Moving from service user to self help group: the experience of a treatment group for social anxiety

First published: 09 May 2019 | Last updated: 20 May 2019

Matthew Gaskell is a Consultant Psychologist and Clinical Lead at Leeds Addiction Unit, where he has worked for the last six years. He oversees treatments delivered to patients with addictions and co-occurring psychological disorders. He is also Programme Leader for the undergraduate degree in Addiction Studies at University of Leeds. Previous to his work at Leeds Addiction Unit he was head of addiction treatment for the Directorate of High Security Prisons in England and Wales. He has published work related to addiction treatment in forensic settings, and has provided consultation and advice to government agencies in the UK and the United States on addiction treatment within the criminal justice system. His main clinical interest is the psychological treatment of addictions and co-occurring disorders.

Moving from service user to self help group: the experience of a treatment group for social anxiety and alcohol dependence

As if the treatment of addiction wasn’t difficult enough, when it is paired with a severe and chronic psychological disorder the challenge magnifies for both practitioner and service user alike. Whilst evidence-based addiction treatment has become more common place over recent years, services appear slow to meet the need for effective integrated treatment for addictions and co-occurring psychological disorders. Affective disorders, personality disorder, and trauma can be left undiagnosed or treated, and services are too often ill equipped and resourced to address these problems simultaneously, despite the persuasive economic arguments for doing so. Treatment resistance, drop out, relapse, and lifelong impairment of functioning are common consequences.

One of the most common co-occurring disorders with addiction (particularly alcohol dependence) is that of social anxiety or social phobia. This distressing condition tends to show itself in the teenage years and leads to significant impairment across all major life domains (education, employment, social, romantic etc) and across the lifespan. It often goes unnoticed by practitioners when patients come forward for alcohol treatment.

A pilot outpatient treatment for alcohol dependence and social anxiety will be outlined incorporating individual and group cognitive behavioural integrated therapy, pharmacotherapy (where necessary), peer support, and peer activity modalities. While the first intake was small, outcomes and service user feedback have encouraged further development of the service.


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