Introduction - The Integrative Model

Brief Couples Therapy: Group and Individual Couple Treatment for Addiction and Related Mental Health Concerns

BCT is based on the Integrative Model* of family/couple treatment that grew from scrutiny of our own practice in a family treatment team at the former Addiction Research Foundation, now the Centre for Addiction and Mental Health (CAMH), where we work with a diverse population. Over the years, the severity of presenting problems, and the frequency of comorbidity of substance use and mental health concerns, have increased tremendously. As a result, we have adapted our model to working with clients with concurrent disorders. The Integrative Model is seen as an effective way of intervening on multi-dimensional levels, an important consideration when working with concurrently disordered clients and their families.

Substance use and mental health are the presenting focus of family concern and the main targets of intervention. At its core, the Integrative Model is an assimilation of theoretical assumptions and techniques from the family therapies, solution-focused therapy and cognitive behaviour therapy that were deemed relevant to the treatment of families and couples faced with substance use issues. The hallmarks of the treatment approaches that the model draws upon are as follows:

• observing cross-generational patterns of family interactions and their effects on present relationships (intergenerational)
• attending to boundaries and coalitions (structural)
• tracking and attempting to change key patterns of interaction (strategic)
• focusing on strengths, making small changes and creating solutions (solution-focused)
• using self-monitoring and focusing on identifying and addressing cognitions and overt, observable behaviour (cognitive behavioural).

Each perspective provides a unique orientation, and taken as an integrated whole, the Integrative Model of therapy allows the clinician to fully address all the issues of concern; something that could not be accomplished as efficiently by any of the treatment modalities alone. The Integrative Model is flexible, making it applicable to families at all stages of clinical contact, from intake to termination, to families at various stages of the life cycle and to different family configurations (multicultural, blended, single-parent, etc.). New approaches and techniques can be incorporated into the model because it is non-prescriptive, and provides the therapist with a number of intervention options rather than limiting the therapist to a particular technique to be used in specific circumstances. The interplay of clinician preference, agency factors, and client needs and strengths will influence the application of the model. This model has been developed specifically for use with families experiencing problems related to concurrent disorders, and is well suited to the range and depth of difficulties that can be present in these situations.

*See Appendix A for "The Background of the Integrative Model"

Brief Couples Therapy

Acknowledgments

Introduction

• Assessment Session
• Session 1: Introduction
• Session 2: Genogram/Family Tree
• Session 3: Miracle Question
• Session 4: Goal Setting
• Session 5: Communication
• Session 6: Trust/Intimacy
• Session 7: Relapse Prevention
• Session 8: Conclusion

References

Appendix A: The Background of the Integrative Model

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