Substance Use Treatment for Those Who Struggle to Express Emotions

Substance Use Treatment for Those Who Struggle to Express Emotions

Relapse is a common theme among those who actually finish a treatment program for any substance abuse problems. Often there are certain circumstances that may make it difficult for an individual to maintain a substance-free life, even following a successful treatment regimen. For instance, some patients may have another mental disorder that has not been identified that may require an adjustment in their treatment program.

Another characteristic that may require special attention in substance abuse treatment is a condition called alexithymia. The term refers to a person’s inability to process understand or describe their emotions.

There is a high rate of alexithymia among those with substance use disorders, with patients at a level of 67 percent for this condition. Despite this high rate, there has been little research exploring the outcomes of patients in substance abuse treatment who also have alexithymia.

In previous research, cognitive behavioral therapy was found to be somewhat successful in treating substance abuse patients who struggled with alexithymia. However, while the dropout rate was low among these patients, follow-up information indicated that relapse was increased.

For the current study, published in the Journal of Psychotherapy and Psychosomatics, researchers wanted to determine whether there might be support for using a screening to identify patients who may be inhibited in their treatment by alexithymia. To measure this, the researchers examined whether alexithymia was a predictor for relapse, expecting to find evidence that alexithymia was negatively linked with recovery outcomes.

The research team examined 187 inpatients for substance use disorder using the European ASI (EuropASI) and the Dutch edition of the Toronto Alexithymia Scale (TAS-20). The EuropASI was used again at a three month follow-up from the initial cognitive behavioral therapy sessions (CBT) or a combined CBT with shared decision making intervention (CBT-SDMI) group.

All of the patients met criteria for at least one substance abuse disorder. In addition 36.9 percent were identified as being highly alexithymic, and an additional 33.2 percent met criteria for a low level of alexithymia. A higher level of alexithymia was associated with lower academic achievement and more frequent unemployment.

Those with a higher level of alexithymia also scored higher relating to problems at work, with income and education. However, low and high level alexithymia patients had similar rates of completion for the treatment programs. In addition, 54 percent of high-scoring alexithymia patients and 45.7 percent of low-scoring alexithymia patients were absent at the follow-up session.

The authors of the study acknowledge that the study’s results may be limited by some factors, including the use of self-report to determine abstinence in the participants.

The results indicated that patients with a high level of alexithymia are not necessarily at an increased risk for relapse. The authors report that patients with alexithymia can benefit from CBT.

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