This book provides clinicians and students with insights on the use of psychodynamic therapy to treat drug abuse and addiction, combining theory with clinical case material. The perspectives of analysts such as Abraham, Rado, Zimmel, Tibout, Wurmser, Khanzian, Krystal and McDougall are reviewed alongside original and more recent conceptualizations of drug addiction and recovery based on Kleinian, Winnicottian and Kohutian ideas. The case material deals with clinical phenomena that characterize working with this complex population, such as intense projective identification, countertransference difficulties and relapses. The theoretical analysis covers a range of concepts, such as John Steiner's psychic shelters and Betty Joseph's near-death-addiction, which are yet to be fully explored in the context of addiction. Prevalent topics in the addiction field, such as the reward system, the cycle of change and the 12-step program, are also discussed in relation to psychodynamic theory and practice. Written by an experienced therapist, Psychodynamic Approaches for Treatment of Drug Abuse and Addiction is useful reading for anyone looking to understand how psychodynamic thought is applicable in the treatment of drug abuse and addiction. It may also be of some relevance to those working on treating alcohol use disorders and behavioral addictions.

This book provides clinicians and students with insights on the use of psychodynamic therapy to treat drug abuse and addiction, combining theory with clinical case material. The perspectives of analysts such as Abraham, Rado, Zimmel, Tibout, Wurmser, Khanzian, Krystal and McDougall are reviewed alongside original and more recent conceptualizations of drug addiction and recovery based on Kleinian, Winnicottian and Kohutian ideas. The case material deals with clinical phenomena that characterize working with this complex population, such as intense projective identification, countertransference difficulties and relapses. The theoretical analysis covers a range of concepts, such as John Steiner's psychic shelters and Betty Joseph's near-death-addiction, which are yet to be fully explored in the context of addiction. Prevalent topics in the addiction field, such as the reward system, the cycle of change and the 12-step program, are also discussed in relation to psychodynamic theory and practice. Written by an experienced therapist, Psychodynamic Approaches for Treatment of Drug Abuse and Addiction is useful reading for anyone looking to understand how psychodynamic thought is applicable in the treatment of drug abuse and addiction. It may also be of some relevance to those working on treating alcohol use disorders and behavioral addictions.

In Psychotherapy for the Treatment of Substance Abuse, leading authorities on substance abuse treatment techniques review and illustrate the most common interventions for opioid-related and alcohol-related substance abuse disorders, as well as crucial methodologies for testing and patient placement. Methods reviewed include self-help fellowships such as Alcoholics Anonymous, cognitive-behavioral and psychodynamic treatments, motivational enhancement, group and family therapy, contingency management, and the multimodal approach called Network Therapy, which recruits the support of friends and family to prompt abstinence and prevent relapse. Each chapter includes vivid case studies to illustrate the approach described, as well as a review of the key clinical concepts and a list of essential readings. Adapting a new, clinically focused manual from their popular American Psychiatric Publishing Textbook of Substance Abuse Treatment, now in its fourth edition, Dr. Galanter and Dr. Kleber have designed Psychotherapy for the Treatment of Substance Abuse to be of practical application to both experienced clinicians and those new to the field. The accompanying DVD demonstrates Network Therapy in practice and includes enlightening commentary on key issues that are relevant across the many modalities of substance abuse treatment discussed in the book.

The Harvard Cocaine Recovery Project, a National Institute on Drug Abuse-funded randomized clinical trial, was initiated in 1986 to compare different approaches for treating cocaine abusers. Modified Dynamic Group Therapy (MDGT), one of the models used in the study, is a short-term supportive-expressive psychodynamic group approach specifically adapted for cocaine addicts. While many previous studies of substance abuse treatment were compromised by extraordinarily high dropout rates, this approach retained nearly 70% of group members for the entire length of treatment. This book describes MDGT and provides a practical guide to implementation. Based on an understanding of the psychological vulnerabilities of addicts, the MDGT model addresses the modifications in psychodynamic technique that are necessary for addicts' needs. It focuses on four main areas of difficulty involving self-regulation; affect, self-esteem, relationship, and self-care problems. Both supportive and expressive, the approach helps group members identify, process, and modify the characterological traits that mask addict's vulnerabilities. With this approach, a well-led group can heighten self-esteem, improve self-care, combat feelings of isolation and shame, and strengthen the individual's capacity for positive change. Concomitant involvement with an individual therapist/counselor is encouraged as a means to support and facilitate the group therapy, especially early in group treatment, and to maintain a flexible individual and group treatment context for self-exploration and understanding. Bringing the model to life are detailed vignettes and transcripts of groups in different phases of recovery. These cases demonstrate techniques, illustrate technical issues, and illuminate major themes that unfold during treatment.

For many practitioners, sifting through the diverse and complex methods available for treating substance abusers can be just as daunting as working with the addict. Drawing on over 30 years of experience, Edward Kaufman has developed a pragmatic approach to treatment that systematically integrates techniques from a variety of influences--from object relations and cognitive-behavioral therapy to structural family therapy and the Twelve-Step movement. Covering the myriad problems encountered with alcoholics and addicts, he presents a workable approach that can be utilized by a broad audience of therapists at varying levels of training in psychotherapy and/or substance abuse. Each of the chapters provides the details necessary for understanding and treating the substance abuser with psychodynamic therapy. The book outlines the personality and psychopathology of addicted persons, taking into account psychodynamic theory, codependent patterns, and risk factors that may predispose individuals to substance abuse. Recognizing the gender specificity of certain issues, the book then describes topics relevant to addicted women, with discussion of personality traits, gender-specific considerations for psychotherapy, feminist therapy, and how women fare in Twelve-Step groups. A chapter on defense mechanisms focuses on denial, projection, and rationalization, and another chapter describes the three most common personality disorders among addicted persons--antisocial, narcissistic, and borderline. Illustrating the approach with case histories, the author describes his three-phase psychotherapeutic method. The first phase--assessment to abstinence--involves evaluation, motivation, detoxification, incorporating the family and social network, developing a method for abstinence, and delineating a workable treatment contract. The second phase--early recovery (sobriety)--focuses on methods for helping an abuser remain drug and alcohol free. Relapse prevention strategies and a variety of coping methods are outlined, and methods are presented for teaching abusers to recognize situations that may provoke their use of drugs, the reasons for relapse, and the psychodynamics of their addictions. Finally, the third phase--advanced recovery (intimacy and autonomy)--addresses such issues as the ability to love in an intimate way, self-sufficiency in work and creativity, and the development of relaxing, pleasurable leisure skills. The therapist's role in transference and countertransference, and the substantial value of interactional methods to create change, particularly in clients with personality disorders, are examined. The book's final chapters focus on the integration of group and family therapy with the proposed individual therapy model. A phase-related model of group therapy is presented, and multiple-family and couples groups are discussed, with a synthesis of several family therapy approaches that emphasize structural and psychodynamic family techniques. Valuable to a wide audience of mental health professionals working with substance abusers, this book will help the addiction therapist to utilize psychodynamic constructs more effectively, and the psychotherapist to incorporate the tools of such programs as Alcoholics Anonymous. It is also ideal as a primary text or supplemental reading for courses dealing with the treatment of substance abuse.

Addiction is increasingly being recognized as a major global public health issue, and an ever-growing number of medical specialties, psychological and social science training programs, and professional associations are including addiction as part of their training and continuing education curricula. The first edition of this book presented an overview of the spectrum of addiction-related problems across different cultures around the globe. Sharing the experience and wisdom of more than 260 leading experts in the field, and promoted by the International Society of Addiction Medicine, it compared and contrasted clinical practices in the field of addiction medicine on the basis of neurobiological similarities as well as epidemiological and socio-cultural differences. Building on the success of this inaugural edition, and taking into account the formal and informal comments received as well as an assessment of current need, this textbook presents general updated information while retaining the most requested sections of the first edition as demonstrated by the number of chapter downloads. It also provides a basic text for those preparing for the ISAM annual certification exam. Written by some 220 international experts, it is a valuable reference resource for anyone interested in medicine, psychology, nursing, and social science.