Understanding and Working with Substance Misusers explores the complex nature of addiction and the challenges involved in responding effectively through policy and practice. It examines the biopyschosocial elements of addiction to substances (including alcohol) and, draws together key research findings from these fields to present a new framework for integrating theory and practice. This book fills the need for a text which makes the complex issues surrounding substance misuse accessible to both students and practitioners.

The Psychological Revolution

The psychological revolution

The aims of this chapter are to:

  • consider the developments in cognitive and behavioural approaches to understanding addiction
  • consider the impact of ideas that have informed harm minimisation and controlled drinking approaches, and the development of social learning techniques
  • pay particular attention to the core psychological constructs of motivation, self-efficacy, and self-esteem
  • discuss issues of co-morbidity.

Psychology has been instrumental in analysing the dimensional nature of addiction and in helping the move away from the unitary disease perspective. Heather and Robertson (1997) describe this as a ‘paradigm shift’. In practice this shift in thinking has been a difficult and contentious one that has challenged the orthodoxy of irreversibility, pathology, and abstinence as the only realistic goal that the ‘alcoholic’ or ‘addict’ should be aiming towards. ...

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