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Cognitive-Behavioural Integrated Treatment (C-BIT)

Hermine L. Graham

Clinical Director, Pierremont Unit, Darlington Memorial Hospital, Hollyhurst Road, Darlington DL3 6HX

Chichester: John Wiley, 2004, 318 pp., £24.95 pb, ISBN: 0 470 85438 3

C-BIT sounds like an item from a DIY catalogue; appropriately so, because it is a type of multi-purpose tool, but one designed for the psychological treatment of patients suffering from both mental illness and problematic substance misuse. It has add-on attachments for every circumstance, whether the identified problems lie with anger control or personal finances. The full range of functions that C-BIT encompasses will probably only be used by specialist therapists in assertive outreach and dual diagnosis teams. However, C-BIT training has been shown (in research reported elsewhere) as helpful to ordinary members of both mental health and substance misuse teams. None of the treatment methods are original in themselves, but this is an excellent guide to how they can be tied together in a coherent system, and how they can be matched to the various phases of treatment, which are themselves determined by the patient’s current levels of motivation and readiness to change.

Addiction therapy has become in general alarmingly depsychologised. This has been due to such factors as the slow death of treatment for alcohol dependence in the UK, the predilection of commissioners for ultra-brief interventions and the rise of methadone substitution as a general answer to drug addiction. Psychologists who remain active in this field are rare, to be cherished, and for some reason predominantly based in Birmingham, where this publication originates.

The manual demonstrates how approaches towards mental illness and addictions have begun to converge recently after drifting apart. In both fields now staff are geared up for the long haul. Schizophrenia is not cured in six sessions, but then neither is serious opiate, alcohol nor cocaine addition. Relapse management and motivational interviewing are the bread and butter of addiction treatment, but are also well suited to helping people avoid psychotic episodes. Addiction workers are learning to use cognitive techniques to tackle the depression and anxiety that so often underlie excessive consumption. Both services are coming to understand that responsibility for motivation lies as much with themselves as with their patients. Ending with a brief review of the literature, the authors claim that there is ‘a solid basis for optimism’ concerning the effectiveness of integrated treatment. This book will have achieved much if it can help reduce the pessimism that is too frequently expressed in the context of ‘dual diagnosis’. Even when treating people who appear at first completely wayward, a patient and collaborative approach can in the end be immensely rewarding.

This Article Full Text (PDF) Submit an eLetter Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Carnwath, T. Search for Related Content PubMed Articles by Carnwath, T.