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    Acceptance and commitment therapy : application in a real-world alcohol and other drug community setting : a thesis presented in partial fulfilment of the requirements for the degree of Doctorate in Clinical Psychology, Massey University, Wellington, New Zealand
    (Massey University, 2018) Cotter, Rachel
    Treating addictive behaviours in alcohol and drug populations in real-world settings carries a range of issues: standardised treatment approaches have been criticised for their complexity and inaccessibility, their failure to retain clients over the course of therapy, and their inability to address the range of coexisting difficulties present. The development of transdiagnostic third wave therapies has recently emerged as an alternative to traditional approaches. One such therapeutic approach is Acceptance and Commitment Therapy (ACT). ACT has proven to be effective in the treatment of several mental illnesses such as anxiety disorders, mood disorders, psychotic symptoms, and personality disorders; it has been found to be effective with medical issues such as chronic pain, cancer, epilepsy, and weight loss; and, importantly, it has been applied across a variety of challenging conditions and evidence of its effectiveness in treatment of addictive behaviours is promising and growing. The current study aims to examine the effectiveness of a manualised ACT-based group treatment programme applied in a real-world Alcohol and Other Drug (AOD) community setting. It was hypothesised that ACT would lead to reductions in alcohol use, substance use and cravings, and common co-occurring symptomology such as anxiety and stress. It was also hypothesised that there would be an increase in mood management skills and mindfulness tendencies. Findings suggest ACT is a promising approach to treating AOD communities as it is well-regarded by clients and it elicits a reduction in several substance use behaviours; however, several outcomes were not statistically significant for many of the comparisons which is likely due to the study being underpowered. In addition, most coexisting problems reduced by post-group and improvements to mood management were evident. However, a rebound effect was found at the three-month follow-up in which the mood management skills reduced, and coexisting stress and anxiety increased. Mindfulness tendencies demonstrated an accumulative effect and showed significant increases by follow-up. These results, although not statistically significant, still provide support for future development and implementation of transdiagnostic approaches such as ACT, particularly in AOD services that commonly deal with dual diagnosis.
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    An evaluation of a methadone treatment programme : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Psychology at Massey University
    (Massey University, 1987) Clark, Jahna
    The evaluation of a methadone treatment programme was the main focus of this study. A posttest-only design, with a nonequivalent comparison group was used to evaluate both summative and formative aspects of the programme. Participants were 21 opiate abusers (methadone group) and 22 alcohol and polydrug abusers (alcohol and polydrug group) who completed a questionnaire designed to assess demographic and treatment variables, alcohol and drug usage, employment, criminal activity, health, and interpersonal relationships, in the before, during, and after treatment periods. The outcome measures revealed that the methadone programme was effective in reducing opiate, nonopiate analgesic, tranquillizer and stimulant use; decreasing high alcohol consumption to a level considered nonabusive, and decreasing the number of marijuana related criminal convictions. Unanticipated findings were a deterioration in rating of health and no change in the number of days spent sick in bed, friendship satisfaction, or number of friends out of the drug scene. No predictors of treatment outcomes were established, and there were no major differences between the methadone group, and the alcohol and polydrug group in terms of treatment effects. Recommendations for the methadone programme included detailed and procedural steps of how to cope when withdrawing from methadone treatment; health and nutrition education; and social skills and assertiveness training. These are considered essential if the philosophy and goals of the programme are to be attained.
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    Effectiveness of treatment for cannabis use disorder in New Zealand : a thesis presented in partial fulfilment of the requirements for the degree of Master of Philosophy in Rehabilitation at Massey University
    (Massey University, 2000) Bashford, Janet Lorraine
    This study, believed to be the first cannabis treatment outcome study in New Zealand, used a naturalistic design to examine the relationships among client characteristics and correlates of cannabis use problems, treatment variables, outcome measures, and client satisfaction. Participants were 63 persons seeking treatment for cannabis use problems recruited from four geographically diverse outpatient settings. All participants completed baseline assessment and began treatment as typically delivered at New Zealand drug treatment services. A high rate of attrition characterized the study from very early on and continued through follow-up. Eighteen participants completed posttreatment assessment. Outcome measures for those who completed treatment revealed a significant reduction in both cannabis use and psychological distress, accompanied by a significant increase in self-efficacy. A significant correlation between attending more sessions and better outcomes on days of cannabis use and self-efficacy was also noted. However, at treatment termination two-thirds (12) were still using cannabis on at least 3 days per week, with half (9) using daily/near daily. Hypotheses regarding the relationship between theoretically important client variables and treatment dropout were tested. No predictors of dropout were established. Attrition peaked at 86% at the final assessment point with 8 (only) responses to the 3-month follow-up survey. While clients were generally satisfied with treatment services received, some suggestions for improvement to the cannabis treatment programmes were made. Retention- and therapeutic-enhancement strategies are discussed in terms of making treatment services more responsive to identified client needs to improve outcomes. Recommendations for clinical and research attention include the development of individualized treatment packages tailored to meet the presenting needs and deficits of cannabis clients, and ongoing routine evaluation of these programmes.