There are clinical indications that alcohol and drug abuse are associated with unhealthy core beliefs (unconditional, schema-level representations). This study examined levels of such cognitions among four groups: alcohol abusers; opiate abusers; combined alcohol and opiate abusers; and a non-clinical group. Each patient completed the short version of the Young Schema Questionnaire, measuring levels of 15 pathological core beliefs. These schema-level cognitions were less healthy in the clinical groups than in the non-clinical group, particularly among individuals who abused alcohol. These findings provide preliminary support for the utility of therapies that address schema-level representations among substance abusers.
The empirical evidence concerning the prevalence and function of reminiscence among the elderly is reviewed and the relevance of such activity for clinical populations is evaluated. Variations in the ways in which reminiscence is defined and methods of eliciting reminiscence activity are described. Data on frequency of reminiscence and its relationship to age are discussed. Studies investigating the functions of reminiscence are divided into three groups according to experimental design and their findings critically reviewed. It is concluded that there is little evidence of an age-specific process of reminiscence, that the functions of such a process are unclear and that the role of reminiscence as a therapeutic activity is in doubt.
This study considered the role of schema-level cognitive processes in alcohol and opiate abuse. It examined the hypothesis that alcohol abuse will be associated with the use of "blocking" behaviours to reduce the experience of emotions (secondary avoidance of affect), while opiate abuse will be associated with a tendency to avoid emotions being activated in the first place (primary avoidance of affect). The sample consisted of 30 patients who abused alcohol, and 30 who abused opiates. Each completed the Young Compensatory Inventory (YCI) and the Young-Rygh Avoidance Inventory (YRAI). There were no differences between the groups in their absolute levels of schema processes (YCI and YRAI scores). However, they differed in the way in which the severity of use was associated with the level of YRAI behavioural-somatic avoidance. Among alcohol abusers only, severity of use was greater in those who were more likely to avoid affective arousal in this way. This association with severity was not found among opiate abusers. Implications are discussed for existing treatments and for the use of schema-level cognitive behavioural interventions with substance-using populations.
Drug Treatment and Testing Orders (DTTOs) were introduced in the 1998 Crime and Disorder Bill and were piloted in three areas in England over the subsequent 18 months. The orders, funded by the Home Office, allow drug using offenders to be coerced into attending for treatment, to have regular urine tests and to be reviewed by the courts. In Croydon an equal partnership was set up between probation, a local statutory provider of drug services and a voluntary sector agency. Treatment plans were individualised and included a variety of treatment options. Forty-eight orders were imposed mainly for persistent shoplifting. Sixty-three percent of individuals had used heroin and 54% crack cocaine in the 30 days before the order was imposed. Ethical issues raised in coerced treatment were important for the individuals providing treatment although the clients all had to consent to treatment. The pilot programme raised issues about the nature of treatment, clinical responsibility, the selection of clients for orders and the objectives of treatment. Frequent urine testing was problematic but in the vast majority of cases clients were not breached just because of positive tests. The provision of DTTOs in an area created unacceptable inequalities in access to treatment. The paper concludes that partnership working and clear objectives are vital for treatment programmes to operate effectively. More research is needed to explore the most optimum way to deliver treatment in the context of a DTTO.
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