Substance Misuse and Therapy

Substance misuse and mental health…

Sign saying addiction we can help

It is a well-known fact, and yes you have probably read or heard it before that Cognitive Behavioural Therapy (CBT) is the most evidenced-based psychological therapy available today and is the preferred therapeutic approach of the NHS. However, it is probably not the first modality one would associate with when working with clients presenting with substance misuse, having said that, CBT is very adaptable and can be integrated with Relapse Prevention (RP), Motivational Interviewing (MI) and Solution Focused Brief Therapy (SFBT), as well as other approaches.

What I do…

Pills a needle and the word addiction

I am a qualified Cognitive Behavioural Therapist working with West Lothian Drug and Alcohol Service (WLDAS), my team is called The Moving on Service where currently, I hold the position of Counsellor/Line Manager working on a 1:1 basis with offenders and vulnerable adults. In addition, I was responsible for compiling and presenting/facilitating the first group work program, appropriately named CBT in Groups which is open to the whole WLDAS service, moreover will now be open to the Addiction Care Partnership (ACP) that incorporates WLDAS, Social Work Addictions, NHS Lothian and Cyrenians Recovery Service. This is due to the successful pilot of CBT in Groups over the past 14 months. Groups have focused on anxiety and depression after my colleagues and I conducted a survey of our clients to ascertain their preferred choice of a group work program, indeed the latest group has just ended after a 12-week run.

How the groups worked…

A group talking during group therapy

There have been 3 groups piloted, covering a total of 30 weeks, with accumulative referrals of 54 clients. There were 29 clients who did not attend or disengaged after 3 weeks, however, a total of 25 clients remained consistently in attendance between the 3 groups: 6, 6 and 13 respectively.

Criteria to attend CBT in Groups (pilot)is simply to have had or currently have a substance misuse issue (stable enough to attend weekly groups), or have been affected by another’s substance misuse, that being a wife, husband, partner, other family member or friend and be working on a 1:1 basis with one of the counselling team at WLDAS.

Bringing two together…

A man with his arms open with joy in glorious sunshine

My colleagues in psychiatry will proclaim, ‘get rid of the substance misuse and your mental health will improve!’ I whole heartily agree but if only the substance misuse has gone the possibilities of relapse significantly remain as drugs and/or alcohol are extensively used as a coping strategy. Therefore, I am of the professional opinion (as are others within the field) that when there is a dual diagnosis (mental health issue and substance misuse)both require to be addressed simultaneously, obviously helping the client to establish a period of stability regarding the substance is vitally important at the beginning of any intervention.

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