Murthy Pratima
Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India.
Indian J Psychiatry. 2018 Feb;60(Suppl 4):S433-S439. doi: 10.4103/psychiatry.IndianJPsychiatry_35_18.
While guidelines for psychosocial interventions in addictive disorders in India were earlier rooted in clinical experience and global empirical evidence, recently there have been efforts to develop guidelines for intervention based on the local needs assessments of specific populations and more appreciably, a testing of the effectiveness of the interventions. This supplement on psychosocial interventions for addictive disorders covers some of the important aspects of psychosocial interventions in five sections. Section I covers the general principles of management and specific assessment approaches, screening for cognitive dysfunction and assessment of co-morbidities. Section II focuses on specific psychosocial interventions including brief interventions, relapse prevention, cognitive behavioural interventions, psychoanalytical interventions, cognitive rehabilitation, interventions in dual disorders, marital and family therapy, psychosocial interventions for sexual dysfunction and sexual addictions. Section III describes innovative approaches including third wave therapies, video-based relapse prevention, digital technology as a tool for psychosocial interventions as well as psychosocial interventions in technological addictions. The latter part of this section also deals with psychosocial interventions in special populations including children and adolescents, women, sexual minorities and the elderly. Section IV pans into community based psychosocial interventions including community camps and workplace prevention. The need to develop task sharing through the involvement of trained health workers to deliver community and home-based interventions is highlighted. Section V underscores the ethical issues in different aspects of psychosocial intervention and the need for research in this area. Although there is a tendency to formulate addiction in biomedical psychosocial terms and to view interventions as pharmacological psychosocial, these dichotomies exist in the affected individual's mind, should be present in the treating clinician. A comprehensive understanding of addiction requires an understanding of the person in his/her environment and needs a personalised holistic approach that addresses the diverse physical/mental health, occupational, legal, social and aftercare needs.
虽然印度成瘾性疾病心理社会干预指南早期基于临床经验和全球实证证据，但最近人们努力根据特定人群的当地需求评估来制定干预指南，更值得注意的是，对干预措施的有效性进行了测试。这本关于成瘾性疾病心理社会干预的增刊分五个部分涵盖了心理社会干预的一些重要方面。第一部分涵盖管理的一般原则和具体评估方法、认知功能障碍筛查及共病评估。第二部分聚焦于特定的心理社会干预，包括简短干预、预防复发、认知行为干预、心理分析干预、认知康复、双重障碍干预、婚姻和家庭治疗、性功能障碍和性成瘾的心理社会干预。第三部分描述了创新方法，包括第三波疗法、基于视频的预防复发、将数字技术作为心理社会干预工具以及技术成瘾中的心理社会干预。本节后半部分还涉及特殊人群的心理社会干预，包括儿童和青少年、女性、性少数群体及老年人。第四部分深入探讨基于社区的心理社会干预，包括社区营地和工作场所预防。强调了通过让经过培训的卫生工作者参与来开展社区和家庭干预以实现任务分担的必要性。第五部分强调了心理社会干预不同方面的伦理问题以及该领域研究的必要性。尽管有一种倾向是以生物医学心理社会术语来界定成瘾，并将干预视为药理学心理社会干预，但这些二分法存在于受影响个体的思维中，也应存在于治疗临床医生的思维中。对成瘾的全面理解需要了解个体在其环境中的情况，需要一种个性化的整体方法来满足其多样的身体/心理健康、职业、法律、社会及后续护理需求。
