Mindfulness and Acceptance for Addictive Behaviors: Applying Contextual CBT to Substance Abuse and Behavioral Addictions

by Steven C. Hayes (Editor), Michael E. Levin (Editor)

This fascinating book for mental health professionals explores emerging mindfulness and acceptance treatments for addictions of all kinds, including gambling addiction, binge eating disorder, pornography addiction, cigarette smoking, and substance abuse. In a series of articles written by leading researchers in addiction and mindfulness therapies, this book reveals the research and methodology behind a range of treatments for addiction.


Edited by Steven Hayes, one of the best-known clinicians working with acceptance and mindfulness-based interventions, Mindfulness and Acceptance for Addictive Behaviors features articles by leading substance abuse and addiction researchers. Each article illuminates the mindfulness and acceptance-based treatments that work best for particular addictive behaviors, reviews empirical data, and discusses future directions for research and treatment applications. One of the articles presents the first controlled study on treating pornography addiction, an increasingly common problem that has been a challenge for therapists to treat in the past. An essential resource for mental health professionals, researchers, and students interested in the most effective treatments for addiction, this book will dramatically impact the way addictions of all kinds are viewed and addressed in therapy.

Genres: Nonfiction, Psychology

376 pages, Paperback

First published November 1, 2012

About the author

Steven C. Hayes, PhD, is Nevada Foundation Professor in the department of psychology at the University of Nevada. An author of thirty-four books and more than 470 scientific articles, he has shown in his research how language and thought leads to human suffering, and cofounded ACT, a powerful therapy method that is useful in a wide variety of areas. Hayes has been president of several scientific societies and has received several national awards, including the Lifetime Achievement Award from the Association for Behavioral and Cognitive Therapy.
He runs the leading Ph.D program in Behavior Analysis, and coined the term Clinical Behavior Analysis. He is known for devising a behavior analysis of human language and cognition called Relational Frame Theory, and its clinical application to various psychological difficulties, such as anxiety.
Hayes has been President of Division 25 of the American Psychological Association, of the American Association of Applied and Preventive Psychology, the Association for Advancement of Behavior Therapy (now known as the Association for Behavioral and Cognitive Therapies), and the Association for Contextual Behavioral Science. He was the first Secretary-Treasurer of the American Psychological Society (now known as the Association for Psychological Science), which he helped form.
Hayes' work is somewhat controversial, particularly with his coined term "Relational Frame Theory" to describe stimulus equivalent research in relation to an elaborate form of B.F. Skinner's Verbal Behavior (also referred to as verbal operants).
An author of 38 books and 550 articles, in 1992 he was listed by the Institute for Scientific Information as the 30th "highest impact" psychologist in the world during 1986-1990 based on the citation impact of his writings during that period.
According to Time columnist John Cloud, "Steven Hayes is at the top of his field. A past president of the distinguished Association for Behavioral and Cognitive Therapies, he has written or co-written some 300 peer-reviewed articles and 27 books. Few psychologists are so well published".

Reviews

[Matt · Rating 3 out of 5]

This book quickly introduces several third-wave therapies such as Dialectical Behavioral Therapy, Acceptance and Commitment Therapy, and the technique of Motivational Interviewing. The chapters with more examples (such as a script in the ACT chapter) are generally more helpful, but none of the chapters has the space to go very deep in instructing a clinician. That said, there are many suggested resources for an interested reader. The second half of the book applies the therapies to special populations such as people reducing a maintenance methadone dose or struggling with binge eating, and though these chapters summarize a breadth of research, they do not have obvious application for the average clinician, and many references are made to exercises like "Joe the Bum" with no indication of how to perform this exercise with a client.
All in all, not a bad introduction, but not of much value to an experienced clinician who wants to deepen skills in these therapeutic techniques and theory.

[Justin · Rating 4 out of 5]

I thought this was specifically about ACT, but it covers other related therapies. Mindfulness and Acceptance for Addictive Behaviors examines third wave cognitive behavioral therapies like Acceptance and Commitment Therapy, Dialectical Behavior Therapy, Motivational Interviewing, and Mindfulness-based Cognitive Therapy to addiction. These approaches go past just the intrapsychic interventions and considers the context of the person. While each chapter goes into more depth of these various approaches, the second part applies it to specific populations such as for smoking cessation, problem gambling, binge eating, and pornography addiction. Considering this is a collection of chapters by various authors, it only skims the surface of each topic, though has ample references for further reading. So if you aren't familiar with any of the approaches covered, it might be helpful to read up on each approach since this book doesn't elaborate on specific concepts as much or at least assumes some familiarity. Overall, if you work with addiction and have an affinity for one of these mindfulness and acceptance based approaches, this was a pretty informative read.

[Jeremy]

These notes are only from the Introduction and Chapter 10: Mindfulness-Based Therapy for Problem Gambling. This is the first time I’ve marked a book as “read” when I’ve actually not read it cover to cover. Feel free to make fun or call me a charlatan.

+ Cognitive fusion can also be called or thought of as “thought-action fusion” (277)
- The will and behavior can be influenced by thoughts but is not directly controlled by thoughts

+ 2 types of meditation (278):
1. Concentration/tranquility
2. Insight/mindfulness
- These can work together in the sense that when we try to sustain focused attention on one object, like the breath, we inevitably get distracted and have the opportunity to mindfully be aware of those distraction processes. We can develop insight into how subjective experiences operate and label them, for example, “thinking,” before returning to focused attention

+ 5 ways mindfulness can help in treatment (although in my opinion these overlap significantly and it was hard to understand them as 5 separate benefits):
1. It emphasizes modifying the relationship to experiences rather than the content of experiences
2. Helps us to respond to triggers with awareness rather than impulsivity
3. Increases ability to cope with urges and cravings
4. Improved concentration leads to decreased rumination in the early phases of recovery, when thoughts tend toward regret and an acknowledgement of the havoc addiction has wreaked. Decreased rumination also improves treatment engagement
5. Decreased intensity of relapse variables such as negative affective states, which increases the sense of having behavioral choices in the face of those states

+ We should educate gamblers that negative experiences are common and normal when beginning a mindfulness practice, especially the rumination that occurs in the early stages of recovery


Potent Quotables:

From the intro, p. 7: “‘The ACT model points to the context of verbal activity as the key element, rather than the verbal content. It is not that people are thinking the wrong thing - the problem is thought itself and how the verbal community supports its excessive use as a mode of behavioral regulation’ (Hayes et al., 1999, p. 49).”

From Chapter 10, p. 278: “Not all meditation is mindful, as meditation encompasses a range of mental disciplines, while the development of mindfulness does not necessarily require formal meditation (Hayes, Follette, & Linehan, 2004).”