Doctor of Psychology
University of Wollongong. School of Psychology
Ciaglia, Danielle, The psychotherapy of drug dependence: changes in core conflictual relationship themes, Doctor of Psychology thesis, University of Wollongong. School of Psychology, University of Wollongong, 2010. http://ro.uow.edu.au/theses/3206
Understanding and resolving relationship conflicts may be a particular benefit for people presenting to psychotherapy for drug dependence issues. This project sought to empirically support this notion by investigating the process-outcome links of cannabis users by measuring changes in Core Conflictual Relationship Themes (CCRT) and their association with psychological outcomes following psychotherapy. Study 1 began this endeavour by observing changes in the CCRTs of one cannabis user undergoing 16 sessions of Supportive-Expressive Dynamic psychotherapy. Clinically relevant changes were observed most notably in the Wish and Response of Self components of the CCRT, where flexible, harmonious, and positive themes occurred over time. An association between this improvement was observed with reduced depressive and anxiety symptoms, greater global functioning, less psychological symptoms, and importantly cannabis abstinence. Study 2 expanded on these single case findings by measuring the CCRTs of 24 cannabis users in psychotherapy. Relationship patterns of cannabis users were found to be significantly modifiable. This was true with the Response of Other component, which showed improved rigidity, Harmony, and Valence of the relationship patterns. The Response of Self component also showed greater Harmonious and positive Valence interactions following psychotherapy. Both CCRT components were significantly associated with symptom alleviation and improved functioning. The Wish component demonstrated a refractory nature with rigid, but relatively Harmonious, patterns. The utilisation of a second tool to measure less conscious CCRT Wish components added greater scope with which to understand this unchanging nature. For this sample, interpersonal effectiveness was an appropriate drug-treatment focus and facilitated good outcomes.