Year : 2018 | Volume
: 60 | Issue : 8 | Page : 430--431
Psychosocial therapies in addictive disorders
TS Sathyanarayana Rao
Professor, Department of Psychiatry, JSS Medical College and Hospital, JSS University, MG Road, Mysore - 570 004, India
Dr. T S Sathyanarayana Rao
Professor, Department of Psychiatry, JSS Medical College and Hospital, JSS University, MG Road, Mysore - 570 004
|How to cite this article:|
Sathyanarayana Rao T S. Psychosocial therapies in addictive disorders.Indian J Psychiatry 2018;60:430-431
|How to cite this URL:|
Sathyanarayana Rao T S. Psychosocial therapies in addictive disorders. Indian J Psychiatry [serial online] 2018 [cited 2019 Nov 13 ];60:430-431
Available from: http://www.indianjpsychiatry.org/text.asp?2018/60/8/430/224346
Substance use disorders form a significant part of global disease burden. With the increasing trend of use of psychoactive substances, the detrimental effects associated with it also increases. Individuals with substance use disorders are heterogeneous with respect to a number of clinically important features and domains of functioning. The pathophysiology of these addictive disorders is complex, not always linear and can be described as a complex bio-psycho-social process, coordinated by the neurological, vascular and endocrine systems. Apart from these biological factors psychological, physiological, environmental, and cultural factors are also invariably associated with use of a particular substance, and may have an independent intervening effect on the patient's overall quality of life and long term outcomes.
Care of individuals with substance use disorders includes conducting a complete assessment, treating intoxication and withdrawal syndromes when necessary, addressing co-occurring psychiatric and general medical conditions, the achievement of abstinence or reduction in the use and effects of the substance, reduction in the frequency and severity of relapse to substance use, and improvement in psychological and social functioning, developing and implementing an overall treatment plan. Methods of intervention for achieving the above objectives vary from pharmacological to behavioral or psychosocial and from singular specific therapies to a broad array of services within a program. The role of psychosocial interventions has been especially underutilized and under studied in this patient population. Treatment services have been developed to address not only the substance use, but also the range of other problems that often predate, co-occur with, and are caused by these substance use disorders. These issues can include family or social relationships, legal matters, job or vocational concerns, medical conditions, and co-occurring psychiatric disorders. Identifying the magnitude of these problems and managing them effectively may have a significant impact on the prevention of relapse. The importance of developing best practices and clinical guidelines in this area is therefore essential.
The essential concepts underlying the management of addiction and related disorders are adoption of a patient-centered framework for evaluation and treatment. As in other areas of health-care, increasing attention is now being focused on providing evidence-based care for persons with substance use disorders and in this context there has been significant progress in the development and standardization of psychosocial treatments for substance use disorders. Psychosocial treatments are now considered essential components to any comprehensive substance use disorder treatment program. Principles of evidence-based medicine may be followed in both men and women in diagnostic and treatment planning and adoption of common psychosocial management approaches for these disorders. They can be implemented individually or in groups and delivered by a range of health workers. Psychosocial treatments are considered to be the foundation of drug and alcohol treatment, especially for substances where pharmacological treatments have not been sufficiently evaluated.
The highlights of this book includes a comprehensive overview of the various psychosocial assessment tools, intervention strategies, the efficacy of a community based approach as well as the use of innovative approaches such as digital technology in formulating an adequate psychosocial management approach. There is a need for research on psychological interventions in special populations such as adolescents, the geriatric population, poly drug misuser, those with medical comorbidities, people with psychiatric comorbidity and other specific groups like LGBT, the tribal population and those with physical impairments. The recent literature regarding the same has been highlighted in this book. Maintaining the ethical frame is paramount in the therapy room and this extends to any intervention research which involves human participants. The chapter on ethics examines the debates and recommendations concerning key ethical issues in research on psychotherapy and various psychosocial interventions. Healthy family interaction and regular treatment follow up with support of family has proved to be the major protective factors of abstinence after treatment. These family based interventions would promote the quality of social support to the individual and it has been documented that social support when supplemented with effective community based interventions is a crucial factor in recovery. These guidelines outline this very model and addresses the importance of training primary health care doctors, NGO staff, volunteers, counselors, college & school teachers, strengthening self-help groups like Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) in case identification, diagnosis, referral to treatment, providing long term care and rehabilitation services of patients with addiction disorders.. We hope that these guidelines would help in facilitating proper management of patients presenting with various types of substance use disorders and that the information provided will be of interest and may serve as a powerful tool to healthcare professionals.