectiveness of exercise, compared to cognitive behavioural therapy (CBT), standard care or no intervention, on decreasing anxiety and depression and improving fitness and quality of life in previous MA users. Methods Seven computerised databases were searched from inception to May 2017, namely Scopus, Cochrane Library, PubMed/MEDLINE, PEDro, CINAHL, and ScienceDirect. Search terms included exercise, methamphetamine, fitness measures, depression, anxiety and quality of life. Randomised and non-randomised controlled- or clinical trials and pilot studies, published in English, were considered for inclusion. Methodological quality was critically appraised according to the PEDro scale. Heterogeneity across studies regarding control groups and assessment intervals rendered meta analyses inappropriate for this review and results were thus described narratively using text and tables. Results Two hundred and fifty-one titles were identified following the initial search, and 14 potentially-relevant titles were selected and the abstracts reviewed. Three studies (two randomised controlled trials and one quasi-experimental pilot) were included, with an average PEDro score of 6.66. Exercise resulted in significantly lower depression and anxiety scores versus CBT (p = 0.001). Balance also significantly improved following exercise versus standard care (p
BACKGROUND: Humans strive for meaning-making, which refers to the process by which a person derives meanings from an activity in life and makes sense of one's life. OBJECTIVE: This paper summarizes the research-based knowledge about the role of leisure in meaning-making, and describes implications of this role for rehabilitation to engage individuals with disabilities. RESULTS: The key themes of meaning-making through leisure include: (1) identity, (2) creativity, (3) connectedness, (4) harmony/balance, (5) stress-coping and healing, (6) growth/transformation, and (7) experiential and existential aspects of leisure. These seven themes seem to converge for the idea that engagement with life is an overarching theme to describe these functions. Specifically, a meaningful engagement with life can be achieved by maintaining several elements including: (a) a joyful life, (b) a composed life, (c) a connected life, (d) a discovered life, and (e) a hopeful and empowered life. Research has shown that leisure can promote all of these elements of meaningful engagement with life. CONCLUSIONS: Any leisure activity that has an element of engagement in a broad sense (e.g., with self, others, and nature/world) can facilitate meaning-making, while meaning-focused leisure practice emphasizes the value of people proactively leading the process rather than people being told what to do in a prescriptive way.
Background:
Tai Chi is a traditional Chinese sport that is classified as a moderate exercise. Recent studies have evaluated the effectiveness of Tai Chi in substance abuse rehabilitation.
Objectives:
The aim of this study was to assess the quality of life and physical effects of a Tai Chi intervention on individuals with amphetamine-type stimulant (stimulant) dependence.
Methods:
Sixty male subjects with stimulant dependence from a Shanghai Mandatory Detoxification and Rehabilitation Center participated in a 12-week trial. Tai Chi was used as an intervention in the experimental group (n = 30). The control group (n = 29) underwent standard care, which included recreation activity, gesture language exercise, and self-education. Outcome measures included the quality of life for drug addiction (QOL-DA) questionnaire [four scales consisting of physiology (e.g., energy level), psychology (e.g., depression), symptoms (e.g., physical symptoms), society (e.g., interpersonal) and fitness evaluations (assessed by body mass index, body fat, hand-grip, flexibility, balance)]. Repeated measures were used to analyze the changes over time.
Results:
Test scores of the QOL-DA in the Tai Chi group significantly increased after 12 weeks in the following areas: physiology, 8.71 (p = 0.005), symptoms, 4.34 (p = 0.042), society, 15.79 (p < 0.001), and total score, 10.60 (p = 0.002). A post hoc test further revealed that quality of life improved in the Tai Chi group but not in the standard care group. Physical results showed a significant interaction with balance(F(1,56) = 6.92, p = 0.011); participants in the Tai Chi group improved by 10 s while there was no change in the standard care group. Although there were no significant interactions in the fitness outcomes (i.e., hand-grip and sit-and-reach tests), the within-group factor displayed significant changes in body fat (F(1,56) = 27.79, p < 0.001) in both groups.
Conclusion:
This study demonstrates that Tai Chi is a promising exercise that improves quality of life for individuals with stimulant dependence.
Research over the past decade into eating disorders and substance use disorders has been considerable. Despite this, response to treatment for many remains poor. New adjunctive therapies that improve the effectiveness of existing treatments and lead to improved mental health outcomes for these patient groups are highly desirable. Recent research into the role of complementary and alternative medicine in eating disorders and substance use disorders has responded not only to the need to improve treatment outcomes but also to the common usage of complimentary therapies by individuals with these disorders. While still in its early stages, research into different types of complimentary therapies including yoga, acupuncture, therapeutic massage, hypnosis, herbal medicine, light therapy, spiritual healing, and art therapy has shown promise both in addressing not only comorbid anxiety and depression but also core disorder symptoms. It is therefore critical that these therapies are rigorously evaluated so we utilize any potential benefits from these treatments and respond to our patients’ considerable interest in and desire to utilize complementary and alternative medicine in their recovery.
The authors describe the introduction of the practice of tai-chi-chuan in a in-patient setting. The presentation of this component of traditional Chinese medicine includes its martial, medical and cultural aspects. A clinical vignette illustrates how one of the first patients reacts to this bodily technique. While somatic benefits of tai-chi are well-known, the authors try to show two major contributions to the improvements of the well-being of traumatized inpatients: Growing mindfulness and active relaxation.
The purpose of this study was to examine the implementation and acceptability of Mindful Awareness in Body-oriented Therapy (MABT), a novel adjunctive approach to substance use disorder (SUD) treatment. The primary aims of the study were to examine implementation of MABT as an adjunct to addiction treatment, and MABT acceptability to study participants and treatment staff.
MABT was delivered to participants randomly assigned to the intervention in a larger ongoing trial. This study focuses only on the implementation and acceptability of the intervention, as outcomes are not yet available. MABT was delivered once weekly for 8 weeks (1.5-hour sessions) and spanned inpatient and outpatient programs at a women-only treatment facility. Descriptive statistics were used to examine participant recruitment and retention to the intervention. To measure MABT acceptability, survey and written questionnaires were administered; analysis involved descriptive statistics and content analysis using Atlas.ti software.
Thirty-one (31) of the women enrolled in the study were randomized to MABT. Eighteen (18) participants completed 75%-100% of the MABT sessions. Intervention implementation required flexibility on the part of both the researchers and the clinic staff, and minor changes were made to successfully implement MABT as an adjunct to usual care. MABT was perceived to increase emotional awareness and provide new tools to cope with stress, and to positively influence SUD treatment by facilitating emotion regulation.
It was feasible to implement MABT and to recruit and retain women to MABT in women's chemical-dependency treatment. MABT acceptability and perceived benefit was high.
Patients with co-occurring disorders (CODs) have a substance use disorder (SUD) and at least one other mental health diagnosis. Many patients with a non-SUD mental health diagnosis also have an SUD, whereas most patients with SUDs have other co-occurring psychiatric disorders. Recognition is growing regarding the importance of identifying and treating CODs. This article reviews the magnitude of CODs, theories by which CODs develop, treatment options for CODs (including psychotherapeutic and psychopharmacologic interventions), current treatment initiatives for CODs, and ways to prevent CODs. Although research on CODs is providing direction and hope for treatment, many more questions than answers remain regarding these challenging conditions.
Cannabis is the most commonly used illicit drug in Papua New Guinea (PNG). Data on the epidemiology and history of cannabis in PNG are presented. The adverse health consequences of cannabis smoking and treatment options for cannabis dependence are discussed. It is recommended that a range of strategies are urgently required in PNG to prevent adverse physical and mental health consequences associated with cannabis smoking.
The prevalence of comorbid alcohol, other drug, and mental disorders in the US total community and institutional population was determined from 20,291 persons interviewed in the National Institute of Mental Health Epidemiologic Catchment Area Program. Estimated US population lifetime prevalence rates were 22.5% for any non-substance abuse mental disorder, 13.5% for alcohol dependence-abuse, and 6.1% for other drug dependence-abuse. Among those with a mental disorder, the odds ratio of having some addictive disorder was 2.7, with a lifetime prevalence of about 29% (including an overlapping 22% with an alcohol and 15% with another drug disorder). For those with either an alcohol or other drug disorder, the odds of having the other addictive disorder were seven times greater than in the rest of the population. Among those with an alcohol disorder, 37% had a comorbid mental disorder. The highest mental-addictive disorder comorbidity rate was found for those with drug (other than alcohol) disorders, among whom more than half (53%) were found to have a mental disorder with an odds ratio of 4.5. Individuals treated in specialty mental health and addictive disorder clinical settings have significantly higher odds of having comorbid disorders. Among the institutional settings, comorbidity of addictive and severe mental disorders was highest in the prison population, most notably with antisocial personality, schizophrenia, and bipolar disorders.
Problems with employment are common among individuals with substance use disorders, yet comprehensive vocational services are not generally available to them, and vocational interventions are often not matched to their specific needs. This article describes the wide range of vocational problems found among individuals with substance use disorders and the elements of a recently funded vocational program for patients in outpatient and residential drug and alcohol treatment programs. Data are presented describing program activity and documenting program effectiveness for the first 2 years of operation of the program. Three case histories are presented to illustrate the types of services delivered and the matching of services delivered to specific, identified client needs (see Case Histories).
Drug-addicted fathers bring to treatment many uncertainties about their relevance to their children. Whether they are in contact with their children or not, they often believe their children are better off without contact with them. In working with these fathers, the authors have observed these men raising a number of issues concerning the father role. These include having no concept of what a father should be, confusing the roles of manhood and fatherhood, feeling inadequate as a provider, and not knowing how to reconnect with children they have not seen, particularly daughters. The fathers also have to learn to deal with their own guilt concerning their abandonment of their children. Suggestions for interventions with the fathers are given and include offering a workshop for fathers where they are shown visual images of positive fathering and can discuss their own parenting experiences.
This article discusses the complex dual diagnosis of HIV/AIDS (Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome) and substance abuse, which affects a growing number of individuals worldwide. A brief review of HIV/AIDS is provided and the connection between HIV/AIDS and substance abuse is described. Substance abuse complicates both HIV/AIDS and its management because of the effects that illicit drugs have on various body systems and because of the behavioral disturbances that accompany substance use. For a variety of reasons adherence to treatment is poor in this population and several factors that negatively impact adherence are outlined. Treatment of drug abusers who are HIV-positive requires more flexibility than treating drug abuse and HIV separately. Because medication regimens can be complicated and demanding and nonadherence to treatment can cause mutation of the virus resulting in drug-resistant strains, it is essential to get the patient committed to treatment The goals of treatment are abstinence from illicit drugs, adherence to a treatment regimen, suppression of viral load, improved CD4 count, and improved quality of life. The role of the case manager is critical to improving treatment adherence. Essential attributes include knowledge of disease processes, critical thinking, and the ability to navigate the healthcare system. Case management interventions to improve treatment adherence should be directed at the patient, the regimen, the client-patient relationship, and the healthcare system. Because HIV/AIDS is now classified as a chronic disease and is no longer viewed as a death sentence, people who are HIV-positive have hope for longevity and a cure. It is this hope for a longer life and possible cure that can be used to motivate substance abusers who are HIV-infected to improve their treatment adherence and quality of life.
Co-morbidity of mental disorders with alcohol and other drug abuse
- M E Farmer
- D S Rae
- B Z Locke
- S J Keith
- L L Judd
- F K Goodwin
Farmer, M.E.; Rae, D.S.; Locke, B.Z; Keith, S.J; Judd, L.L. & Goodwin, F.K. 1990. Co-morbidity of mental disorders with alcohol and other drug abuse. Journal of American Medical Association 264: 25 11-18.
The Th eory and Practice of Group Psychotherapy. Fourth Ed. Philadelphia, Pennsylvania: Basic Books
- I D Yalom
Yalom, I. D. 1995. The Th eory and Practice of Group Psychotherapy. Fourth Ed. Philadelphia, Pennsylvania: Basic Books. Vo lume 35 (2), April -June 2003