Cognitive-behavioural integrated treatment (c-bit): a treatment manual for substance misuse in people with severe mental health problems

Book Title: 
Cognitive-behavioural integrated treatment (c-bit): a treatment manual for substance misuse in people with severe mental health problems
Author(s): 
Hermine L. Graham, with Alex Copello, Max J. Birchwood, Kim T. Mueser, Jim Orford, Dermot McGovern, Emma Atkinson, Jenny Maslin, Mike Preece, Derek Tobin and George Georgiou
Reviewer: 
Alan Marlatt
Source: 
University of Washington Seattle USA

I highly recommend this excellent therapy manual that provides an overview of a cognitive-behavioural integrated treatment (C-BIT) program for clients with cooccurring substance misuse and severe mental health problems. Designed originally for use in settings that provide assertive outreach, the C-BIT approach can be used for a wide variety of dual diagnosis treatment approaches. Based on a harm-reduction philosophy, the manual provides a wealth of assessment and intervention options in the context of a structured CBT program that is administered Typically over a 6-month period. This structured but flexible program consists of the several core components: an assessment phase (screening and assessment), four treatment phases (engagement and building motivation to change; negotiating some behaviour change; early relapse prevention; and relapse prevention and relapse management) and two additional treatment components (skills training and working with families and social network members). Assessment and intervention methods are evidence-based and user-friendly. Part One of the manual provides an overview of issues in working with clients with occurring substance misuse and severe mental health problems (three chapters). The core of the manual is presented in Part Two, that outlines the C-BIT Core Components (five chapters), skills-building for clients coping with anxiety, anger, depression, social skills deficits, low self-esteem and life-style imbalance (six chapters). A final chapter on working with families and social network members is also helpful. Part Three consists of a single concluding chapter on implementation issues (coping with obstacles, and training and supervision). Overall, this is an outstanding integrated treatment manual that is current, empirically supported and attractive to therapists and their clients who are seeking a single treatment approach for diverse co-morbid problems.