Σύνδεσμος Μελών Γυναικείων Σωματείων Ηρακλείου & Νομού Ηρακλείου
European research report Patterns of Behavioral Addiction
State of the art and Good Practices in Addiction Treatment: Greece, Spain, and Germany
GREECE
Overview of Addiction Models and Treatment Approaches: In Greece, addiction treatment revolves around three principal models:
1. Psychosocial Model: Emphasizes holistic treatment addressing all facets of an individual's life, including emotional, psychological, and physical well-being, as well as social interactions, education, and employment.2. Disease Model: Focuses on biological sensitivity to addiction, viewing it as a chronic condition that individuals have limited control over.3. Self-Help Promotion Programs: Encourages self-help and mutual aid, emphasizing active participation and responsibility within a supportive community context.
Common Treatment Approaches:
● Pharmaceutical Interventions: Utilizes medications like methadone, buprenorphine, and naloxone for harm reduction and substitution therapy. These programs are designed to stabilize individuals and reduce substance consumption.● Psychosocial Interventions: Include motivational enhancement, contingency management, cognitive-behavioral techniques, and communal support, focusing on the environmental, social, and psychological dimensions of addiction.● Self-Help Programs: Based on the 12-step philosophy, these programs are outpatient and abstinence-based, involving activities like support groups and individual counseling.
Challenges and controversies:
● Dual Diagnosis: Individuals with co-occurring psychiatric disorders and substance abuse face inadequate services tailored to their needs.● Stigma: Pervasive stigma prevents many from seeking help, leading to social marginalization.● Insufficient Resources: Lack of funding and specialized staff, particularly in remote areas, hinders the effectiveness of treatment programs.● Good practices emphasize integrated pharmacological and psychosocial interventions, tailored to individual needs, and the importance of public education and professional training to improve treatment outcomes.
SPAIN
Overview of Addiction Models and Treatment Approaches: In Spain, addiction is understood through various models:
1. Disease Model: Views addiction as a chronic brain disorder, focusing on medical and behavioral interventions.2. Biopsychosocial Model: Considers the interaction of biological, psychological, and social factors.3. Behavioral Model: Emphasizes the role of environmental cues and reinforcement mechanisms in shaping addictive behaviors.
Common Treatment Approaches:
● Pharmacological Interventions: Medications like methadone, buprenorphine-naloxone, and disulfiram are used to manage withdrawal symptoms and reduce cravings.● Psychosocial Interventions: Cognitive-behavioral therapy (CBT), motivational interviewing (MI), and family therapy are commonly employed to address the psychological and social aspects of addiction.● Holistic Approaches: Integrate mindfulness-based interventions, art therapy, and yoga to promote overall well-being and self-awareness.
Challenges and Controversies:
● Stigma and Access to Treatment: Stigma remains a significant barrier, and there are disparities in access to treatment, particularly for marginalized populations.● Integration of Holistic Approaches: While recognized for their benefits, holistic approaches face challenges in widespread adoption due to limited resources and training.● Good practices include expanding treatment facilities, integrating addiction services into primary healthcare, and implementing policies to reduce financial barriers. Efforts to educate the public and reduce stigma are also crucial .
GERMANY
Overview of Addiction Models and Treatment Approaches: Germany employs a multifaceted approach to addiction treatment:
1. Disease Model: Focuses on addiction as a chronic brain disease, requiring medical and behavioral interventions.2. Biopsychosocial Model: Holistically addresses the biological, psychological, and social factors influencing addiction.3. Cognitive-Behavioral Therapy (CBT): Emphasizes modifying maladaptive thoughts and behaviors.4. Motivational Interviewing (MI): Enhances motivation and readiness for change.5. Therapeutic Community Model: Provides structured, residential treatment environments .
Common Treatment Approaches:
● Pharmacological Interventions: Includes methadone, buprenorphine, and naltrexone for opioid dependence, and acamprosate and disulfiram for alcohol use disorder.● Psychotherapeutic Approaches: CBT, MI, psychodynamic therapy, and systemic family therapy are widely used.● Holistic Approaches: Integrate complementary therapies like acupuncture, herbal medicine, and nutritional therapy alongside traditional methods .
Challenges and Controversies:
● Accessibility and Integrated Care: Despite a robust healthcare system, geographic disparities and fragmented care between addiction and mental health services pose challenges.● Harm Reduction Strategies: While effective, harm reduction programs face social stigma and public safety concerns.● Resource Allocation: Balancing funding for various treatment needs remains a critical issue.● Good practices include the adoption of integrated treatment models and continuous evaluation of resource allocation to optimize treatment efficacy.
CONCLUSION
The state of the art in addiction treatment across Greece, Spain, and Germany highlights diverse approaches shaped by cultural, economic, and healthcare system factors. Common challenges include stigma, accessibility, and the integration of comprehensive care models. Each country utilizes a blend of pharmacological, psychosocial, and holistic interventions, reflecting an evolving understanding of addiction as a complex, multifaceted issue. Good practices emphasize the integration of pharmacological and psychosocial interventions, the use of holistic methods, and the importance of public education and professional training. Collaborative efforts and continuous research are essential to enhance the effectiveness and accessibility of addiction treatment in these countries.
Results of National field research
GREECE
Research Overview: The national field research in Greece involved collecting data from professionals, individuals struggling with addiction, and family members of individuals with addiction. This research aimed to gain insights into the current state of addiction models and treatment and to identify best practices and approaches.
Professionals and Experts:
● Geographical Distribution: All five respondents were from Greece.● Profession: Participants included one psychiatrist, three psychologists, and one therapist.● Years of Experience: Most professionals had 0-5 years of experience, with one having over 16 years.● Encounter Frequency: Professionals frequently encountered individuals with addiction issues.● Familiarity with Experiential Therapy: Most were familiar, with three very familiar and two somewhat familiar.● Perceived Effectiveness: Four professionals viewed experiential therapy as highly effective.● Beneficial Modalities: Music therapy, therapy through writing, role-playing, and nature visits were frequently chosen.● Advantages of Experiential Therapy: Enhanced awareness, better emotional regulation, improved social relationships, and addressing underlying trauma were noted as key benefits(Addiction Stop_A2_ Nati…) .
Individuals Struggling with Addiction:
● Geographical Distribution: All respondents were from Greece.● Gender and Age Distribution: The sample included diverse gender and age groups.● Living Situation: Respondents had varied living situations, including living with family, friends, or alone.● Duration of Struggling with Addiction: Experiences varied from less than a year to over seven years.● Previous Participation in Treatment: Most had participated in some form of addiction treatment previously.● Coping Mechanisms: Support groups, therapy, medication-assisted treatment, and self-help resources were commonly used.● Familiarity with Experiential Therapy: Most were somewhat familiar, with one very familiar.● Participation in Experiential Therapy: Most had participated in experiential therapy as part of their treatment .
Family Members:
● Geographical Distribution: All respondents were from Greece.● Relationship to Individual with Addiction: Included parents, spouses/partners, and other family members.● Impact of Addiction: All indicated a significant impact on family life.● Participation in Support Programs: Less than half had participated in support programs for families.● Coping Mechanisms: Education, self-help resources, and support groups were commonly used.● Familiarity with Experiential Therapy: Most were somewhat familiar, with one very familiar.● Perceived Benefits of Experiential Therapy: Coping with stress, enhancing communication, and strengthening family bonds were noted as benefits.
SPAIN
Research Overview: The field research in Spain followed a similar structure, collecting data from professionals, individuals struggling with addiction, and family members to understand the national landscape of addiction treatment .
Professionals and Experts:
● Geographical Distribution: All five respondents were from Spain.● Profession: Included therapists, psychologists, and addiction specialists.● Years of Experience: Varied from 6-10 years to over 16 years.● Encounter Frequency: Encountered individuals with addiction issues frequently.● Familiarity with Experiential Therapy: Most were very familiar.● Perceived Effectiveness: Most viewed experiential therapy as very effective.● Beneficial Modalities: Adventure therapy, equine-assisted therapy, and expressive arts therapy were noted.● Advantages of Experiential Therapy: Developing teamwork skills, building self-confidence, and emotional expression were key benefits .
Individuals Struggling with Addiction:
● Geographical Distribution: All respondents were from Spain.● Gender and Age Distribution: Predominantly female, with ages ranging from 18 to 55.● Living Situation: Varied living situations, with some living with family or friends, and one living alone.● Duration of Struggling with Addiction: Varied experiences from less than a year to over seven years.● Previous Participation in Treatment: Most had participated in some form of addiction treatment.● Coping Mechanisms: Support groups, therapy, and medication-assisted treatment were commonly used.● Familiarity with Experiential Therapy: Most were somewhat familiar, with one very familiar.● Participation in Experiential Therapy: Most had participated in experiential therapy.● Perceived Benefits of Experiential Therapy:Addressing underlying trauma and increasing motivation for change were noted .
Family Members:
● Geographical Distribution: All respondents were from Spain.● Relationship to Individual with Addiction: Included parents, spouses/partners, and other family members.● Impact of Addiction: All indicated a significant impact on family life.● Participation in Support Programs: Forty percent had participated in support programs.● Coping Mechanisms: Education, support groups, and establishing boundaries were commonly used.● Familiarity with Experiential Therapy: Most were somewhat familiar.● Perceived Benefits of Experiential Therapy: Coping with stress, enhancing communication, and strengthening family bonds were noted as benefits.
GERMANY
Research Overview: The national field research in Germany also involved collecting data from professionals, individuals struggling with addiction, and family members to provide insights into addiction treatment practices and challenges .
Professionals and Experts:
● Geographical Distribution: All five respondents were from Germany.● Profession: Majority were psychologists, with some doctors.● Years of Experience: All had 0-5 years of experience.● Encounter Frequency: Frequently encountered individuals with addiction issues.● Familiarity with Experiential Therapy: Most were somewhat familiar.● Perceived Effectiveness: Viewed experiential therapy as somewhat effective.● Beneficial Modalities: Role-playing, art therapy, and creative writing/poetry were noted.● Advantages of Experiential Therapy: Improved emotional regulation, enhanced self-awareness, and addressing underlying trauma were key benefits .
Individuals Struggling with Addiction:
● Geographical Distribution: Data specific to individuals were not provided.● Gender and Age Distribution: Not detailed in the available excerpts.● Living Situation: Not detailed in the available excerpts.● Duration of Struggling with Addiction: Not detailed in the available excerpts.● Previous Participation in Treatment: Not detailed in the available excerpts.● Coping Mechanisms: Not detailed in the available excerpts.● Familiarity with Experiential Therapy: Not detailed in the available excerpts.● Participation in Experiential Therapy: Not detailed in the available excerpts.● Perceived Benefits of Experiential Therapy: Not detailed in the available excerpts.
Family Members:
● Geographical Distribution: Data specific to family members were not provided.● Relationship to Individual with Addiction: Not detailed in the available excerpts.● Impact of Addiction: Not detailed in the available excerpts.● Participation in Support Programs: Not detailed in the available excerpts.● Coping Mechanisms: Not detailed in the available excerpts.● Familiarity with Experiential Therapy: Not detailed in the available excerpts.● Perceived Benefits of Experiential Therapy: Not detailed in the available excerpts.
Conclusion
The national field research across Greece, Spain, and Germany highlights the diverse experiences and perceptions of professionals, individuals struggling with addiction, and their family members. Key findings include a high level of familiarity and perceived effectiveness of experiential therapy, the significant impact of addiction on family life, and the need for comprehensive, tailored, and evidence-based treatment approaches. Common challenges include stigma, resource constraints, and the need for specialized training and support for integrating experiential therapy into addiction treatment.
International Perspectives- Round Table results (3 000- 5 000 characters)
Debate questions for the Round Table from Spain (3 specialists/ country: professionals and experts in the field of addiction treatment, including therapists, doctors, researchers, psychologists, psychiatrists, addiction specialists, and policymakers)
Objective: to foster a robust and insightful debate among professionals and experts in the field of addiction treatment during the round-table
1. Effectiveness of Experiential Therapy:● How do we define and measure success in experiential therapy, and what challenges exist in evaluating its outcomes?2. Integration into Treatment Protocols:● In your opinion, how well is experiential therapy integrated into existing addiction treatment protocols, and what barriers or facilitators impact its adoption?● Should experiential therapy be considered a standalone intervention or an integrated component within a broader treatment plan?3. Tailoring Approaches for Diverse Populations:● How can experiential therapy be adapted to meet the diverse needs of individuals from different cultural backgrounds, ages, and socioeconomic statuses?4. Professional Training and Competency:● What level of training and competency should professionals have before incorporating experiential therapy into their practice?5. Client Preferences and Informed Decision-Making:● To what extent should clients be involved in deciding whether experiential therapy is suitable for their treatment plan, and how can informed consent be effectively obtained?● How can professionals balance client preferences with evidence-based practices when considering experiential therapy?6. Cost and Accessibility:● What are the cost implications of incorporating experiential therapy into addiction treatment, and how can accessibility be ensured for individuals with different financial resources?7. Combination of Experiential and Traditional Approaches:● How can experiential therapy be effectively integrated with traditional therapeutic approaches in addiction treatment, and what synergies or conflicts may arise?● In what scenarios might a combination of experiential and traditional therapies be most beneficial?8. Long-Term Impact and Relapse Prevention:● How can experiential therapy contribute to building resilience and coping mechanisms for sustained recovery?
SUMMARY OF DISCUSSIONS:
Effectiveness of Experiential Therapy:
● Germany: Success is measured using client self-reports, standardized assessments, and clinical observations. Challenges include individual and cultural differences, long-term tracking, and the subjective nature of experiential therapy.● Greece: Effectiveness is informally evaluated by therapists based on client motivation, commitment, and therapeutic progress due to the qualitative nature of experiential therapies and lack of standardized evaluation tools.● Spain: Success is defined by improved quality of life, self-awareness, and coping abilities, measured through a combination of qualitative and quantitative data. Challenges include the subjective nature of experiences and the need for long-term follow-up and cultural adaptation.
Conclusion: Defining and measuring success in experiential therapy is complex due to its subjective nature. Each country utilizes a mix of qualitative and quantitative methods, facing common challenges such as cultural differences and the lack of standardized evaluation tools.
Integration into Treatment Protocols:
● Germany: Integration is growing, supported by a holistic approach in healthcare, but barriers include insurance coverage, awareness, and specialized training.● Greece: Integration is adequate but hindered by cost, time, and skepticism about its measurability and alignment with traditional medical models.● Spain: Increasing integration with support from recognition of effectiveness, yet barriers include limited resources, training, and resistance to change.
Conclusion: While experiential therapy is being integrated into addiction treatment protocols, each country faces barriers such as cost, awareness, training, and alignment with traditional medical models. Collaborative efforts are necessary to enhance integration.
Standalone vs. Integrated Component:
● Germany: Pros and cons exist for both standalone and integrated approaches. The best approach depends on individual needs and goals.● Greece: Should be an integrated component within a broader treatment plan.● Spain: Most effective as an integrated component within a comprehensive treatment plan for addiction.
Conclusion: There is consensus that experiential therapy should primarily be integrated into a broader treatment plan, complementing other therapeutic modalities to address the multifaceted nature of addiction.
Tailoring Approaches for Diverse Populations:
● Germany: Therapists must create a culturally sensitive space and tailor interventions to the client's age, development stage, and socioeconomic status.● Greece: Experiential therapy is inherently adaptable to diverse backgrounds without specific modifications.● Spain: Requires cultural sensitivity, flexibility, and inclusivity, with interventions tailored to cultural values, developmental stages, and socioeconomic factors.
Conclusion: Adapting experiential therapy to diverse populations involves cultural sensitivity and flexibility. Each country emphasizes the importance of creating a supportive and inclusive environment.
Professional Training and Competency:
● Germany: Professionals need formal qualifications, ongoing training, and supervision. Cultural competency is also vital.● Greece: Should be delivered by specifically trained professionals following the curriculum and preconditions of each approach.● Spain: Requires comprehensive training, ongoing supervision, and continuous professional development. Standardized training and certification ensure quality.
Conclusion: High levels of training and competency are essential for incorporating experiential therapy into practice. This includes formal qualifications, ongoing training, and adherence to ethical standards.
Client Preferences and Informed Decision-Making:
● Germany: Client involvement and informed consent are crucial, fostering a collaborative and trusting therapeutic environment.● Greece: Clients' preferences should be considered, allowing them to choose suitable experiential therapies.● Spain: Active client participation in decision-making is encouraged, with comprehensive information provided to ensure informed consent.
Conclusion: Client involvement in treatment decisions is essential, with an emphasis on informed consent and respecting client preferences. This approach enhances therapeutic outcomes and client satisfaction.
Cost and Accessibility:
● Germany: Costs related to training and equipment are high, with limited insurance coverage. Government grants and virtual therapy can enhance accessibility.● Greece: Rehabilitation programs are free, making cost less of an issue, but the diversity of therapies needed increases overall costs.● Spain: Public funding, insurance coverage, sliding-scale fees, and teletherapy can improve accessibility.
Conclusion: Cost and accessibility vary across countries. Solutions include government funding, sliding-scale fees, and leveraging technology to reduce costs and enhance accessibility.
Combination of Experiential and Traditional Approaches:
● Germany: Effective integration requires balancing structured learning and open exploration, with collaboration enhancing outcomes.● Greece: Synergetic cooperation among professionals is necessary to overcome conflicts arising from different therapeutic philosophies.● Spain: Collaboration and communication among professionals are key. Tailoring interventions to individual needs can maximize benefits and minimize conflicts.
Conclusion: Combining experiential and traditional therapies can enhance treatment outcomes. Effective integration requires collaboration among professionals and tailoring interventions to individual needs.
Long-Term Impact and Relapse Prevention:
● Germany: Experiential therapy helps build resilience and coping mechanisms through emotional processing and self-awareness.● Greece: Experiential knowledge strengthens resilience and enriches coping mechanisms by working on realistic scenarios.● Spain: Promotes resilience and coping mechanisms by fostering emotional regulation, social support, and adaptive strategies.
Conclusion: Experiential therapy significantly contributes to building resilience and coping mechanisms essential for sustained recovery. It empowers clients by enhancing self-awareness, emotional regulation, and social support.
Final Recommendations:
1. Standardize Training and Evaluation: Develop standardized training curricula and evaluation tools to ensure consistent quality and effectiveness across different cultural and socioeconomic contexts.2. Enhance Integration: Foster collaboration between experiential and traditional therapy practitioners to maximize therapeutic benefits.3. Improve Accessibility: Advocate for public funding, insurance coverage, and sliding-scale fees to make experiential therapy more accessible.4. Emphasize Client Involvement: Ensure clients are actively involved in treatment decisions, with clear and comprehensive information provided to facilitate informed consent.5. Cultural Sensitivity: Tailor therapeutic approaches to respect and accommodate diverse cultural values, beliefs, and communication styles.
Findings, conclusions, and recommendations
GREECE
Findings:
1. Addiction Models and Treatment Approaches:Greece primarily employs the psychosocial model, disease model, and self-help programs. These models focus on holistic treatment, addressing emotional, psychological, and physical well-being, along with social and familial interactions.2. Pharmacological Interventions: Medications such as methadone, buprenorphine, naloxone, and naltrexone are used for opioid addiction, along with other medications for alcohol and nicotine dependence.3. Psychosocial Interventions: Techniques include motivational enhancement, cognitive-behavioral therapy, contingency management, and family therapy.4. Challenges: Key issues include dual diagnosis, stigma, insufficient resources, and lack of gender-specific services.
Conclusions:
1. Comprehensive Approach: A multifaceted approach is crucial, integrating pharmacological and psychosocial interventions tailored to individual needs.2. Addressing Stigma: Reducing stigma through public education and advocacy is essential to encourage treatment seeking.3. Resource Allocation: Increasing funding and resources, particularly in remote areas, is necessary to improve treatment accessibility and effectiveness.
Recommendations:
1. Enhanced Training: Provide comprehensive training for professionals to address dual diagnosis and integrate experiential therapy.2. Public Awareness Campaigns: Implement campaigns to reduce stigma and educate the public on addiction and available treatments.3. Gender-Specific Services: Develop dedicated support structures for women, addressing the unique challenges they face in addiction treatment.
SPAIN
Findings:
1. Addiction Models and Treatment Approaches: Spain utilizes the disease model, biopsychosocial model, and behavioral model, reflecting an evolving understanding of addiction.2. Pharmacological Interventions: Includes methadone, buprenorphine-naloxone, disulfiram, and other medications for substance use disorders.3. Psychosocial Interventions: Cognitive-behavioral therapy, motivational interviewing, and family therapy are commonly used, with a growing emphasis on holistic approaches like mindfulness and art therapy.4. Challenges: Stigma and access to treatment remain significant barriers, particularly for marginalized populations.
Conclusions:
1. Integrated Treatment: Combining pharmacological, psychosocial, and holistic interventions can provide comprehensive care and improve recovery outcomes.2. Reducing Barriers: Efforts are needed to improve access to treatment services and reduce stigma associated with addiction.
Recommendations:
1. Expand Treatment Facilities: Increase the availability of treatment centers, especially in underserved areas.2. Policy Support: Advocate for policies that reduce financial barriers to treatment and support the integration of addiction services into primary healthcare.3. Holistic Approaches: Promote the inclusion of holistic therapies in standard treatment plans to address the diverse needs of individuals in recovery.
GERMANY
Findings:
1. Addiction Models and Treatment Approaches:Germany employs the disease model, biopsychosocial model, cognitive-behavioral therapy, and motivational interviewing, supported by a robust healthcare system.2. Pharmacological Interventions: Utilizes methadone, buprenorphine, naltrexone, acamprosate, and disulfiram.3. Psychosocial Interventions: Integrated treatment models address both addiction and co-occurring mental health disorders, using techniques like CBT, MI, psychodynamic therapy, and systemic family therapy.4. Challenges: Fragmentation between addiction and mental health services, geographic disparities in treatment access, and stigma around harm reduction strategies.
Conclusions:
1. Holistic and Integrated Care: A cohesive approach that integrates pharmacological, psychosocial, and complementary therapies can address the complex nature of addiction.2. Overcoming Stigma: Reducing stigma and improving public understanding of addiction are vital for effective treatment.
Recommendations:
1. Interdisciplinary Training: Provide interdisciplinary training for healthcare providers to enhance integrated care for addiction and mental health.2. Enhance Access: Develop strategies to improve access to addiction treatment services in rural and underserved areas.3. Support for Harm Reduction: Promote the acceptance and implementation of harm reduction strategies through public education and policy support.
SUMMARY
The findings from Greece, Spain, and Germany reveal a need for comprehensive and integrated approaches to addiction treatment, addressing both the biological and psychosocial aspects of addiction. Common challenges include stigma, resource constraints, and the need for specialized training and support for integrating various treatment modalities. Recommendations focus on enhancing training for professionals, reducing stigma, expanding treatment facilities, promoting holistic approaches, and ensuring equitable access to care. Continuous research, policy development, and public education are essential to improving the effectiveness and accessibility of addiction treatment in these countries.
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Εκατοντάδες αποδέκτες στο πρόγραμμα διπλής διάγνωσης του ΚΕΘΕΑ ΕΞΕΛΙΞΙΣ - ΚΕΘΕΑ – This is an article from KETHEA that shares the problem of double diagnosis which is one of the most important obstacle in treating addictions30. Το πρόγραμμα των 12 βημάτων | Ανώνυμοι Υπερφάγοι Ελλάδος – This is an informative site on behavioral addiction of overeating, which cite the intervention of self – help, based on the program of 12 steps.31. Support for people with addiction problems This is an informative site for people with addiction problems who are being helped through the psychosocial model and it provides information on their goals and principles that are being adopted by the psychosocial model.
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