************* therapy ******* ** *********** ********* ** **** *** manifested in the ******** present ******** The ***** ** ************* ******* are ****** ************** *** understanding of the ********* ** *** **** ** ******* behavior In *** ***** **** * ************* ******** ******* *** ****** to ******* ********** ********* *** ******** **** ***** from **** dysfunctional ************* and manifest ********** ** *** **** *** ****** to abuse ***************** ********* ********** ** brief ************* psychotherapy **** ******* **** psychoanalytic ****** *** have **** ********** applied ** * wide ***** ** psychological ********* * ******* body ** ******** supports *** efficacy ** ***** approaches **************** *********** *** Warren *************** ************* therapies *** ********** ** the ************* of treatments *** ********* ***** ********* ***** psychodynamic ********* ******** have *** **** ****** ** ** ********* when **** *** integrated into * relatively ************* substance ***** treatment ******* that ******** ************ ************* such ** ******* urinalysis **** ********** and *** opioid-dependents methadone *********** pharmacotherapy ***** psychodynamic therapies *** ******* **** ******* ***** ********** is well established **** *** ** **** beneficial *** ******* **** ** ******* than ******** severity ** ********* ***** ** ** **** ********* that *** psychodynamic therapist **** about *** ************ ** abused drugs *** subculture of ********* abuse *** ******* ********************* therapy ** the ****** ** the modern therapies ** such it ** ***** ** a ****** ********* *** multifaceted theory of ***** *********** *** *********** This chapter demonstrates how **** ** is for ********** *** further ********* ** ************ ********** *** ******** purposes The ******** presented in **** ******* ******** * ***** ****** ** *** ********** *** the complex ****** of **** **** ** ******************** ******** Useful in ********* ***** TreatmentPsychodynamic ******** endeavor ** provide ******** ************ *** ************ *** ************* ******** ******* of the ********** of **** ******** ** the development of ****** ******* the ********** **** **** from ***** ******** *** ********** **** ** *** type ** psychotherapy whether or *** ** ** ********** ** *************** *** ******* people *** have ****** **** ***** *** **** ********* ***** ********* *** ******** **** ******** **** ** they *** *** ***** **** **** ******* ** one of *** ************* ******* ********** Counselors ***** clients **** ** ********* and ****** negative reaction to **** ***** ******* from an ************* ** *** ******* of ************** ** **** is ******* *** ** ******* and drug counselor *** ** **** ******* ******** *** ******** after * ******* to understand *** ********************* ***** be ** **** ********* ********** who ***** ******* with ********* ***** ********* can benefit **** understanding *** basic concepts ** ******* ************* ****** discussed ** **** section even if **** ** *** use a ******** ************* *************** *********** *********** ******** that ******** between ********* *** ****** ** * **** important ****** ** ********** therapeutic outcomes ********* ***** **** is true ********** ** *** ******** ** ******* *** ************* ***** *** ****** ****** *** **************** ************ ** ******* *** *** ******* ******* ***** ****** ****** Of *** the ***** *************** ************* ********** ***** *** **** ******** ** the *********** relationship and ******* the **** ******** *** ************* explanations of *** to *** **** ************ *********** ******** and ********** are ***** ***** *** have ********** *** ******** ****** **** the therapist-client ************ *** on the success ** ********* ******* brief ********* ** ** 1985)The psychodynamic ***** ****** * ********** *********** of *** the *********** ************ ***** *** guidelines *** *** ** *** ** *** positive ****** and ****** ** *** ************* ********* *** ***** goal is ** ********* * “therapeutic alliance” between ********* *** ****** ** **** ***** *** *********** ** * *********** ******** ** ********* * ******* ** *** passage ** **** The more ****** *** ******** disorder *** **** time it **** **** The capabilities ** *** ********* to ** honest *** ******** *** ** *** ****** ** ** ******** are **** ******* A *********** ******** ******** ******** self-disclosure ** *** **** of the client and ** empathic and *********** ******** ** *** **** ** *** ********* ******* ** brief psychodynamic therapy this alliance **** ** *********** ** **** ** ******** *** therapists ********** **** **** ** therapy must ** able ** ********* * trusting ************ **** their clients ** a ***** ******* ***** ** *** *********** alliance *** its relationship ** ********** treatment ***** that for alcoholic *********** ******* of *** therapeutic ******** ** the patient ** ********* **** *********** predictors ** ********* ************* *** ** ******** behavior ****** ********* *** at ******** ******** ****** *** ****** ** ******** explained *** small ******** ** ** 1997) ***** ***************** ******** another study ***** that patients’ ******* of the *********** ******** ********* *** ***** of ******* **** use ** * ***** *** *** ** * months (Barber ** al ***** *** ******** ** * ***** however ********* *********** in ********** ******** at * ****** ***** ******** suggest that *** *********** ******** exerts * ******** but *********** ********* ** outcome ** *** ********* of ********* abuse ********* *** ******** ******** ******** **** **** ***** ** ***** but ******* length ** ************* in ********* reduction ** **** use *** ********* in ********** ********************* ****************** ****** emphasizes **** *** client’s ***** ** functioning ****** determine *** nature ** *** ************ ** ******** ************** theory ********* ***** ** ********** * ******* associated with the **** ** most ********* ***** ** *********** and ********** ** attempt ** ********* a *************** ********* state ****** *** *********** 1996) ******** ********* ****** *** ****** ********* ****** **** **** ********** stand ** *** the functions ******* ********** ** the ******* ******** *** ************ ****** ** a ****** the substance ****** ******* to the ********* ***** ** *** ********* ******* ** relating that ** experienced **** the ******** ****** (Krystal ***** This ***** ** ********** a variant ** borderline psychopathology ***** ** ****** as a ****** ****** *********** ** *** *********** and ****** ********* ** is *** **** reason **** ***************** clients **** *** perhaps ***** *** ***** ********** ********** *** psychoanalysis *** **** unsuitable for many of the ********** analytic ****** **** ******* * very focused and active uncovering ** *** unconsciousContemporary analytic ********* *** ******* ********** **** ********* ***** disorders ********* ** not ***** ** *** **** **** addiction ** ****** ** * developmentally ********* ***** ** ego *********** ******** **** *** ******* ** *** reason ** **** this **** ***** ** * ****** pessimistic belief ********* *** ******* of ******** ********** *** ********* ***** ********* ******* ****** ** that it **** not ********** helpful *********** ** *** *********** ******** and it *** ****** *** *********** of ** ******** *** ********** *********** alliance *********** ***** ** increasing ********* evidence *** *** idea **** ****** ********* abuse ** largely ****** ** ************* ****** *** **** ********** psychological ******* *** ** lesser ********** (Babor ***** Although analytic ******** **** ****** ** ****** **** ****** *** Morgenstern ***** ** *** ****** ************ * part ** *** ********* **** ** ************* ********* abuse *********************** ******** ********** concept of psychodynamic *********** *** **** *** be ** ***** ******* to *** ************** *** ******* ** ******* ************* approaches ****** ******* ** * particular kind ** self-realization or ************** ********** regarding the connections of *********** *** conflicts ** *** past **** ******* perceptions *** ******** *** the *********** of ******** or motivations that **** **** ********* Insight can **** ******* * ****** flash ** ************* ** **** ******* acquisition of self-knowledge ** *** ******* a client who feels ********* and ***** and ************ ****** ***** ** ******* **** *** ******** ****** his ****** *** ********** ** ** *********** ******* ********** ** work **** **** ** *********** ***** *** ****** *** optionsThese ******* ******* ******** to ******** his ********* to *** ********** **** *** ******** about his ****** ******* through his feelings about his ****** *** ***** ** *** not **** **** ********** ****** ******** ******** alternative ********* ** ******** **** he ***** bad *** ********* * ******* ******** and ********* greater ************** for *** feelings *** behaviorsA ******* ********** ** ******* also promoted by ***** ************* therapies ** simply *** *********** ***** ******* ***** ***** ******** ** one’s ******** For example * ****** who **** **** only ******* * ****** **** ** ****** has ****** *** door to understanding *** ****** others **** on *** and vice ***** She *** **** begin ** ******* alternative behaviors to ***** **** ********** ******** ************* **** her anger ***** as drinking) ** **** ** ** ********** why her ********* repertoire ** so ************** involves **** ******** and ******** A purely ************ ******** **** *** **** ** ******** change True insight involves a ******** ********* experience as **** ** a ********* ********* *** ***** to a ******* ********** ** ************** *** feelings *** ******** ** ******** ********* ***** disorders it ** ********* to ********* that ******* ***** ** often *** sufficient ** ****** ****** ********** ** ***** *** ******** ********** reinforcers *** *** ********* ***** ** help *** ****** ******* the ****** ********** ****** for **** **** in addition ** insight ** ***** be helpful ** ***** psychoeducation *** **** ********** ************* ***** ***** ******* *********** attendance *** participation ** self-help programs and requiring regular ******* ** ********** ****** Breathalyzer™ Many ********** *** ******* ********* abuse ********* **** a ************* perspective *** comfortable ********* insight-oriented therapy **** concrete ********** ******************** ********** *** ************ ************** ****** ******* mechanisms ******* *** ************ ego ** **** ***** *** pressure ** the excessive ******* produced ** ** ************ ********** ** *** *********** *** *** ** forced ** ******* *** ******* by defending ****** The ******** ** ***** to ** **** *** ******** ** ** ******** mechanisms” *** ******* ********** **** *** characteristics in ******* they **** distort ** ******* ******* *** **** operate unconsciously **** ******* ********** *** adaptive *** ******* the ****** *********** ** the individual ***** ****** *** *********** *** ****** the ************ ****** ********* *** ******** ****** the ******* ** *********** ** ******* *** *** this ****** **** are ***** ********** ** *** **** expressive ****** of ******** ******* ******* ** **** ********** types ** ******* ******** defenses are supported *** **** *** *********** defenses *** *** ** confronted ***** *** ********* *** ******* *** ****** to ******* **** **** * **** ************ means ** copingIn *** ********* ** ********* ***** ********* ******** *** **** ** * means ** ********* *************** **** ********** ******* eliminating ** ** ***** ******** **** *** **** *** ********** noted **** *** ******** frequently seen ** ***** **** ********* ***** ********* *** ****** *** *********** (Mark and Luborsky 1992) ************ **** **** group ** ******* handling ******** can ********** **** ** *********** *********** ***** **** accusations; *** ******* **** * ********* admonishes *** client by saying **** are in ******* ***** *** ******** ***** **** recommend avoiding *********** *********** ************ around the ******** *** ** ******** by ***** *** ********* ***********