2013

Drugs: education, prevention and policy, December 2013; 20(6): 494

� 2013 Informa UK Ltd.

ISSN: 0968-7637 print/1465-3370 online

DOI: 10.3109/09687637.2013.783195

Book Review

Group cognitive therapy for addictions, by AmyWenzel, Bruce S. Liese, Aaron T. Beck, Dara G.Friedman-Wheeler, London, Guilford Press, 2012, 255pp. ISBN; 978-1462505494.

This book is aimed at a broad array of health andsocial care practitioners who work with clients withaddictive problems. It is designed as a ‘how to’ text,helping the reader think about and plan an open groupregardless of their client’s stage of change and theassociated difficulties with remaining engaged intreatment, with its roots clearly delineated in Beck’scognitive paradigm.

A Cognitive Therapy Addictions Group (CTAG) isdiscussed giving frequent transcript examples. CTAGclearly incorporates an educative approach althoughthe authors make clear that group work is collaborativeand members are supportive of one another. It wouldhave been refreshing to see a chapter on maintainingengagement as this is clearly a high ranking problemwith clients with a dual diagnosis but is rarelyaddressed in addictions texts. However, the authorsdo acknowledge the high rate of group drop out whilstdiscussing advantages and disadvantages of maintain-ing an open group, and make a coherent rationale forthe need to transition in and out of open groups at anytime, rather than making them closed groups.

In their initial chapter, the authors clearly set out arationale as to why group therapy for addictions isfundamental and explore the increase in prevalence forthis high risk group. A number of ideas and conceptsare raised for the facilitator to be mindful of particu-larly in planning groups. They clearly set out atreatment strategy that is flexible enough to recognisethat lapses and relapses are possible, but also incorp-orate pragmatic strategies to help clients increasemotivation to change if this is necessary.

The text incorporates the need to think about whatcharacteristics are required of successful facilitators ofa cognitive therapy group. It gives guidance as to howto structure the sessions and ideas for group topics. Italso helps facilitators consider strategies to bring innew members and advises on how to deal withmembers who come in with alternative agendas,whilst being empathic but boundaried.

Of great use to practitioners who work with clientswith a dual diagnosis, they identify a useful two-tieredmodel, acknowledging the possibility of proximaland distal background factors, i.e. among clients withmental health problems, before examining a numberof strategies to manage cognitions and addictivebehaviour.

The authors have interwoven the need to considerindividual group member’s stages of change with arationale as to why this is so fundamental and the needto recognise dynamics, such as incorporating groupsupport and reducing the risk of members feeling as ifthey are back at school.

The strategies include: evaluating thoughts andbeliefs; learning new coping skills; improving com-munication; managing unpleasant emotions; activitymonitoring; relaxation; relapse prevention and mana-ging cravings; problem solving; developing and lead-ing healthy lifestyles; homework and closure. There isa useful relapse prevention plan template at the back ofthe book. The authors note the opposing arguments ofharm minimisation but argue that this approach, beinga collaborative endeavour, is therefore compatible withthe cognitive paradigm.

I would have liked to see aims and outcomes at thebeginning of the chapters as this would have beenhelpful, particularly to students of psychology andnursing. However, this book aims to bring together allthe essential key elements when working with peoplewith a drug or alcohol problem, as well as those whohave addictions in gambling, the internet, cigarettes,sex and overeating, in a group format utilising cogni-tive principles, in an easily readable text for alldisciplines. The text meets the needs of health andsocial care professionals planning addictions groupwork, utilising Beck’s model, and, as it is mindful oftheories around dual diagnosis, they will find this bookan asset to their practice.

Amanda Collins EadeSchool of Family care and Mental Health

University of Greenwich,London, UK

Email: A.CollinsEade@greenwich.ac.uk

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