Relapse prevention therapy: an integrated approach to the treatment of alcohol disorders and comorbid anxiety : a review of literature on anxiety, alcoholism and relapse prevention therapy - recommendations for clinical psychology groups conducted as part of an inpatient alcohol rehabilitation programme in the Western Cape

Rufus, Brett Charles (2004-11)

Thesis (MA)--University of Stellenbosch, 2004.

Thesis

ENGLISH ABSTRACT: Two recent local studies of relapse among individuals who had attended inpatient alcohol rehabilitation programmes in the Western Cape found relapse rates of up to 60%. A high incidence of comorbid anxiety, low self-efficacy and avoidant coping style were principal reasons cited for relapse. The following literary review was undertaken in an effort at better understanding current findings on the comorbid relationship between alcohol abuse/dependency and anxiety, and on dysfunctional coping styles and relapse. It also reviews current literature and theory concerning the treatment of alcoholics using the Relapse Prevention (RP) model of therapy. Based on these findings, recommendations are made for the application of RP to the clinical psychology groups run for alcohol abusing/dependent inpatients at Neuro Clinic D, Stikland Hospital, Western Cape. Relapse Prevention Therapy was selected because of its integrated approach to addressing both substance abuse and the inadequate coping styles that often render people vulnerable to anxiety, depression and relapse. It was also chosen because of the more constructive, less punitive approach it takes to substance dependence/abuse and the issue of lapses and relapse. The recommendations made in this review should not, in any way, be seen as criticism of the existing programme at Neuro Clinic D. They are, essentially, the individual reflections of the author based on the four months he spent conducting clinical psychology groups in the unit and the findings of two local studies that looked at some of the reasons for relapse following treatment in this and other local facilities. The specific focus on the groups run by clinical psychologists should also not be seen as ignoring the important and valuable work done by other professionals in the unit; notably those in psychiatry, nursing, social work, occupational therapy and pastoral care. On the contrary, information gathered by these professionals is vital to the team effort of rehabilitation, and the identification of psychosocial stressors and cognitive patterns that place people at risk of relapse.

AFRIKAANSE OPSOMMING: Twee onlangse plaaslike studies van terugvalonder pasiënte wat binnepasiëntalkoholrehabilitasieprogramme in die Weskaap bygewoon het, het terugvalkoerse van tot 60% gerapporteer. 'n Hoë voorkoms van komorbiede angs, lae sin van self-vermoë en 'n vermydende streshanteringstyl was die hoofredes aangevoer vir die terugval. Die volgende literatuur-oorsig is onderneem in 'n poging tot 'n beter begrip van huidige bevindinge oor die komorbiede verhouding tussen alkoholmisbruik/afhanklikheid en angs, en oor wanfunksionele streshanteringstyle en terugval. Die oorsig beskou ook huidige literatuur en teorie aangaande die behandeling van alkoholiste deur middel van die Relapse Prevention (RP) model (Terugvalvoorkomingsmodel) van terapie. Op grond van hierdie bevindinge word aanbevelings gemaak VIr die toepassing van RP op die kliniese-sielkundegroepe aangebied VIr alkoholmisbruikende/afhanklike binnepasiënte by Neurokliniek D, Stiklandhospitaal, Weskaap. RP is gekies op grond van sy geïntegreerde benadering tot beide substansmisbruik en die onvoldoende streshanteringstyle wat dikwels mense kwesbaar maak vir angs, depressie en terugval. Die model is ook gekies as gevolg van die meer konstruktiewe, minder strafgerigte benadering tot substansafhanklikheid/misbruik en tot val en terugval. Die aanbevelings in hierdie oorsig moet in geen opsig beskou word as kritiek op die bestaande programme in Neurokliniek D nie. Hulle is, in wese, die individuele gevolgtrekkings van die skrywer gebaseer op sy vier maande ondervinding met sielkundegroepe in die eenheid en op die bevindinge van twee plaaslike studies wat ondersoek ingestel het na sommige van die redes vir terugval na behandeling in hierdie en ander plaaslike fasiliteite. Die spesifieke fokus op die groepe wat deur kliniese sielkundiges bestuur word moet ook nie gesien word as 'n geringskatting van die belangrike werk van ander professionele mense in die eenheid nie, in die besonder dié in psigiatrie, verpleging, maatskaplike werk, arbeidsterapie and pastorale sorg. In teendeel, inligting ingesamel deur hierdie mense is lewensbelangrik vir die spanpoging van rehabilitasie, en vir die identifisering van psigo-sosiale stressors en kognitiewe patrone wat pasiënte vatbaar maak vir terugval.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/50078
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