Group relationships during a dialectical behavior therapy skills training program for the treatment of alcohol and concurrent substance use disorders: Evidence and theoretical considerations.

Cavicchioli, Marco; Vassena, Giulia; Ramella, Pietro; Simone, Giulia; Movalli, Mariagrazia; Maffei, Cesare

doi:10.1037/gdn0000138

Cited by 9 publications

(4 citation statements)

References 71 publications

(113 reference statements)

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“…In contrast, previous research has shown mixed findings on the relationship between the client and peers in substance use disorder populations: some research found a significant association between group cohesion and intervention outcomes, and group processes and outcomes,32–37 while other research found no significant association between group cohesion and outcomes 38 39. Even though there seems to be no consensus in the literature on the association between the relationship between client and peers and intervention outcomes for the general adult population, we argue that there could be a strong association for older adults.…”

Section: Discussioncontrasting

confidence: 85%

Professionals’ perspectives on interventions to reduce problematic alcohol use in older adults: a realist evaluation of working elements

van den Bulck,

Knijff,

Crutzen

et al. 2024

BMJ Open

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ObjectivesThis study set out to understand how (which elements), in what context and why (which mechanisms) interventions are successful in reducing (problematic) alcohol use among older adults, from the perspective of professionals providing these interventions.DesignGuided by a realist evaluation approach, an existing initial programme theory (IPT) on working elements in alcohol interventions was evaluated by conducting semistructured interviews with professionals.Setting and participantsThese professionals (N=20) provide interventions across several contexts: with or without practitioner involvement; in-person or not and in an individual or group setting. Data were coded and links between contexts, elements, mechanisms and outcomes were sought for to confirm, refute or refine the IPT.ResultsFrom the perspective of professionals, there are several general working elements in interventions for older adults: (1) pointing out risks and consequences of drinking behaviour; (2) paying attention to abstinence; (3) promoting contact with peers; (4) providing personalised content and (5) providing support. We also found context-specific working elements: (1) providing personalised conversations and motivational interviewing with practitioners; (2) ensuring safety, trust and a sense of connection and a location nearby home or a location that people are familiar with in person and (3) sharing experiences and tips in group interventions. Furthermore, the mechanisms awareness and accessible and low threshold participation were important contributors to positive intervention outcomes.ConclusionIn addition to the IPT, our findings emphasise the need for social contact and support, personalised content, and strong relationships (both between client and practitioner, and client and peers) in interventions for older adults.

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Section: Discussioncontrasting

confidence: 85%

Professionals’ perspectives on interventions to reduce problematic alcohol use in older adults: a realist evaluation of working elements

van den Bulck,

Knijff,

Crutzen

et al. 2024

BMJ Open

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“…Third, while a large literature highlights the importance of the therapeutic alliance in DBT and other therapies, few have examined potentially relevant therapeutic processes within the DBT skills group. One recent study found that the strength of relationships among members with each other and with group leaders in DBT skills training was associated with individual treatment outcomes (Cavicchioli et al, 2020). Understanding the role of group processes in client treatment is particularly relevant for racially, ethnically, and culturally diverse clients, as group harmony and interdependent functioning was a key cultural value and priority for several participants in the reviewed studies (e.g., Cheng & Merrick, 2017; Yang et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

Cultural adaptations of dialectical behavior therapy: A systematic review.

Haft¹,

O’Grady²,

Shaller³

et al. 2022

Journal of Consulting and Clinical Psychology

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Objective: Adapting mental health-care interventions to the race, ethnicity, or culture of the target group can enhance the acceptance and effectiveness of the treatment. Dialectical behavior therapy (DBT) is an evidence-based treatment that is principle-driven, rendering it well-suited for adaptations across cultural contexts. This article conducts a systematic review of the literature to determine the nature and extent of cultural adaptations of DBT to date. Method: We searched databases for original articles describing cultural adaptations of DBT, as applied to both (a) people of color within Western countries and (b) populations within non-Western countries. Consistent with the focus on descriptively characterizing extant DBT cultural adaptations, we included both published and nonpublished studies, as well as both observational and experimental studies. Results: Our search yielded 18 articles that met inclusion criteria. Of these articles, half described adaptations made with people and communities of color within the U.S. Most adaptations involved modifications to language, metaphors, methods, and context. Conclusions: Culturally adapted DBT has been implemented and accepted among several racial, ethnic, and cultural groups, although there is insufficient evidence to determine whether culturally adapted DBT is more efficacious than nonadapted DBT. We conclude with recommendations for best practices for DBT researchers and clinicians, and situate our findings among larger efforts to render existing evidence-based psychotherapies more optimal for people of color and people from non-Western countries.What is the public health significance of this article? Dialectical behavior therapy (DBT) may require cultural adaptation to be efficacious and accepted by all racial, ethnic, and cultural groups. The studies reviewed detail a number of cultural adaptations of DBT, most commonly in terms of language translation and addition of culturally congruent metaphors and sayings. The field must continue to both train culturally competent DBT clinicians and further adapt DBT to different cultural contexts.

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“…In SUD populations, there have been mixed findings on group cohesion. Some research has found a significant relationship between group cohesion (or group relationships more broadly), and group processes and outcomes [16][17][18][19][20][21]. Other research has found no significant association [22,23], or found it to be related to other outcome variables, such as psychological distress, however not reductions in substance use [24].…”

Section: Group Cohesionmentioning

confidence: 99%

The influence of members’ attachment style on group cohesion in substance use therapy groups

2021

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Group cohesion is an important factor in group therapy as it influences treatment outcomes and group processes. One’s attachment style has been found to impact experiences of group cohesion, however research into this relationship in substance use disorder (SUD) group treatment is lacking. This is of particular concern as insecure attachment presentations are more prevalent in this clinical population and group therapy is often treatment of choice. The current study sought to determine whether attachment style significantly predicted group cohesion. It also provided a qualitative exploration of factors that promote group cohesion in SUD group treatment. Participants (N = 38) attending a SUD therapy program completed self-report measures. Attachment avoidance was a significant negative predictor of positive bonding and positive working, and a significant positive predictor of negative relationships. Attachment anxiety was a significant negative predictor of negative relationships, however, unexpectedly did not significantly predict positive bonding or positive working. The current findings highlight the importance of group therapists tailoring group treatment to meet the attachment needs of individuals to promote a group therapy environment conducive to recovery.

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Group relationships during a dialectical behavior therapy skills training program for the treatment of alcohol and concurrent substance use disorders: Evidence and theoretical considerations.

Cited by 9 publications

References 71 publications

Professionals’ perspectives on interventions to reduce problematic alcohol use in older adults: a realist evaluation of working elements

Professionals’ perspectives on interventions to reduce problematic alcohol use in older adults: a realist evaluation of working elements

Cultural adaptations of dialectical behavior therapy: A systematic review.

The influence of members’ attachment style on group cohesion in substance use therapy groups

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