Struggling to hold addiction treatment talk and relapse in mind

Doctoral Thesis


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University of Cape Town

Addiction is a common problem, as is relapse. People often struggle to come to terms with and manage the intoxicating effects of substances and consequently need treatment. This dissertation focusses on treatment talk as it relates to addiction counselling in a residential setting in order to understand relapse and the addict’s return to treatment. Current treatment approaches that address addiction comprise several evidence-based approaches and yet relapse rates remain high. Attempts to explain this phenomenon are varied and interventions tend to have a disease model approach in common with one another. Neurobiological and psychological theories of addiction are examined to understand this treatment conceptualization and consider its efficacy as a means of directing counselling interventions. Mentalization theory and critical discourse theory are used as a discursive lens in an attempt to understand these interventions and consider their shortcomings. In order to approach the question of relapse and addiction treatment, twenty interviews were conducted with clients and their counsellors - 10 dyads - who had completed residential addiction treatment for relapse. Counsellors and clients were interviewed and asked about their treatment experience, either as a client or clinician respectively. Both sets of participants were also asked about counselling as a relapse prevention intervention. Focus on the counselling relationship was in order to elicit talk about mental states related to treatment for addiction and relapse.

Includes bibliographical references.