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首页> 外文期刊>Behavioural and cognitive psychotherapy >Overcoming challenges in delivering integrated motivational interviewing and cognitive behavioural therapy for bipolar disorder with co-morbid alcohol use: therapist perspectives
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Overcoming challenges in delivering integrated motivational interviewing and cognitive behavioural therapy for bipolar disorder with co-morbid alcohol use: therapist perspectives

机译：克服综合励磁面试和认知行为治疗对双相障碍的综合励磁面试和认知行为治疗的挑战：治疗师观察

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Background: Alcohol misuse is common in bipolar disorder and is associated with worse outcomes. A recent study evaluated integrated motivational interviewing and cognitive behavioural therapy for bipolar disorder and alcohol misuse with promising results in terms of the feasibility of delivering the therapy and the acceptability to participants. Aims: Here we present the experiences of the therapists and supervisors from the trial to identify the key challenges in working with this client group and how these might be overcome. Method: Four therapists and two supervisors participated in a focus group. Topic guides for the group were informed by a summary of challenges and obstacles that each therapist had completed at the end of therapy for each individual client. The audio recording of the focus group was transcribed and data were analysed using thematic analysis. Results: We identified five themes: addressing alcohol useversusother problems; impact of bipolar disorder on therapy; importance of avoidance and overcoming it; fine balance in relation to shame and normalising use; and 'talking the talk'versus'walking the walk'. Conclusions: Findings suggest that clients may be willing to explore motivations for using alcohol even if they are not ready to change their drinking, and they may want help with a range of mental health problems. Emotional and behavioural avoidance may be a key factor in maintaining alcohol use in this client group and therapists should be aware of a possible discrepancy between clients' intentions to reduce misuse and their actual behaviour.
机译：背景：酒精滥用在双相情感障碍中是常见的，并且与更糟糕的结果有关。最近的一项研究评估了对双相障碍和酒精滥用的综合励磁性面试和认知行为治疗，在提供治疗的可行性和对参与者的可接受性方面具有有前途的结果。目标：在这里，我们从审判中展示了治疗师和主管的经验，以确定与本客户组合作的关键挑战以及如何克服这些挑战。方法：四名治疗师和两个主管参加了一个焦点小组。本集团的主题指南通过挑战和障碍的总结了解，每个治疗师在每个个人客户的治疗结束时完成。转录焦点组的音频记录，并使用主题分析分析数据。结果：我们确定了五个主题：解决酒精使用者的问题;双相情感障碍对治疗的影响;避免和克服它的重要性;与羞耻和常规使用有关的细平衡;并“谈谈谈话'漫步走路'。结论：调查结果表明，客户可能愿意探讨使用酒精的动机，即使他们还没准备好改变他们的饮酒，他们可能需要帮助一系列心理健康问题。情绪化和行为避免可能是维持本客户组中的酒精使用的关键因素，治疗师应该了解客户意图之间可能的差异，以减少滥用和实际行为。

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