Cognitive-Behavioural Integrated Treatment (C-BIT) A Treatment Manual for Substance Misuse in People with Severe Mental Health Problems
by Graham, Hermine L.; Copello, Alex; Birchwood, Max J.; Mueser, Kim T.; Orford, Jim; McGovern, Dermot; Atkinson, Emma; Maslin, Jenny; Preece, Mike; Tobin, Derek; Georgiou, GeorgeBuy New
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Summary
Author Biography
Dr Hermine L. Graham is a Consultant Clinical Psychologist and Lecturer on the Doctorate in Clinical Psychology course at the University of Birmingham, UK. She has led a programme of collaborative research and service innovation in the NHS focused on the integration of substance misuse treatment into mental health services.
Table of Contents
| About the Authors | p. xi |
| Aims of the Book | p. xv |
| Acknowledgements | p. xvii |
| Introduction to Cognitive-Behavioural Integrated Treatment (C-BIT) | p. 1 |
| Issues in Working with those with Coexisting Severe Mental Health Problems Who Use Substances Problematically | p. 3 |
| The Nature of Coexisting Severe Mental Health and Alcohol/Drug Problems | p. 3 |
| Models of Comorbidity | p. 6 |
| Obstacles to Treatment and Behaviour Change | p. 9 |
| Treatment Needs | p. 10 |
| Overview of C-BIT Approach | p. 14 |
| Objectives | p. 14 |
| Structure | p. 15 |
| How to Know When to Move on to the Next Phase | p. 16 |
| Treatment Sessions | p. 20 |
| Overview of C-BIT Theory and Techniques | p. 22 |
| Brief Introduction to Cognitive Therapy | p. 22 |
| Cognitive Therapy Techniques in C-BIT | p. 28 |
| Cognitive-Behavioural Integrated Treatment (C-BIT) | p. 37 |
| C-BIT Core Components | p. 39 |
| Assessment Phase: Screening and Assessment | p. 39 |
| Clinical Assessment of Drug/Alcohol Use | p. 40 |
| Assessment and Screening Tools | p. 42 |
| Case Formulation | p. 46 |
| Treatment Planning | p. 49 |
| Treatment Phase 1: Engagement and Building Motivation to Change | p. 51 |
| Strategies to Increase Engagement | p. 51 |
| How to Put Drug/Alcohol Use on the Agenda | p. 55 |
| Building on Motivation for Change | p. 59 |
| Dealing with Resistance | p. 64 |
| Identifying Social Networks Supportive of Change | p. 65 |
| Finances/Money Management | p. 68 |
| Treatment Phase 2: Negotiating Some Behaviour Change | p. 73 |
| Identifying and Setting Achievable Harm-Reduction Goals | p. 73 |
| Working with Resistance to Goal Setting | p. 75 |
| Identifying Activities of Interest | p. 79 |
| Engaging the Client's Interest in the Activity | p. 81 |
| How to Build Social Networks Supportive of Change | p. 81 |
| Strategies to Increase Awareness of Problematic Links Between Mental Health and Substance Use | p. 84 |
| Treatment Phase 3: Early Relapse Prevention | p. 88 |
| Formulating Problems: Cognitive Model of Substance Use | p. 88 |
| Relapse Prevention: Helping Your Clients Manage Their Substance Use | p. 93 |
| Relapse Prevention: Including Social Network Member(s) | p. 94 |
| Coping with Cravings and the Abstinence-Violation Effect | p. 99 |
| Relapse Prevention: For Substance Use and Its Links with Mental Health | p. 102 |
| Treatment Phase 4: Relapse Prevention/Relapse Management | p. 106 |
| Including Social Network Member(s) in Relapse Prevention | p. 107 |
| Identifying a Relapse Signature to Psychotic Relapses and Role of Substance Use | p. 108 |
| Developing a Comprehensive Relapse-Prevention/Relapse-Management Plan | p. 116 |
| Using a Comprehensive Relapse-Prevention/Management Plan--Relapse Drill | p. 118 |
| Additional Treatment Components I--Skills Building | p. 122 |
| Coping with Different Moods: Anxiety | p. 122 |
| The Role of Substances in Creating or Maintaining Anxiety | p. 122 |
| Starting Out: Assessing Anxiety | p. 123 |
| Strategies to Manage Anxiety | p. 125 |
| Coping with Different Moods: Anger and Impulse Control | p. 136 |
| The Role of Drugs/Alcohol in Creating/Maintaining Anger | p. 137 |
| The Role of Psychosis in Creating/Maintaining Anger | p. 138 |
| Starting Out: Assessing Anger | p. 138 |
| Strategies to Manage Anger | p. 140 |
| Impulse Control | p. 148 |
| Coping with Different Moods: Depression | p. 151 |
| The Role of Drugs/Alcohol in Creating and Maintaining Depression | p. 152 |
| The Role of Psychosis in Creating/Maintaining Depression | p. 152 |
| Starting Out: Assessing Depression | p. 153 |
| Strategies to Manage Depression | p. 154 |
| Communication: Social Skills | p. 164 |
| Social Skills | p. 165 |
| Social Skills Training for Mental Health Problems and Substance Use | p. 166 |
| Social Skills Training | p. 167 |
| Applying Social Skills to Specific Situations | p. 173 |
| Assertiveness | p. 175 |
| Assertiveness Training | p. 178 |
| Strategies to Tackle Lack of Assertiveness | p. 179 |
| Applying Assertiveness Skills to Specific Situations | p. 188 |
| Self-Esteem | p. 194 |
| Effect of Low Self-Esteem on Mental Health and Drug/Alcohol Use | p. 194 |
| Effects of Psychosis and Drugs/Alcohol on Self-Esteem | p. 195 |
| Starting Out: Assessing Self-Esteem | p. 196 |
| Strategies to Improve Self-Esteem | p. 197 |
| Lifestyle Balance | p. 205 |
| Strategies to Encourage Lifestyle Balance | p. 206 |
| Increasing Activity Levels | p. 206 |
| Time Management | p. 212 |
| Money Management | p. 213 |
| Additional Treatment Components II--Families and Social Network Members | p. 215 |
| Working with Families and Social Network Members | p. 215 |
| Provision of Psychoeducation | p. 216 |
| Encouraging Involvement | p. 221 |
| Practical Coping Strategies and Skills | p. 223 |
| Implementation Issues | p. 231 |
| Implementation Issues | p. 233 |
| Overview | p. 233 |
| Implementation Obstacles and Solutions | p. 233 |
| Training and Supervision (Capacity Building) | p. 237 |
| Organisational Factors | p. 238 |
| Overview of the Evidence Base and Future Directions for Research | p. 239 |
| Appendices | p. 245 |
| References | p. 285 |
| Index | p. 295 |
| Table of Contents provided by Rittenhouse. All Rights Reserved. |
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