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\"The most innovative leaders in progressive addiction treatment in the US offer a groundbreaking, science-based guide to helping loved ones overcome addiction problems and compulsive behaviors. The New Road to Recovery eschews the theatrics of interventions and tough love to show family and friends how they can use kindness, positive reinforcement, and motivational and behavioral strategies to help their loved ones change. Drawing on forty collective years of research and decades of clinical experience, the authors present the best practical advice science has to offer. Delivered with warmth, optimism, and humor, The New Road to Recovery defines a new, empowered role for friends and family and a paradigm shift for the field. Learn how to tap the transformative power of relationships for positive change, guided by exercises and examples. Practice what really works in therapy and in everyday life and discover many different treatment options along with tips for navigating the system. And have hope: this guide is designed not only to help someone change, but to help someone want to change\"-- Provided by publisher.

The impact of obsessive-compulsive disorder (OCD) on objective indicators of labour market marginalisation has not been quantified. Linking various Swedish national registers, we estimated the risk of three labour market marginalisation outcomes (receipt of newly granted disability pension, long-term sickness absence and long-term unemployment) in individuals diagnosed with OCD between 2001 and 2013 who were between 16 and 64 years old at the date of the first OCD diagnosis (n = 16 267), compared with matched general population controls (n = 157 176). Hazard ratios (HR) with 95% confidence intervals (CI) were calculated using Cox regression models, adjusting for a number of covariates (e.g. somatic disorders) and stratifying by sex. To adjust for potential familial confounders, we further analysed data from 7905 families that included full siblings discordant for OCD. Patients were more likely to receive at least one outcome of interest [adjusted HR = 3.63 (95% CI 3.53-3.74)], including disability pension [adjusted HR = 16.36 (95% CI 15.34-17.45)], being on long-term sickness absence [adjusted HR = 3.07 (95% CI 2.95-3.19)] and being on long-term unemployment [adjusted HR = 1.72 (95% CI 1.63-1.82)]. Results remained similar in the adjusted sibling comparison models. Exclusion of comorbid psychiatric disorders had a minimal impact on the results. Help-seeking individuals with OCD diagnosed in specialist care experience marked difficulties to participate in the labour market. The findings emphasise the need for cooperation between policy-makers, vocational rehabilitation and mental health services in order to design and implement specific strategies aimed at improving the patients' participation in the labour market.

The study was aimed at assessing the prevalence of compulsive exercising to control shape and weight in eating disorders (EDs) and its relationship with treatment outcome. Compulsive exercising to control shape and weight, defined according to a modified version of the Intense Exercising to Control Shape or Weight section of the Eating Disorder Examination (EDE), was assessed in 165 consecutive ED inpatients entering a protocol based on the transdiagnostic cognitive behavior theory and treatment of EDs. Baseline assessment also included anthropometry, the global EDE interview, the Beck Depression Inventory, the State-Trait Anxiety Inventory (STAI), the Eating Disorders Inventory–Perfectionism Scale, and the Temperament and Character Inventory. Of the patients, 45.5% were classified as compulsive exercisers, the prevalence being highest (80%) in restricting-type anorexia nervosa (AN), lowest in EDs not otherwise specified (31.9%), and intermediate in binge/purging AN (43.3%) and in purging-type bulimia nervosa (39.3%). Compulsive exercising to control shape and weight was independently predicted by the EDE restraint score (odds ratio, 1.32; 95% confidence interval, 1.06-1.64; P = .014) after adjustment for ED; the total amount of exercise was associated with EDE restraint, as well as with the Temperament and Character Inventory reward dependence. At follow-up, an improved EDE global score was predicted by lower baseline values, higher baseline STAI and STAI improvement, and lower amount of exercise in the last 4 weeks. Voluntary treatment discontinuation was not predicted by baseline exercise. Compulsive exercising to control shape and weight is a behavioral feature of restricting-type AN, associated with restraint and temperament dimensions, with influence on treatment outcome.

\"Recovery from addiction doesn't happen all at once -- it's something that must be practiced, day by day and moment to moment. In good moments -- when things are going well in your life -- your recovery may feel easy, like second nature. But in moments of stress, confusion, temptation, or pain, you need simple, go-to strategies to maintain your healthy recovery. [This book] offers fifty-two in-the-moment mindfulness skills to help you cope with daily stress and stay grounded in your recovery. You'll find powerful advice to help you navigate relationships, take time for self-care, and manage intense emotions that can get in the way of feeling better. Recovering from addiction is hard and sometimes lonely -- and it takes a lot of courage. This gentle, easy-to-use book will guide you as you continue to take steps toward your recovery\" -- Back cover.

Introduction: Obesity is a multifactorial condition strongly associated with physical and psychological comorbidities. This study aimed to evaluate changes in psychological symptoms and their correlation with anthropometric and body composition improvements in hospitalized obese patients undergoing a multidisciplinary rehabilitation program (MRP). Methods: A total of 178 obese patients (61 males and 117 females; mean age 58.5 ± 14.0 years; mean BMI 41.3 ± 6.1 kg/m2) completed a two-month structured intervention combining a low-energy Mediterranean-style diet, individualized physical activity, and psychological support. Body composition by DXA, biochemical markers, and psychological outcomes (Beck Depression Inventory [BDI] and Binge Eating Scale [BES]) were assessed at baseline and discharge. Results: At baseline, 72.3% of participants showed depressive symptoms (BDI > 10), and 42.7% exhibited binge eating behaviors (BES ≥ 17). The intervention led to significant reductions in weight (−7.08 kg), BMI (−2.68 kg/m2), fat mass (−4.43 kg), and visceral adipose tissue (−329 g) (all p < 0.001). Mean BDI and BES scores decreased by 5.9 and 6.4 points, respectively (both p < 0.001). Moderate correlations were observed between reductions in adiposity and improvements in psychological symptoms, such as r = −0.45 for depressive symptoms (BDI) and r = −0.39 for binge eating behaviors (BES) (p-values < 0.001). Conclusions: A structured multidisciplinary intervention significantly improved body composition and psychological well-being in hospitalized obese patients. The moderate association between reduced adiposity and alleviation of depressive symptoms and binge eating behaviors underlines the value of integrated physical, nutritional, and psychological care. Level of Evidence: Level 3, according to the Oxford Centre for Evidence-Based Medicine.

Owing to the gap between treatment supply and demand, there are long waiting periods for patients with binge eating disorder, and there is an urgent need to increase their access to specialized treatment. Guided self-help cognitive behavioral therapy-enhanced (CBT-E) may have great advantages for patients if its efficacy can be established. The aim of this study was to examine the efficacy of guided self-help CBT-E compared with that of a delayed-treatment control condition. A single-blind 2-arm randomized controlled trial was designed to evaluate guided self-help CBT-E according to an intention-to-treat analysis. A total of 180 patients were randomly assigned to guided self-help CBT-E (n=90, 50%) or the delayed-treatment control condition (n=90, 50%) for which guided self-help CBT-E was provided after the initial 12-week delay. The primary outcome was reduction in binges. The secondary outcome was full recovery at the end of treatment, as measured using the Eating Disorder Examination during the last 4 weeks of treatment. A linear mixed model analysis was performed to compare treatment outcomes at the end of treatment. A second linear mixed model analysis was performed to measure between- and within-group effects for up to 24 weeks of follow-up. The Eating Disorder Examination-Questionnaire and clinical impairment assessment were conducted before and after treatment and during follow-up. In addition, dropout rates were assessed in both conditions. During the last 4 weeks of treatment, objective binges reduced from an average of 19 (SD 16) to 3 (SD 5) binges, and 40% (36/90) showed full recovery in the guided self-help CBT-E group. Between-group effect size (Cohen d) was 1.0 for objective binges. At follow-up, after both groups received treatment, there was no longer a difference between the groups. Of the 180 participants, 142 (78.9%) completed treatment. The overall treatment dropout appeared to be associated with gender, level of education, and number of objective binges at baseline but not with treatment condition. This is the first study to investigate the efficacy of guided self-help CBT-E. Guided self-help CBT-E appeared to be an efficacious treatment. This study's findings underscore the international guidelines recommending this type of treatment for binge eating disorder. Netherlands Trial Registry (NTR) NL7994; https://trialsearch.who.int/Trial2.aspx?TrialID=NL7994. RR2-10.1186/s12888-020-02604-1.

Recent research identifies unhealthful weight-control behaviors (fasting, vomiting, or laxative abuse) induced by a negative experience of the body, as the common antecedents of both obesity and eating disorders. In particular, according to the allocentric lock hypothesis, individuals with obesity may be locked to an allocentric (observer view) negative memory of the body that is no longer updated by contrasting egocentric representations driven by perception. In other words, these patients may be locked to an allocentric negative representation of their body that their sensory inputs are no longer able to update even after a demanding diet and a significant weight loss. To test the brief and long-term clinical efficacy of an enhanced cognitive-behavioral therapy including a virtual reality protocol aimed at unlocking the negative memory of the body (ECT) in morbidly obese patients with binge eating disorders (BED) compared with standard cognitive behavior therapy (CBT) and an inpatient multimodal treatment (IP) on weight loss, weight loss maintenance, BED remission, and body satisfaction improvement, including psychonutritional groups, a low-calorie diet (1200 kcal/day), and physical training. 90 obese (BMI>40) female patients with BED upon referral to an obesity rehabilitation center were randomly assigned to conditions (31 to ECT, 30 to CBT, and 29 to IP). Before treatment completion, 24 patients discharged themselves from hospital (4 in ECT, 10 in CBT, and 10 in IP). The remaining 66 inpatients received either 15 sessions of ECT, 15 sessions of CBT, or no additional treatment over a 5-week usual care inpatient regimen (IP). ECT and CBT treatments were administered by 3 licensed psychotherapists, and patients were blinded to conditions. At start, upon completion of the inpatient treatment, and at 1-year follow-up, patients' weight, number of binge eating episodes during the previous month, and body satisfaction were assessed by self-report questionnaires and compared across conditions. 22 patients who received all sessions did not provide follow-up data (9 in ECT, 6 in CBT, and 7 in IP). Only ECT was effective at improving weight loss at 1-year follow-up. Conversely, control participants regained on average most of the weight they had lost during the inpatient program. Binge eating episodes decreased to zero during the inpatient program but were reported again in all the three groups at 1-year follow-up. However, a substantial regain was observed only in the group who received the inpatient program alone, while both ECT and CBT were successful in maintaining a low rate of monthly binge eating episodes. Despite study limitations, findings support the hypothesis that the integration of a VR-based treatment, aimed at both unlocking the negative memory of the body and at modifying its behavioral and emotional correlates, may improve the long-term outcome of a treatment for obese BED patients. As expected, the VR-based treatment, in comparison with the standard CBT approach, was able to better prevent weight regain but not to better manage binge eating episodes.

This book is a treatment manual providing guidance for therapists treating clients with gambling addictions. In this book the authors use a cognitive behavioural approach and provide a session by session guide for overcoming problem gambling. Essential topics covered include: assessment and psychoeducation cognitive behavioural strategies to stabilize gambling identifying and challenging thinking errors relaxation and imaginal exposure problem solving and goal setting managing negative emotions relapse prevention: maintaining a balanced lifestyle and coping with high risk situations A Cognitive Behavioural Therapy Programme for Problem Gambling supplies detailed information to help the therapist and client understand gambling behaviours, as well as practical advice on techniques that can be used with the client to change these behaviours. This practical guide includes handouts and exercises that can be downloaded by purchasers of the print edition. It will provide helpful guidance for addiction counsellors and therapists worldwide. \"I would thoroughly recommend this comprehensive and clear CBT manual to clinicians treating problem gamblers. It is easy to follow and detailed in rationale and guidance to assist practitioners of varying levels of experience and knowledge to deliver effective treatment.\" - Melanie Walls, Behavioural and Cognitve Psychotherapy, Volume 40, 2012 \"A comprehensive review of the literature concerning the development, maintenance and treatment of problem gambling underpins the treatment programme presented. The programme itself delivers valuable insights into the assessment and formulation of the difficulties and needs problem gamblers have. Excellent psychoeducation resources, cognitive behavioural coping skills, relapse prevention and motivational interviewing strategies are detailed within it. ... The sessions are clearly explained and a rationale is offered for their use, allowing therapists to comfortably navigate the programme implementing sessions at a duration, frequency and distribution applicable to their client. The practicality of this guide is possibly its strongest attribute with work sheets for both client and therapist provided in the appendix. The discussion and exploration of cultural differences in attitudes to gambling further highlight the applicability of this book to clinical work.\" - Deanna Hall, Journal of Critical Psychology, Counselling & Psychotherapy , 2012 Overview. Review of the Problem Gambling Treatment Literature. Session One: Assessment. Session Two: Psychoeducation and Self-management Strategies to Stabilize Gambling. Session Three: Cognitive-restructuring I: Identifying Gambling Specific Thinking Errors. Session Four: Cognitive-restructuring II: Challenging Gambling Specific Thinking Errors. Session Five: Cognitive-restructuring III: Identifying and Challenging Other/General Thinking Errors. Session Six: Relaxation and Imaginal Exposure. Session Seven: Problem Solving and Goal Setting Skills Training. Session Eight: Management of Negative Emotions. Session Nine: Relapse Prevention and Maintenance of Therapeutic Gains I: Balanced Lifestyle. Session Ten: Relapse Prevention and Maintenance of Therapeutic Gains II: Coping with High Risk Situations. Elective Session: Assertiveness Skills Training. Elective Session: Getting Out of Debt. Elective Session: Teaching Significant Others Strategies to Cope/Deal with the Gambler’s Behaviors. Appendices. Namrata Raylu has been involved in a number of research activities in the area of addictive behaviours over the last 12 years and has published in the problem gambling area. Currently, she works as a research collaborator at the Psychology Department, University of Queensland and as a clinical psychologist in private practice. Tian Po Oei has published widely in the areas of substance, anxiety and mood disorders and processes of change in psychotherapy, especially CBT in Asian cultures. Currently, he holds a personal Chair in Clinical Psychology at the University of Queensland and is the Director of the CBT Unit at Toowong Private Hospital.

Background Rumination is an essential trans-diagnostic process associated with substance use disorders (SUDs) in psychopathology. In China, methamphetamine and heroin have become major illegal drugs, but the role of rumination in their use remains unclear. The objective of this study was to investigate the relationship between rumination subtypes and drug craving in patients with methamphetamine use disorder (MAUD) and 81 patients with heroin use disorder (HUD). Methods A total of 489 participants, including 408 patients with MAUD and 81 patients with HUD, were recruited from a rehabilitation center. Participants were screened for inclusion criteria, and the Obsessive Compulsive Drug Use Scale (OCDUS) was used to assess drug craving. Rumination was assessed using the Ruminative Responses Scale (RRS), categorized into three dimensions: symptom rumination, brooding, and reflective pondering. Correlational and multiple regression analyses were conducted to examine associations between rumination and craving. Results Compared to patients with MAUD, patients with HUD had significantly higher RRS and OCDUS total score (42.51 vs 39.71 and 25.99 vs 20.95, both p  < 0.01). In patients with MAUD, the OCDUS total score was positively correlated with the total score ( r  = 0.298, p  < 0.01) and all subscale scores of the RRS (for reflective pondering, r  = 0.180; for brooding, r  = 0.230; for symptom rumination, r  = 0.325; all p  < 0.01). However, in patients with HUD, only symptom rumination was positively associated with the OCDUS total score ( r  = 0.247, p  < 0.05). Multiple regression showed symptom rumination was independently associated with OCDUS total score in both groups (for patients with MAUD, β = 0.324, p  < 0.001; for patients with HUD, β = 0.252, p  < 0.05). Conclusions Our findings suggest that rumination shows different effects on craving in male patients with MAUD and HUD. Moreover, symptom rumination may have a significant influence on the connection between rumination and craving in individuals with MAUD and HUD.