assignment psychotherapy for clients with addictive disorders

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• Indian J Psychiatry
• v.60(Suppl 4); 2018 Feb

Psychoanalytic psychotherapy in addictive disorders

Malika verma.

Tara Clinic, Kozhikode, Kerala, India

Ajay Vijayakrishnan

Psychoanalytic psychotherapy can afford a viable treatment option for certain carefully chosen patients whose needs go beyond the immediate control of substance use. Though the evidence base specifically for addictions is lacking, an emerging body of evidence has demonstrated good effect in the commonly seen co-morbid conditions such as depression, anxiety and personality pathology.

WHAT IS PSYCHOANALYTIC PSYCHOTHERAPY?

Psychoanalytic Psychotherapy helps individuals achieve a deeper awareness of themselves, their unconscious desires, motivations and conflicts. Awareness does not in itself bring about change, however, it offers the individual a choice; a choice to not repeat unhelpful and self-damaging patterns. The individual may choose to not use the awareness that they have worked hard in therapy to achieve but in our experience most people do.

Psychodynamic and psychoanalytic psychotherapies have their roots in the clinical work of Sigmund Freud, Melanie Klein, Donald Winnicott and others. The focus of these therapies is the transference relationship between the therapist and the patient. Psychodynamic therapy happens at a frequency of once or twice a week and is done with the therapist and patient facing each other. They can be brief and may even have a focus or predetermined goal. Psychoanalytic psychotherapy is more exploratory in nature. The patient is on the couch, facing away from the therapist and sessions happen at a frequency of 3 to 5 times a week. With increasing frequency, the work and the transference relationship become more intensive.

For the purpose of this article the word psychoanalytic psychotherapy has been used to designate both psychoanalysis and psychoanalytically informed therapies.

Current Evidence

The evidence base for psychoanalytic psychotherapies has been generally considered weak. This belies the vast body of peer reviewed published work that exists in the field. Unfortunately, the research has largely not translated to the standards expected of modern evidence based practice but this deficit is being rectified. Over the last two decades there has been an emerging body of good quality longitudinal studies looking at specific outcome measures 1 , 2 , 3 , 4 . Randomization has been a problem but that is also being addressed for example in the recently published work by Taylor et al . in 2012 5 .

Psychoanalytic writing has also been criticized for its lack of focus on specific disorders and syndromes. This is inherent in the way psychoanalytic psychotherapy approaches symptoms, as an indicator of the underlying pathology but not the main focus of treatment. Studies looking at effectiveness specifically in addictions are few in number. Establishing efficacy and effectiveness requires standards of control that are more difficult to maintain in long term, open ended therapies 6 .

A review of the available literature reveals some important findings. Psychoanalytic Psychotherapy shows impressive effect sizes as a long-term therapy 3 , 7 , 8 . Effect sizes are greater at longer follow ups than immediately after the end of therapy suggesting that those who have undergone psychoanalytic psychotherapy keep making gains long after the therapy has ended 1 , 9 , 10 . The inclusion of psychoanalytic techniques and process in non-psychoanalytic interventions can increase effectiveness of these treatments 1 . There are significant positive findings in treatments for personality pathology 3 , 11 .

When looking specifically at addictions we find that there are more exploratory studies looking at process rather than outcome.

Yalisove and Daniel 12 recommend the use of modified psychoanalysis as a treatment for addiction and review the outcome research for such therapy. They suggest “modifications to traditional psychoanalysis that may be made for persons with addiction include an initial phase of treatment that is supportive and didactic, followed by more psychoanalytically oriented treatment; a therapist who is active rather than passive; the forestalling of transference; and the recommendation for participation in Alcoholics Anonymous.” 2 out of 3 studies in which modified psychoanalysis was used with persons with addiction found that those subjects derived significant benefit from the therapy.

Prochaska and Diclemente 13 , state that change processes traditionally associated with Experiential, Cognitive and Psychoanalytic traditions are most helpful during contemplation and pre-contemplation stages whereas change processes associated with behavioural and existential processes are most suitable during action and maintenance stages. Mc Govern and Caroll 14 in their paper on evidence based practice for substance use disorders found psychodynamic supportive–expressive psychotherapy as developed by Luborsky 15 to be an effective intervention for opiate use disorders, especially when delivered by skilled therapists.

Rosenthal in 2008 16 asserts that both CBT and pharmacotherapy have high dropouts when working with pathological gambling while psychodynamic psychotherapy with its focus on therapeutic relationship and the meaning of the patient's destructive behaviour, could provide better results.

In his doctoral study, ‘Therapy with couples with Addiction: A psychoanalytic perspective’, Loveland 17 concludes that use of Psychodynamic approach is effective since each couple is unique and morphing and a manualized approach is not helpful. He also recommends that his psychodynamic colleagues challenge their anxieties regarding working with couples with addictions.

To summarize, the evidence specifically for psychoanalytic psychotherapy in addictions is limited but there is a definite interest.

Psychoanalysis and Addictions: A road less travelled

The website of the British Psychoanalytic Council has a quotation from Jane Milton's book (18) “if you are a heavy user of drugs or alcohol, you are unlikely to benefit from exploratory psychotherapy until you are completely free of the substance you are dependent on, and physically recovered. Only then you will have a clear enough head, and enough self-control, to be able to work together with the therapist and to hold onto what happens in the session. While you are still using the substance, a structured educational approach aiming to help you free yourself of the addiction will probably make most sense or a self-help approach like Alcoholics Anonymous or Narcotics Anonymous”. This polite notice succinctly summarizes the stance psychoanalysts have held but more importantly the stance psychoanalysis is believed to hold by the wider community.

This is a common view, very much in practice, that the patient needs to be ‘clean or dry’ before they can start psychoanalytic psychotherapy. Also, treatment is stopped if the patient uses again. A young man, to whom I was trying to explain that psychoanalytic psychotherapy is not the right course for him since he was actively using substances said ‘but you want me to be cured of that which I need treatment for! ‘ I thought he had a point but I also believed that a man who will just smoke away the anxiety after each session cannot be helped by psychoanalytic psychotherapy. People prone to addictions can use the understanding afforded by the psychotherapy to justify their actions and their helplessness.

Looking back, however, I used to manage my own analysis by walking into the various pretty boutiques that lined the way to my analyst's office and often giving into the impulse to buy the bright, shiny, beautiful objects they sold. What a relief! We all use addictive states to get rid of distress but for some this is a very entrenched compulsion.

Addictive behaviours are desperate attempts to get rid of overwhelming emotional states and is successful in short spurts. Addictive behaviours aim at getting rid of anxieties while psychoanalytic psychotherapy aims at staying with a difficult experience to understand it better. In a way this is similar to exposure therapy but here the exposure is to unconscious internal states. Many people would hence not wish to work analytically with individuals suffering from addictions. Equally, psychoanalytic psychotherapy does not focus overtly on presenting symptoms which would make it unsuitable as a first line of treatment.

However, none of what we have said is untrue for other presentations. All patients present to the psychotherapist with a symptom. All symptoms are an individual's way of managing their anxieties and anyone can misuse knowledge or use psychotherapy as an intellectual escape. Dodes, in his 2003 paper expands on this view 19 . The particular difficulty with addictions, I think is the individual's tendency to become addicted; a state where something is used repetitively for immediate and short term relief. While psychotherapy offers a safe space to think, it can easily be manipulated to offer an addiction. These reasons could have kept psychoanalysts away from working with persons with addictions. Addictions are a difficult condition to treat because at their core it is an addiction to something destructive 20 .

In the preface of the book ‘Addictive States of Mind’ 21 , Bower writes about the essential core of psychoanalytically informed treatments in addictions. The “strong commitment to tolerate, and to work with, often very extreme degrees of trauma, disturbance, perversity, and horrifying cycles of self- and other- destructive behaviours of a kind that makes such patients very hard to reach” and the “maintaining of a psychoanalytic attitude of mind can be seen to support the capacity to contain anxiety and also ‘to think under fire’.”

What we think Bower is stating is that not only is psychoanalytic psychotherapy used to work with individuals with very deep seated and entrenched addictive states of mind but that even where the setting uses different types of interventions a psychoanalytically supported thinking space has been found to be very useful.

Here we would specifically like to mention the Tavistock and Portman clinics both of which are bastions of psychoanalytic psychotherapy. The Portman largely deals with patients who have come into contact with the legal system and amongst whom the prevalence of addictions both to substances and paraphilias is higher. Hence it would be ignorant to think that psychoanalytically oriented therapies are ineffective in treating addictions.

Understanding Addictions – A psychoanalytic perspective

In our work, we see individuals suffering from addictions even if they are not abusing any substance. An addiction is a tendency to use repetitively and hence without thought, something - a substance, a state, an experience or a relationship. The addiction can be in the form of gambling, pornography, use of the internet, shopping and in perverse ways of relating. This either provides immediate relief or at least a distraction from something that feels unbearable. The individual sets up a repetitive cycle that offers a retreat from real life, ‘real’ others and importantly, allows for the illusion of complete control.

Most people come to psychotherapy because they are troubled by something and because they feel that their problems are having an adverse impact upon those they love and care for. They are troubled by the fact that despite talent they have become stuck in their lives. In contrast a person with addiction is often brought by others. Most persons with addictive disorders are not able to think about changing anything, at least not in themselves. Usually people suffering from a drug or alcohol use disorder do not come to see a psychotherapist. People suffering from sex addictions might because they may think that sex is of interest to a psychotherapist. They do not realize that their problem is not sex, but addiction to something repetitive and meaningless and an absence of any real relationships.

Early psychoanalytic theories on addictions stressed on pleasurable and aggressive drives. Today, however, psychoanalysis takes a much broader perspective, understanding addictive states as ways to manage intolerably painful and confusing affect. It is like self-medicating states of subjective stress and suffering 22 . That it comes at a cost often does not form a part of the addicted individual's visual field and if at all they are irked by guilt or loss those too can be dealt with via the addiction.

Clinical Implications

Working with a person suffering from an addiction is a challenge. It requires one to be able to bear something that is destructive and perverse. Psychoanalytic space can allow for thinking and provide a containment of overwhelming anxieties 23 .

When working with addictive states psychoanalytically, the emphasis is not so much on discrete symptomatology but rather on the whole person and how particular defense mechanisms came into existence. Persons suffering from an addiction protect themselves from unbearable pain and confusion by developing a narcissistic defense organization that combines omnipotence with denial of dependency (24). This pathological defense organization rests on a split and confusing world which is both strengthening and overpowering; secure and abusive; all in one. Understandably, alcohol and drugs are often referred to as self- medication chasing away depression, anxiety and even psychosis 24 , 25 , 26 .

Given that addictive states can be so destructive both to the individual and others trying to help them we have to be constantly aware of our countertransference. Psychoanalytic thinking can offer a space to multidisciplinary groups to maintain compassion and a wish to understand under such an attack. The work is always through transference and countertransference. Dysfunctional, abusive dynamics get transferred to the therapist, the team or the family easily. The dynamic of ‘I don't depend on anyone’ is very much reflected in the rigidly hierarchical systems in teams, where it would be unthinkable that every member of staff irrespective of their position can stand in for anyone else.

Case Vignette

Mr A is a young married man, living abroad. He sought a consultation because his wife of 3 years was unable to have sex with him and he managed the situation by having sex with multiple women he met on dating websites. He would meet a girl only a few times, for the express purpose of having sex. He did not want a relationship, because that could lead to a divorce, which was unthinkable for him. He said he was sexually active before marriage; however the only women he had sex with were sex workers. He had two girlfriends but never had sex with them because he was terrified of their fathers.

He would often send his wife back to India and then go through an elaborate process of cleansing the house of her presence. He would then invite women home. He would also meet the women in hotel rooms during work hours. He said his work was flexible. The girls all believed him to be unmarried. He said that recently he had met a girl and was now ‘completely hooked on to her’. However, she did not wish to see him for some time. This had made things very difficult for him and hence he had written to me and had come down to India to see me for a one off consultation. I told him that since his girlfriend will not have him he has come to me for a one night stand. It did not seem that he wished to seriously think about his predicament.

He said that the girl had a few other regular partners but since he had met her he had only wanted her. He felt that sex with this girl was the best he had because she did not ask him to use a condom. I was surprised. I checked again that did he not say that she had a few other partners. He said yes. I asked him why he would have unprotected sex with a woman who had multiple partners. He looked unclear about my question and said ‘because I trust her!’ I observed that on the one hand he did not wish to have a long term relationship with anyone of them but on the other hand they all knew his address despite having created a false profile on Tinder. Once again he looked confused.

Mr A appears very confident of his elaborate plans, completely unaware of the many ways things that could go wrong. In his mind it was all foolproof. He had seen a few psychiatrists by himself. He did not think his wife should be exposed to discussions regarding sex. She was naive in such matters, he said smiling. What was interesting however, is the split in his mind. There were women one had sex with and there were women who one had a relationship with. One is stained and sexually potent, the other pure and virginal, with a powerful and threatening father watching over her. As we explored this issue he said that he grew up in a house with his mother and his sister. His father worked abroad and came down only once a year. His parents fought a lot and his father would beat up his mother and him, if angered in the slightest. He was terrified of him. He said that in contrast, his parents in law treated him like a son. He told me that the only girl he had fallen in love with was his first cousin. He had wanted to marry her but her father, his uncle, was dead against it.

As a psychoanalytic psychotherapist, I notice three things about his presentation. First, that he was addicted to a particular type of sexual relationship. The lies, the hiding, the charade is foreplay. He engages in his habit secretly and the shame and fear of exposure are essential ingredients to heighten excitement. He justifies the entire set up by stating that his wife cannot have sex.

Second, I notice a repetition. A young boy growing up as the man of the house with two women, who he loves and respects and whom he must protect from all that is experienced as murky and dark in him; his sexual feelings and fantasies. There is also the figure of a frightening father looming in the background who thrashes him regularly as if he knew.

Third, the nature of the relationship such a split creates. He does not have a real, adult relationship with anybody; with neither man nor woman. It is as though the only relationships he can have are these rushed sexual encounters in a hotel room, just like the rushed consultation with me. I am very sure that he will cleanse his mind of me as quickly as he cleanses his body of the women he has been with. He can have sex but he cannot relate with another person. He believed that his wife cannot have sex but I think equally he cannot have sex with a woman who lives in the house with him and whose father treats him like his own son.

When I shared these thoughts with him he said that he had not thought about things in this way but it didn't feel completely alien. He said that his sister was born within less than one year of his birth and he had always felt he rushed into growing up. He shared memories of coming to his mother distressed or scared and seeking warmth and contact but his mother would tell him that he was a big boy, there to look after her. She would constantly fill him up with stories of how his father mistreated her and remonstrated that he must never become like his father. He didn't think he had a close relationship with anyone.

The idea of finding out the meaning and origin of the addictive behaviour and treating it at its source is an appealing and seemingly logical proposition, one that many persons suffering from an addiction themselves seek. Alas, what seems logical and clear is in practice beset with obstructions and blind alleys. The addiction itself often becomes a hurdle to a fuller and deeper engagement with the analytic process as it can anaesthetize the anxieties that this process brings up. This necessitates a careful assessment process before recommending this method as a treatment option. Where there is a good match the process and outcome can be fruitful for both the patient and the therapist.

Nursing Bay

Nrnp 6645 week 8 assignment psychotherapy for clients with addictive disorders.

A long-standing debate has roiled over whether addicts have a choice over their behaviors. The disease creates distortions in thinking, feelings, and perceptions, which drive people to behave in ways that are not understandable to others around them. Simply put, addiction is not a choice. Addictive behaviors are a manifestation of the disease, not a cause.

—Dr. Raju Hajela, former president of the Canadian Society of Addiction Medicine

A common misconception is that addiction is a choice, and addicts are often labeled as individuals who lack morals, willpower, or responsibility. However, addiction is a clinical disorder that must be treated with the support of a health care professional. Although many people who are exposed to potentially addictive substances and behaviors continue life unaltered by their experiences, some people are fueled by these experiences and spiral out of control.

In your role as the psychiatric-mental health nurse practitioner, you must be prepared to not only work with these individuals who struggle with addiction but also help them and their families overcome the social stigmas associated with addictive behavior.

This week, you will assess a research article on psychotherapy for clients with addictive disorders. You also examine therapies for treating these clients and consider potential outcomes. Finally, you will discuss how therapy treatment will translate into your clinical practice.

NRNP 6645 Week 8 Assignment Psychotherapy for Clients With Addictive Disorders Learning Objectives

Students will:

• Analyze literature on interventions and therapeutic approaches used for treating clients with addictive disorders
• Evaluate the application of current literature on addiction treatment to clinical practice

NRNP 6645 Week 8 Assignment Psychotherapy for Clients With Addictive Disorders Learning Resources

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.)

For reference as needed

Wheeler, K. (Ed.). (2020). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (3rd ed.). Springer Publishing.

Chapter 9, “Motivational Interviewing” Chapter 19, “Psychotherapeutic Approaches for Addictions and Related Disorders”

AllCEUs Counseling Education. (2017, November 4). 187 models of treatment for addiction | Addiction counselor training series [Video]. YouTube. https://www.youtube.com/watch?v=eQkA0mIWx8A

Assignment: NRNP 6645 Week 8 Assignment Psychotherapy for Clients With Addictive Disorders

Addictive disorders can be particularly challenging for clients. Not only do these disorders typically interfere with a client’s ability to function in daily life, but they also often manifest as negative and sometimes criminal behaviors. Sometimes clients with addictive disorders also suffer from other mental health issues, creating even greater struggles for them to overcome.

In your role, you have the opportunity to help clients address their addictions and improve outcomes for both the clients and their families.

To prepare for NRNP 6645 Week 8 Assignment Psychotherapy for Clients With Addictive Disorders:

• Review this week’s Learning Resources and consider the insights they provide about diagnosing and treating addictive disorders. As you watch the  187 Models of Treatment for Addiction  video, consider what treatment model you may use the most with clients presenting with addiction.
• Search the Walden Library databases and choose a research article that discusses a therapeutic approach for treating clients, families, or groups with addictive disorders.

NRNP 6645 Week 8 Assignment Psychotherapy for Clients With Addictive Disorders The Assignment

In a 5- to 10-slide PowerPoint presentation, address the following. Your title and references slides do not count toward the 5- to 10-slide limit.

• What population (individual, group, or family) is under consideration?
• What was the specific intervention that was used? Is this a new intervention or one that was already studied?
• What were the author’s claims?
• Explain the findings/outcomes of the study in the article. Include whether this will translate into practice with your own clients. If so, how? If not, why?
• Explain whether the limitations of the study might impact your ability to use the findings/outcomes presented in the article.
• Use the Notes function of PowerPoint to craft presenter notes to expand upon the content of your slides.
• Support your response with at least three other peer-reviewed, evidence-based sources. Explain why each of your supporting sources is considered scholarly. Provide references to your sources on your last slide. Be sure to include the article you used as the basis for this Assignment.

Submit your Assignment. Also, attach and submit PDFs of the sources you used.

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To submit your completed Assignment for review and grading, do the following:

• Please save your Assignment using the naming convention “WK8Assgn+last name+first initial.(extension)” as the name.
• Click the  Week 8 Assignment Rubric  to review the Grading Criteria for the Assignment.
• Click the  Week 8 Assignment   link. You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the  Browse My Computer  button. Find the document you saved as “WK8Assgn+last name+first initial.(extension)” and click  Open .
• If applicable: From the Plagiarism Tools area, click the checkbox for  I agree to submit my paper(s) to the Global Reference Database .
• Click on the  Submit  button to complete your submission.

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Psychotherapy for Clients with Addictive Disorders Example Approach

Addictive Disorders manifest via deficits in regulating emotions, self-esteem, relationships, and self-care, leading to the inability to abandon detrimental substances or behaviors. Often, causal factors for addictive disorders include biological, psychosocial, cultural, and social factors. According to Khantzian (2020), environmental influences such as traumatic abuse, peer pressure, safety, and parenting may increase individual susceptibility to addiction. With much emphasis regarding addictive disorders resting on substance abuse and gambling, various psychoanalytical psychotherapy is one of the most profound interventions for treating and preventing addiction.

Psychoanalytical Psychotherapy and Addiction Treatment

Psychoanalytical/psychodynamic psychotherapy assumes that essential psychological factors lead to addictive behaviors and activities (Khantzian, 2020). In a retrospective study by Mooney et al. (2019), the researchers evaluate the applicability of psychoanalytical psychotherapy in treating and preventing gambling addiction. Therefore, the research targets patients struggling with compulsive addiction seeking treatment at the National Problem Gambling Clinic (NPGC) in London. According to Mooney et al. (2019), psychodynamic therapy is crucial in exposing unconscious patterns by enabling patients to reflect, clarify, and confront interpersonal conflicts, wishes, and defenses that strengthen addiction.

The research revealed that psychodynamic psychotherapy successfully treated patients’ addiction problems by imparting a sense of intrinsic awareness while reducing depression and anxiety. However, researchers acknowledged that various limitations hampered the study’s precision and validity of the conclusion. For instance, investigators identified a lack of scholarly literature, data disparities, and research model as the major drawbacks for the study. Therefore, it is essential to evaluate scholarly evidence to justify the applicability of psychodynamic psychotherapy in addressing addiction.

Additional Scholarly Evidence

Although insufficient scholarly evidence compromises the determination to render psychodynamic psychotherapy effective in treating addiction, some studies support this approach. Verma & Vijayakrishnan (2018) argue that this therapeutic approach helps patients better understand themselves, their unconscious desires, motivations, and conflicts. On the other hand, Whitman & Olesker (2021) contend that psychoanalytic approaches play a significant role in treating opiate, alcohol, and marijuana dependence patients. Finally, Khantzian (2020) supports the topic by arguing that psychodynamic psychotherapy enables change agents to identify, target, modify and eliminate causal factors for addiction. Undoubtedly, these sources are scholarly because they are peer-reviewed, organized, and published in reputable databases to provide additional insights into the topic.

Khantzian, E. (2020). Psychodynamic psychotherapy for the treatment of substance use disorders. Textbook Of Addiction Treatment, 383-389. https://doi.org/10.1007/978-3-030-36391-8_26

Mooney, A., Roberts, A., Bayston, A., & Bowden‐Jones, H. (2019). The piloting of a brief relational psychodynamic protocol (psychodynamic addiction model) for problem gambling and other compulsive addictions: A retrospective analysis. Counselling And Psychotherapy Research, 19(4), 484-496. https://doi.org/10.1002/capr.12251

Verma, M., & Vijayakrishnan, A. (2018). Psychoanalytic psychotherapy in addictive disorders. Indian journal of psychiatry, 60(Suppl 4), S485–S489. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_16_18

Whitman, L., & Olesker, W. (2021). Introduction – Addiction: A ubiquitous problem. The Psychoanalytic Study of The Child, 74(1), 227-233. https://doi.org/10.1080/00797308.2020.1859302

NRNP 6645 Week 8 Assignment Psychotherapy for Clients With Addictive Disorders Rubric Detail

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Also Read: NRNP 6645 Week 6 Supportive and Interpersonal Psychotherapy

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NRNP 6645 Assignment: Psychotherapy for Clients With Addictive Disorders

• WALDEN UNIVERSITY

Walden University NRNP 6645 Assignment: Psychotherapy for Clients With Addictive Disorders- Step-By-Step Guide

This guide will demonstrate how to complete the Walden University NRNP 6645 Assignment: Psychotherapy for Clients With Addictive Disorders  assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for  NRNP 6645 Assignment: Psychotherapy for Clients With Addictive Disorders

Whether one passes or fails an academic assignment such as the Walden University NRNP 6645 Assignment: Psychotherapy for Clients With Addictive Disorders depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for NRNP 6645 Assignment: Psychotherapy for Clients With Addictive Disorders

The introduction for the Walden University NRNP 6645 Assignment: Psychotherapy for Clients With Addictive Disorders  is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

How to Write the Body for NRNP 6645 Assignment: Psychotherapy for Clients With Addictive Disorders

After the introduction, move into the main part of the NRNP 6645 Assignment: Psychotherapy for Clients With Addictive Disorders assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for NRNP 6645 Assignment: Psychotherapy for Clients With Addictive Disorders

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for NRNP 6645 Assignment: Psychotherapy for Clients With Addictive Disorders

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Introduction

¡Addiction is a complex disorder

¡ Uncontrolled use of a substance

¡Rx- pharmacotherapy & psychotherapy

¡The presentation will analyze an article on addiction treatment

¡Target population & intervention

¡Study findings & limitations

Addiction is a complex disorder characterized by uncontrolled use of a substance in spite of harmful consequences.

Various treatment approaches are available to treat addiction disorders, including Detoxification, Therapeutic communities, Outpatient medication management and psychotherapy, Intensive outpatient programs, Residential treatment, Mutual-aid group, and Self-help groups that have family members (Kalin, 2020).

This presentation will analyze an article that discusses a therapeutic approach for treating patients with an addictive disorder , including target population, intervention used, study findings, and limitations.

Article Overview

¡E-cigarettes vs. NRT in nicotine addiction

¡The study examined 1-year efficacy

¡Limited evidence on the effectiveness of e-cigarettes vs.NRT

¡Two-group, pragmatic, multicentre RCT

¡Randomization of 886 participants

¡Primary outcome- sustained abstinence for 1-year

Hajek et al. (2019) examined the 1-year efficacy of refillable e-cigarettes compared with nicotine replacement therapy (NRT) when given to adults seeking help on smoking cessation and combined with face-to-face behavioral support. The study was informed by the limited evidence regarding the effectiveness of e-cigarettes compared with that of nicotine products approved for the treatment of smoking cessation. The researchers conducted a two-group, pragmatic, multicenter, individually randomized, controlled trial (RCT). The study randomized 886 participants (Hajek et al., 2019). Randomization occurred on the cessation date to limit differential dropout. The primary outcome was sustained abstinence for one year, which was confirmed biochemically at the final visit.

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Population under Consideration

¡Target- Adults seeking help on smoking cessation

¡Adult smokers were invited to the study

¡Criteria: Not pregnant/lactating

¡No strong preference for e-cigarettes or NRT

¡Currently not using e-cigarettes or NRT

The study’s target population was adults seeking help on smoking cessation. The researchers invited adult smokers to participate in the study if they were not pregnant or lactating, had no strong preference to use or not to use nicotine replacement or e-cigarettes, and were currently not using either NRT or e-cigarettes (Hajek et al., 2019).

Specific Intervention Used

¡NRT group selected preferred product

¡Used patch+ short-acting oral product for 3 months

¡E-Cigarette Group- given a starter pack +30-ml e-liquid

¡Taught on using refillable e-cigarette products

¡Weekly behavioral support for both

¡Both interventions have previously been studied

Participants were randomly assigned to either a Nicotine-Replacement Group or an E-Cigarette Group. Participants in the Nicotine-Replacement Group were educated on nicotine-replacement products, such as patch, lozenge, gum, nasal spray, inhalator, mouth spray, mouth strip, and micro tabs, and chose their preferred product. Use of combined products was encouraged, mostly the patch and a short-acting oral product (Hajek et al., 2019). They were also free to switch products. The nicotine replacement supplies were provided for up to 3 months.

Participants in the E-Cigarette Group were provided a starter pack (One Kit) to encourage the initial use and teach them how to use refillable e-cigarette products. They were also given one 30-ml bottle of e-liquid containing nicotine at 18 mg per milliliter (Hajek et al., 2019).

Treatment entailed weekly behavioral support for at least four weeks for both groups.

The E-cigarette and Nicotine replacement interventions have previously been studied, but there is limited evidence comparing their effectiveness.

Author’s Claims

¡The study would show a stronger effect of e-cigarettes than previous trials

¡Previous trials provided limited or no face-to-face support

¡Previous trials used 1st generation cartridge products

¡Refillable devices are more efficient at nicotine delivery

The authors claimed that the RCT study would show a stronger effect of e-cigarettes than previous trials. This is because they included smokers seeking help in quitting, provided face-to-face support, and used refillable e-cigarettes with free choice of e-liquids (Hajek et al., 2019). They also asserted that previous trials provided limited or no face-to-face support and used first-generation cartridge products.

Besides, they argued that refillable devices are generally more efficient at nicotine delivery.

Study Findings/Outcomes

¡E-cigarettes were more effective

¡High rate of continuing e-cigarette

¡The E-cigarette group was more likely to decrease smoking

¡E-cigarettes- throat/mouth irritation; NRT- nausea

¡The study will translate in managing nicotine addiction patients

¡Recommend e-cigarettes for successful outcomes

E-cigarettes were more effective in promoting smoking cessation than NRT. The rate of continuing e-cigarette use was relatively high. Among participants in the trial in whom full abstinence was not met, those in the e-cigarette group were more likely to decrease their smoke intake than those in the NRT group (Hajek et al., 2019). E-cigarettes were associated with more throat and mouth irritation, while NRT caused more nausea. More subjects in the e-cigarette group than in the NRT group reported respiratory adverse events.

The study findings will translate into my practice when managing clients with nicotine addiction, aiming at quitting tobacco use. I can recommend e-cigarettes to these patients to promote more successful outcomes.

Impact of Limitations in Using the Findings

¡Product assignments could not be blinded

¡Lack of blinding could affect the results

¡CO validation detects only over the past 24 hours

¡Limitations will not affect the use of findings

¡NRT interventions were provided under expert guidance

Limitations in the study include: Product assignments could not be blinded, affecting the results. Positive expectations partially affect long-term abstinence, but if NRT was viewed as an inferior option, participants in the NRT group could have put less effort into their cessation attempt than those in the e-cigarette group (Hajek et al., 2019). Validation of carbon monoxide detects smoking only over the past 24 hours, and therefore there may have been some false-negative results. The study’s limitations will not affect my ability to use the findings because the NRT interventions were provided under expert guidance.

¡The article compared the effectiveness of E-cigarettes vs.NRT

¡E-cigarettes had better ratings than NRT

¡Primary outcome- smoking abstinence for 1 year

¡Participants were offered face-to-face support

¡Established that E-cigarettes are more effective

¡Intervention can be applied in patients with nicotine addiction

Hajek, P., Phillips-Waller, A., Przulj, D., Pesola, F., Myers Smith, K., Bisal, N., … & McRobbie, H. J. (2019). A randomized trial of e-cigarettes versus nicotine-replacement therapy.  New England Journal of Medicine ,  380 (7), 629-637. https://doi.org/10.1056/NEJMoa1808779

Kalin, N. H. (2020). Substance Use Disorders and Addiction: Mechanisms, Trends, and Treatment Implications.  American Journal of Psychiatry ,  177 (11), 1015-1018. https://doi.org/10.1176/appi.ajp.2020.20091382

Ivory Lessons

Assignment: Psychotherapy for Clients with Addictive Disorders

Addictive disorders can be particularly challenging for clients. Not only do these disorders typically interfere with a client’s ability to function in daily life, but they also often manifest as negative and sometimes criminal behaviors. Sometime clients with addictive disorders also suffer from other mental health issues, creating even greater struggles for them to overcome. In your role, you have the opportunity to help clients address their addictions and improve outcomes for both the clients and their families.

Photo Credit: Getty Images

To prepare:

· Review this week’s Learning Resources and consider the insights they provide about diagnosing and treating addictive disorders. As you watch the  187 Models of Treatment for Addiction  video, consider what treatment model you may use the most with clients presenting with addiction.

· Search the Walden Library databases and choose a research article that discusses a therapeutic approach for treating clients, families, or groups with addictive disorders.

The Assignment

In a 5- to 10-slide PowerPoint presentation, address the following. Your title and references slides do not count toward the 5- to 10-slide limit. 

· Provide an overview of the article you selected.

· What population (individual, group, or family) is under consideration?

· What was the specific intervention that was used? Is this a new intervention or one that was already studied?

· What were the author’s claims?

· Explain the findings/outcomes of the study in the article. Include whether this will translate into practice with your own clients. If so, how? If not, why?

· Explain whether the limitations of the study might impact your ability to use the findings/outcomes presented in the article. 

· Use the Notes function of PowerPoint to craft presenter notes to expand upon the content of your slides. 

· Support your response with at least three other peer-reviewed, evidence-based sources. Explain why each of your supporting sources is considered scholarly. Provide references to your sources on your last slide. Be sure to include the article you used as the basis for this Assignment.

Submit  your Assignment. Also attach and submit PDFs of the sources you used.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

· Please save your Assignment using the naming convention “WK8Assgn+last name+first initial.(extension)” as the name.

· Click the  Week 8 Assignment Rubric  to review the Grading Criteria for the Assignment.

· Click the  Week 8 Assignment  link. You will also be able to “View Rubric” for grading criteria from this area.

· Next, from the Attach File area, click on the  Browse My Computer  button. Find the document you saved as “WK8Assgn+last name+first initial.(extension)” and click  Open .

· If applicable: From the Plagiarism Tools area, click the checkbox for  I agree to submit my paper(s) to the Global Reference Database .

· Click on the  Submit  button to complete your submission.

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Psychotherapy For Addictive Disorders

• Post category: Nursing
• Reading time: 2 mins read

Nursing homework help

This week, you will assess a research article on psychotherapy for clients with addictive disorders. You also examine therapies for treating these clients and consider potential outcomes. Finally, you will discuss how therapy treatment will translate into your clinical practice.

Assignment: Psychotherapy for Clients With Addictive Disorders

Addictive disorders can be particularly challenging for clients. Not only do these disorders typically interfere with a client’s ability to function in daily life, but they also often manifest as negative and sometimes criminal behaviors. Sometime clients with addictive disorders also suffer from other mental health issues, creating even greater struggles for them to overcome. In your role, you have the opportunity to help clients address their addictions and improve outcomes for both the clients and their families.

Photo Credit: Getty Images

To prepare:

· Review this week’s Learning Resources and consider the insights they provide about diagnosing and treating addictive disorders. As you watch the   187 Models of Treatment for Addiction  video, consider what treatment model you may use the most with clients presenting with addiction.

· Search the Walden Library databases and choose a research article that discusses a therapeutic approach for treating clients, families, or groups with addictive disorders.

The Assignment

Address the following.

Provide an overview of the article you selected.

· What population (individual, group, or family) is under consideration?

· What was the specific intervention that was used? Is this a new intervention or one that was already studied?

· What were the author’s claims?

· Explain the findings/outcomes of the study in the article. Include whether this will translate into practice with your own clients. If so, how? If not, why?

· Explain whether the limitations of the study might impact your ability to use the findings/outcomes presented in the article.

· Support your response with at least three other peer-reviewed, evidence-based sources. Explain why each of your supporting sources is considered scholarly. Provide references to your sources on your last slide. Be sure to include the article you used as the basis for this Assignment.

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Discussion: end-user satisfaction of health information systems, healthcare policy 5351557 2, future recommendations.

PSYCHOTHERAPY FOR CLIENTS WITH ADDICTIVE DISORDERS

• Similar Questions

THE ASSIGNMENT

In a 5- to 10-slide PowerPoint presentation, address the following. Your title and references slides do not count toward the 5- to 10-slide limit. 

• What population (individual, group, or family) is under consideration?
• What was the specific intervention that was used? Is this a new intervention or one that was already studied?
• What were the author’s claims?
• Explain the findings/outcomes of the study in the article. Include whether this will translate into practice with your own clients. If so, how? If not, why?
• Explain whether the limitations of the study might impact your ability to use the findings/outcomes presented in the article. 
• Use the Notes function of PowerPoint to craft presenter notes to expand upon the content of your slides. 
• Support your response with at least three other peer-reviewed, evidence-based sources. Explain why each of your supporting sources is considered scholarly. Provide references to your sources on your last slide. Be sure to include the article you used as the basis for this Assignment.

 AllCEUs Counseling Education. (2017, November 4). 187 models of treatment for addiction | Addiction counselor training series Links to an external site. [Video]. YouTube. https://www.youtube.com/watch?v=eQkA0mIWx8A

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Assignment: Psychotherapy for Clients With Addictive Disorders/NRNP 6645: Psychotherapy with Multiple Modalities

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Assignment: Psychotherapy for Clients With Addictive Disorders

Addictive disorders can be particularly challenging for clients. Not only do these disorders typically interfere with a client’s ability to function in daily life, but they also often manifest as negative and sometimes criminal behaviors. Sometime clients with addictive disorders also suffer from other mental health issues, creating even greater struggles for them to overcome. In your role, you have the opportunity to help clients address their addictions and improve outcomes for both the clients and their families.

To prepare:

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Psychotherapy for Clients with Addictive Disorders

Assignment: Psychotherapy for Clients with Addictive Disorders

Addictive disorders can be particularly challenging for clients. Not only do these disorders typically interfere with a client’s ability to function in daily life, but they also often manifest as negative and sometimes criminal behaviors. Sometime clients with addictive disorders also suffer from other mental health issues, creating even greater struggles for them to overcome. In your role, you have the opportunity to help clients address their addictions and improve outcomes for both the clients and their families.

Photo Credit: Getty Images

To prepare:

· Review this week’s Learning Resources and consider the insights they provide about diagnosing and treating addictive disorders. As you watch the  187 Models of Treatment for Addiction  video, consider what treatment model you may use the most with clients presenting with addiction.

· Search the Walden Library databases and choose a research article that discusses a therapeutic approach for treating clients, families, or groups with addictive disorders.

The Assignment

In a 5- to 10-slide PowerPoint presentation, address the following. Your title and references slides do not count toward the 5- to 10-slide limit.

· Provide an overview of the article you selected.

· What population (individual, group, or family) is under consideration?

· What was the specific intervention that was used? Is this a new intervention or one that was already studied?

· What were the author’s claims?

· Explain the findings/outcomes of the study in the article. Include whether this will translate into practice with your own clients. If so, how? If not, why?

· Explain whether the limitations of the study might impact your ability to use the findings/outcomes presented in the article.

· Use the Notes function of PowerPoint to craft presenter notes to expand upon the content of your slides.

· Support your response with at least three other peer-reviewed, evidence-based sources. Explain why each of your supporting sources is considered scholarly. Provide references to your sources on your last slide. Be sure to include the article you used as the basis for this Assignment.

Submit  your Assignment. Also attach and submit PDFs of the sources you used.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

· Please save your Assignment using the naming convention “WK8Assgn+last name+first initial.(extension)” as the name.

· Click the  Week 8 Assignment Rubric  to review the Grading Criteria for the Assignment.

· Click the  Week 8 Assignment  link. You will also be able to “View Rubric” for grading criteria from this area.

· Next, from the Attach File area, click on the  Browse My Computer  button. Find the document you saved as “WK8Assgn+last name+first initial.(extension)” and click  Open .

· If applicable: From the Plagiarism Tools area, click the checkbox for  I agree to submit my paper(s) to the Global Reference Database .

· Click on the  Submit  button to complete your submission.

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