Addiction: A motivational problem with a cognitive solution

The webinar draws on recent research findings showing that addiction is maintained by changes in core cognitive processes such as selective attention, reward processing and biased decision-making. These processes are driven by unexpected and rapidly driven rewards associated with drug use and wins in gambling and gaming. In combination, these processes contribute to the persistence of addictive behaviour in the face of known negative impacts on health and wellbeing and in the face of repeated efforts to stop. Cognitive behavioural approaches should therefore aim to modify these core processes in pursuit of enhanced outcomes.

The Webinar should be relevant to both specialist substance misuse practitioners as well as those who encounter drug and alcohol problems in generic mental health or primary care settings. The therapeutic framework termed CHANGE (Change Habits and Negative Generation of Emotion) places the development of impulse control or habit management strategies at the centre of the therapeutic intervention. Accordingly, interventions that augment cognitive control processes such as selective attention and working memory are likely to enhance outcomes. The programme is organised into four sequential stages known as the “Four M s”:

· Motivation and engagement.

· Manage impulses and craving.

· Mood management.

· Maintenance and relapse prevention

Each of these stages requires tailored intervention strategies reliant on the therapist deploying specific competencies. Throughout, particular emphasis is placed on the importance of a robust therapeutic alliance based on a clear conceptualisation of the psychology of addictive behaviour drawing on both tried and tested and emergent cognitive neuroscience paradigms.