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Group Cognitive Therapy for AddictionsAmy Wenzel, Bruce S. Liese, Aaron T. Beck and Dara G. Friedman-Wheeler New York: Guilford Press, 2012. pp. 274, £29.99 (hb). ISBN: 978-1-4625-0549-4.

Published online by Cambridge University Press:  01 September 2014

Sam Parker*
Affiliation:
Assistant Psychologist
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Abstract

Type
Book Review
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2014 

This book is well structured and provides readers with all the necessary tools for implementing the Cognitive Therapy Addictions Group (CTAG) treatment. It is divided into three clearly organized sections, is well signposted and gives useful introductions and summaries for each section and chapter. The book is unique in its outlining of an evidence-based, cost effective protocol for supporting clients who are struggling with the consequences of out-of control addictive behaviour. The concept presented is one of a continuously running, open group where participants can come and go but benefit from any one individual session. The idea is to create an accessible group, without long waiting times; the need to assemble a homogenous group of clients or to impose a requirement for consecutive or compulsory attendance on clients who are struggling in their lives.

Part One provides the background information necessary to understand the context and rationale for the various CTAG components. Part Two provides a detailed description of the CTAG sessions and its components and Part Three provides an overall summary of the ground covered. The book begins with a chapter that generally describes the scope of the problem, including the prevalence and consequences of various addictive behaviours. Chapter two discusses cognitive therapy treatment and older models of additive behaviour that are supported empirically in the literature. These models inform the CTAG group model and the theoretical framework for the treatment is described. The chapter also introduces Beck et al.'s Comprehensive model of addictions. This model was developed using previous cognitive models of addictions and modified to include important factors identified in the literature. The authors acknowledge that the treatment has not been evaluated in a randomized controlled trial; however they view it as an evidence-informed treatment as its structure, theory and strategies are grounded in the findings of empirical research. Future research is needed to evaluate the model and the clinical effectiveness of the CTAG group.

Chapter three discusses a group therapy theory (Yalom and Leszcz, Reference Yalom and Leszcz2005) that describes the processes involved in the implementation and delivering of group therapy. It then gives an overview of the Stages of Change model TTM (Prochaska and DiClemente, Reference Prochaska, DiClemente, Norcross and Goldfreid2005), which is linked to the readiness of a patient to change. It highlights that the CTAG is flexible and allows patients to join regardless of their stage of change but makes the reader aware that the group facilitator must be able to match the strategies used for each individual to the stage of change they are currently in.

Chapter four gives an overview of the CTAG and its basic characteristics. This includes the goals of the treatment, focusing on the modification of an individual's addictive behaviour, the fostering of group cohesiveness and support and monitoring of goals within and across the sessions. It describes the make-up of the group both in terms of the number of participants and facilitators and the characteristics of being a successful facilitator. It then briefly covers preparing a group member to join the group. Finally, it describes the structure of a CTAG session.

Chapters five to eight use composite case history figures and illustrate aspects of CTAG sessions to give a clear road map for both experienced and inexperienced therapists wanting to work with a partner in this way. The sample forms and worksheets included (which can be photocopied) provide measurement tools and promote self-help skills for participants. Furthermore, these chapters clearly signpost how to apply the comprehensive cognitive model of addictions both to individual and group formulations. Chapter nine highlights the importance of homework and closure and how to integrate these into the session whilst keeping the cognitive therapy protocol in mind at all times.

The final section was written to pull together all the information presented in the book. It acknowledges that although the structure of the group session may be predictable the absence of a session by session guide can be challenging and frustrating to a facilitator less versed in delivering a CTAG group. The authors however see this flexibility as a major strength of the CTAG. This is because all the CTAG members, including the facilitators, can work collaboratively to decide the focus of the group. It gives a useful figure that links a variety of the CTAG intervention strategies to the different components of the cognitive model of addiction. The authors stress, however, that the facilitators of a CTAG group should not just limit themselves to strategies described in the book and should implement any that follow on from an individual's case conceptualization.

Overall, the book's main strength is the way it outlines the CTAG protocol; it gives clear guidance and will be especially useful to therapists commencing in group work and experienced therapists commencing CTAG work. The first section of the book could have been shorter with less background information on the prevalence of addiction, therefore giving more space to focus on the rationale for the CTAG group and exploring the underlying biochemistry and psychological aetiology of addictions.

References

Beck, A.T., Wright, F.D., Newman, C.F. and Liese, B.S. (1993). Cognitive Therapy of Substance Abuse. New York: Guildford Press.Google Scholar
Prochaska, J.O. and DiClemente, C.C. (2005). The transtheoretical approach. In Norcross, J.C and Goldfreid, M.R. (Eds.), Handbook of Psychotherapy Integration (2nd ed., pp. 147171). New York: Oxford University Press.CrossRefGoogle Scholar
Wenzel, A., Liese, B. S., Beck, A. T. and Friedman-Wheeler, D.G. (2012). Group Cognitive Therapy for Addictions. New York: The Guilford PressGoogle Scholar
Yalom, I. and Leszcz, M. (2005). The Theory and Practice of Group Psychotherapy ( 5th ed.). New York: Basic Books.Google Scholar
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