Group Psychotherapy with Addicted Populations: An Integration of Twelve-Step and Psychodynamic Theory, Third Edition

by Flores, Philip J.

• ISBN13: 9780789035301
• ISBN10: 0789035308
• Edition: 3rd
• Format: Paperback
• Copyright: 2007-10-22
• Publisher: Routledge

Summary

Group Psychotherapy with Addicted Populations: An Integration of Twelve-Step and Psychodynamic Theory, Third Edition is the newly revised edition of the classic text, that brings together practical applications of 12-step programs and psychodynamic groups to provide proven strategies for defeating alcohol and drug addiction through group psychotherapy.

Table of Contents

Foreword	p. xv
Theoretical Models
Interpersonal Neurobiology and Addiction: An Attachment Theory Perspective	p. 3
Interpersonal Neurobiology	p. 4
The Neurophysiology of Attachment	p. 7
Interdisciplinary Research and Attachment Theory: A Source for Informing Addiction Treatment	p. 9
Contributions from Child Development Studies	p. 10
Contributions from the Neurosciences	p. 19
Reward Deficiency Syndrome	p. 19
Attachment and Animal Research	p. 37
Contributions of the Relational Perspective to Group Psychotherapy	p. 38
Attachment Theory As a Theoretical Basis for Understanding Addiction	p. 43
Attachment Theory and Self-Psychology	p. 45
Attachment Styles and Secure Attachment	p. 46
Ainsworth and the Strange Situations	p. 47
Implications for Treatment	p. 48
Implications for Addiction Treatment	p. 60
Summary of Treating Addiction As an Attachment Disorder	p. 62
The Disease Concept and Group Psychotherapy	p. 65
Abstinence: Is it Necessary?	p. 66
Paradigm Shift	p. 74
Specific Implications of Group Therapy and the Disease Concept	p. 81
Addiction, Abstinence, and the Disease Concept	p. 84
Psychodynamic Theory and the Relational Models	p. 97
Character Pathology and Addiction	p. 99
Contributions of Object-Relations Theory and Self-Psychology	p. 101
Margaret Mahler's Theory of Normal Development	p. 106
Ego Psychology and Object-Relations Theory	p. 107
Mahler's Stages of Normal Development	p. 112
Beyond the Ego: Kohut's Self-Psychology	p. 126
Definition of Terms	p. 134
The Self-Medication Hypothesis and Affect Regulation	p. 138
Application for Therapy: Corrective Emotional Expression	p. 143
Addiction As an Attempt at Self-Repair	p. 152
Self-Esteem Vulnerabilities	p. 154
The Reparative Approach	p. 160
Alcoholics Anonymous and Twelve-Step Programs	p. 163
Misconceptions About Alcoholics Anonymous	p. 164
Values, Science, and AA	p. 167
Philosophy of Science and the Limits of Rationality	p. 173
The Self-Help Movement	p. 177
Alcoholics Anonymous: Its Historical Roots	p. 178
AA-Why and How It Works: An Interpretation of AA	p. 182
Pragmatism: Its Influence on AA	p. 185
Existential View of AA	p. 188
AA-How it Works: A Phenomenological Perspective	p. 196
The Self-Attribution of Alcoholism	p. 201
Honesty, Denial, and the Need for Others	p. 204
AA: A Self-Psychology Perspective	p. 207
AA: A Treatment for Shame and Narcissism	p. 209
Higher Power As an Attachment Object	p. 214
Addiction Treatment In The Group
Different Models of Group Psychotherapy	p. 221
Some Models of Group Psychotherapy	p. 222
Psychological Levels of Intervention	p. 223
Specific Applications for Addictions Treatment	p. 250
Preparing the Chemically Dependent Person for Group Therapy	p. 257
Selection and Composition	p. 259
Implications of Research Findings	p. 261
Therapeutic Alliance and Cohesion in Group	p. 262
Pre-Group Preparation: Increasing Treatment Retention and Reducing Dropouts	p. 267
Recommendations for Entry into a Therapy Group	p. 269
Present and Gain Acceptance of the Contract	p. 282
Interactional Group Psychotherapy	p. 287
Yalom's Basic Tasks	p. 288
The Model-Setting Participant	p. 291
Interpersonal Honesty and Spontaneity	p. 295
Establishment of the Group Norms	p. 298
The Norm of Self-Disclosure	p. 299
Procedural Norms and Antitherapeutic Norms	p. 302
Importance of Group	p. 303
The Here-and-Now Activation and Process Illumination	p. 305
Interpersonal Theory of Behavior	p. 316
Sullivan's Interpersonal Theory of Psychiatry	p. 317
Examples of Yalom's Here-and-Now Focus	p. 324
Integration of Modern Analytic Approach	p. 332
Conclusion	p. 348
Modifications of Yalom's Interactional Model	p. 351
Treatment Considerations and Group Therapy	p. 353
Recommendations for Group Psychotherapy	p. 356
Protocol	p. 356
Early and Later Stage Treatment	p. 361
Therapist Attributes and Special Considerations for Affect Attunement	p. 364
Careseeking, Affect Attunement, and Psychotherapy	p. 368
Group Therapy and ACOA	p. 370
Addiction and the Family	p. 371
Common Identified Characteristics of ACOA	p. 372
ACOA and Shame	p. 375
Alcoholics Anonymous and Group Psychotherapy	p. 376
Co-Occurring Disorders and Group Psychotherapy: An Attachment Theory Perspective	p. 379
Addiction-The Cart or Horse of Mental Illness?	p. 380
Cross-Addiction	p. 381
The Relationship Between Mental Health and Addiction	p. 384
Axis I Disorders	p. 386
Axis II: Character Pathology and Addiction	p. 386
Borderline Personality Organization and Pathological Narcissism	p. 388
Kernberg's Borderline Pathology	p. 390
Kernberg's Description of Supportive Psychotherapy	p. 391
Narcissistic Personality Disorder	p. 395
Dynamics of Multiple Addictions	p. 404
Integration of Divergent Treatment Philosophies	p. 407
The Relational Models: An Integration	p. 410
The Leader in Group Therapy	p. 413
Values of the Group Leader	p. 414
The Therapist As a Person	p. 417
Qualities of the Group Leader	p. 417
Guidelines and Priorities for the Group Leader	p. 431
Roles of the Group Leader	p. 431
Focus of the Group Leader	p. 434
Characteristics of the Group Leader	p. 438
The Therapeutic Process: Therapists' and Patients' Contributions	p. 443
The Alliance and Addiction: Special Considerations	p. 452
Group Leadership Functions	p. 454
The Implications for Conducting a Successful Therapy Group	p. 456
Alcoholism Treatment Outcome Studies	p. 458
Patient Characteristics Related to Types of Therapy	p. 460
Specific Group Strategies and Requirements	p. 463
Recommendations	p. 466
Convergence of Therapist and Patient Characteristics	p. 467
Clinical Applications
Diagnosis and Addiction Treatment	p. 473
Avoidant Society: Cultural Roots of Impaired Attachment	p. 475
Criterion Definitions of Addiction	p. 478
Drug Groups	p. 480
Drug Dependence and the Drug Groups	p. 481
Neuropsychological Impairment	p. 483
Stages of Change Model	p. 490
Relapse Prevention	p. 492
Interpersonal Neurobiology, Motivation, and Stages of Change Model and Brain Impairment	p. 493
Early Stage Group Treatment: Confrontation, Intervention, and Relapse	p. 495
Special Problems of the Addicted Patient	p. 496
The Use of Therapeutic Leverage	p. 498
Confrontation	p. 501
Intervention	p. 512
Relapse and Recovery	p. 525
Early Stage versus Later Stage Relapse	p. 528
Therapist versus Patient's Contributions to Relapse	p. 530
Later Stage Relapses	p. 532
Relapse Prevention	p. 534
Inpatient Groups and Middle Stage Treatment	p. 535
Yalom's Recommendations for Inpatient Groups	p. 544
Composition of the Inpatient Groups	p. 547
Yalom's Strategies and Techniques of Leadership	p. 549
Agenda Rounds	p. 552
Difficulties with Agenda Rounds	p. 557
The Special Circumstances of Inpatient Therapy Groups Within the Hospital	p. 558
Leader's Transparency About Alcohol and Drug Use	p. 559
The Group Contract	p. 560
Simultaneous Membership in Other Groups	p. 562
The Special Problems of Confidentiality on an Inpatient Unit	p. 564
Active Outreach	p. 567
Group Members Who Relapse and Come to Group	p. 568
Attending Group Under the Influence	p. 569
Summary Recommendations for Inpatient Group Therapy	p. 572
Late Stage Group Treatment: Conflict, Repair, and Reunion	p. 575
Paradigm Shift	p. 577
The Concurrent Treatment of Addiction and Character Pathology	p. 580
Later Stage Treatment Strategies	p. 583
Yalom's Model and Self-Psychology	p. 584
Treatment of Internal Structural Deficits	p. 587
Treatment of Introjections	p. 589
Later Stage Treatment: Conflict, Repair, and Reunion	p. 593
Attachment, Addiction, and the Working Alliance	p. 597
Research and the Therapeutic Alliance	p. 601
The Alliance: What Is it and Why Is it Important?	p. 603
Attachment, the Therapeutic Alliance, and Negative Process	p. 608
Transference in Groups	p. 613
Definition of Transference	p. 614
Transference Possibilities in Group	p. 618
Modification of Transference Distortions in Groups	p. 621
Types of Transference in Groups	p. 623
Common Types of Acting Out Transference	p. 625
Abuse of Transference	p. 631
Countertransference	p. 631
Projective Identification	p. 636
Pathways for Psychological Change	p. 640
Addiction and Countertransference	p. 641
Resistance in Group	p. 647
Resistance: A Definition	p. 648
Group Resistance and the Work of Wilfred Bion	p. 651
The Leader's Influence on the Basic Assumptions	p. 654
Resistance to Intimacy in Groups	p. 658
Resistance to Immediacy	p. 663
Resistance to Feelings in Group	p. 665
Special Considerations of Resistance to Addiction	p. 669
The Group Leader's Effect on Group Resistance	p. 672
The Curative Process in Group Therapy	p. 677
Yalom's Curative Factors	p. 679
Curative Factors in Group	p. 679
Existential Factors	p. 682
Curative Factors in AA	p. 687
Curative Factors Operating in Different Types of Therapy Groups	p. 689
Mechanisms of Change and Cure in Group Therapy	p. 689
The Curative Process	p. 694
Working Through with the Addicted Patient	p. 698
Stages of Cure in a Therapy Group	p. 699
Addiction and Goals of Termination	p. 704
Conclusion	p. 707
References	p. 711
Index	p. 737
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