Cases reported "Heroin Dependence"

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1/6. Treatment of dual diagnosis patients: a relapse prevention group approach.

    The authors describe the successful use of an adjunctive group psychotherapy for substance-abusing patients with major psychiatric disorders (bipolar, schizophrenia, schizoaffective, psychotic depression, and atypical psychosis). The group utilizes a psychoeducational approach that focuses on substance abuse causes and consequences, principles of recovery, and relapse prevention strategies. Eight patients with prolonged histories of abuse of cocaine, alcohol, marijuana, or other drugs were enrolled in this weekly group treatment at a community mental health center drug treatment program, while continuing in treatment with their current case manager or primary therapist. Six of the eight patients achieved periods of stable abstinence, documented by self-report, urine toxicology screens, continued group attendance, and improved social functioning. Case examples are utilized to illustrate the group process.
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ranking = 1
keywords = psychotherapy
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2/6. To surrender drugs: a grief process in its own right.

    The basic thesis of this article is that addictive substances, because of their need-grafifying and self-medication value, become so central to the life of the addicted person that their absence is associated with a grief reaction. Painful feelings of loss and helplessness accompany drug surrender. This view contrasts with formulations that indicate that mourning experiences observed in recovering persons are specific to and determined by unresolved past losses of loved ones. The author discusses the theoretical underpinnings of the drug-loss grief reaction. Also presented are case vignettes that demonstrate the grief aspects of drug surrender. Finally, the role of brief psychotherapy as a vehicle for helping clients cope with their grief reactions is discussed.
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ranking = 1
keywords = psychotherapy
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3/6. Denial and split identity: timely issues in the psychoanalytic psychotherapy of compulsive drug users.

    Quite generally, psychotherapy and psychoanalysis are under great pressure today to account for what they are doing, to prove their scientific validity and their therapeutic efficacy. Those of us who use clinical experience in conducting their practice in ways which seem optimal, as judged both by them and by their patients, are increasingly challenged to respond to a canon of scientific method and validity that claims its brief for truth. What I am going to say will not live up to such high standards of proof, but will simply reflect my clinical experience: what helps and what fails with most patients that come to me, often after a string of previous treatment failures. What I am going to say claims practical usefulness, not ultimate scientific truth. I would like to highlight a number of issues that have proven themselves as of special importance for the long term treatment of substance abuse dependent patients. The first is the role various forms of denial play and how these might best be approached. Multiple layers of denial entail usually some form of split identity--rapid alternations from one part identity to the other. Then I shall briefly study the role of impulsivity and of various forms of impulsive action. These topics of denial, split identity and impulsive action dictate some reflexions on attitude and technique necessary for the long term psychotherapy of patients with prominent problems of substance abuse and impulsivity. I shall conclude with some more general recommendations for the future of psychotherapy with substance abusers.
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ranking = 7
keywords = psychotherapy
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4/6. Juvenile drug addiction: a typology of heroin addicts and their families.

    In this article the authors propose: 1) a typology of drug addiction cases consisting of four main classes: A. traumatic drug addiction, B. drug addiction from actual neuroses, C. transitional drug addiction, and D. sociopathic drug addiction; 2) a clinical study (with 18 months of follow-up data) involving 131 heroin addicts mostly treated with structural or counterparadoxical family therapy in the same psychotherapy center and in the same year; and 3) some preliminary conclusions emerging from an examination of the four-class typology with respect to the effectiveness of family therapy interventions. If, for example, structural family therapy techniques seem more suitable in type-B cases (similar to cases described by Haley in his Leaving Home), the counterparadoxical techniques are likely to be more effective in type-C cases (similar to the anorectics described by Selvini-Palazzoli).
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ranking = 1
keywords = psychotherapy
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5/6. Drug addiction among young people: a study of typology and its relevance to treatment programmes.

    On the basis of clinical observation, the authors have classified drug addiction into four types: traumatic, actual, transitional and sociopathic. Such classification helps in epidemiological research to understand better the distribution of people addicted to a given drug. Each type of addiction differs in respect of onset, evolution, prognosis and certain other characteristics relevant to the treatment of drug-addicted persons. Thus, the classification helps in making an appropriate selection of a treatment method and in the evaluation of a treatment programme. It has been observed that (a) traumatic and actual types of addiction have a much more favourable prognosis; (b) individual psychotherapy and support in a medical setting is effective for the traumatic type of addiction; (c) treatment in a family setting appears to be suitable for actual and transitional types of addiction; and (d) the therapeutic community may prove to be effective in the treatment of persons affected by socio-pathic type of addiction.
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ranking = 1
keywords = psychotherapy
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6/6. Enhancing addiction treatment through psychoeducational groups.

    Clients with an addiction disorder generally present with an ego deficit in the area of self-care. This deficiency manifests itself in an inability to suffer and struggle with day-to-day problem solving. Outpatient addiction treatment today places significant resources in psychotherapy and psychodynamic group therapy often at the expense of teaching basic life skills our clients need to negotiate day-to-day living. To address both issues of ego and life skills deficits, the use of a psychoeducational group is presented. This specialized, task-oriented didactic group experience is a necessary component of a comprehensive addiction treatment program. A psychoeducational group in the treatment of addictions can serve as a synthesis for problem-solving skills training used in mental health and the psychodynamic theory of addictive behavior. Cases are presented to illustrate the efficacy of psychoeducational groups.
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ranking = 1
keywords = psychotherapy
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