John Marsden PhD, PgDip CBT, BABCP is Professor of Addiction Psychology at the Addictions Department, Institute of psychiatry, psychology and neuroscience, Kings College London. Holding professional appointments in the Addictions treatment and research field since 1987, John is a clinical research psychologist and cognitive behavioural psychotherapist and a senior member of the addictions department. He has held research grants from a range of public finders of research in the UK and overseas, with a focus on the development and evaluation of novel psychological and medication-assisted treatments for opioid, stimulant and alcohol use disorders. John is the deputy Editor-in-Chief of the academic journal Addiction.
The aim of this symposium is to describe and discuss a new cognitive therapy for cocaine use disorder (CUD). CUD is an adaptive disorder, mediated by conditioning, motivation and inhibition. As CUD develops there is a progressive imbalance between implicit-autonomous and explicit-reflective cognitive systems which favour the former, coupled with neutral and drug-related exteroceptive stimuli which become cue-associated. Drug liking and wanting beliefs and expectancies strengthen and attention is biased towards conditioned cues. Craving for cocaine often intensifies and feels unpleasant when drug access is prevented or delayed, or when an effort is made to resist. There may be autonomic (interoceptive) reactions, including changes in breathing, heart rate and sweating. However, craving is not always intense or persistent, and cocaine seeking is sometimes initiated by low-level desire.
Unlike opioids, nicotine and alcohol there are no specific medication or psychotherapies approved to treat CUD. In 2016/16, 150,000 adults in England sought help for CUD from NHS and NGO clinics. Typically, they received general, one-to-one counselling of variable effectiveness. In this symposium, a novel psychotherapy for CUD – Memory-Focused Cognitive Therapy (MFCT) is described. MFCT follows our group’s work on developing personalized psychosocial interventions (Marsden et al., 2017; doi: 10.1016/j.cct.2016.12.003). MFCT is a relatively intensive intervention which includes imaginal and in vivo exposure and memory reconsolidation methods adapted from trauma-focused therapy (Marsden, Goetz, Meynen et al., 2017; doi.org/10.1016/j.conctc.2017.10.009).
In the first talk, John Marsden will trace the development of MFCT, summarizing the change methods used and presenting preliminary evidence for the safety and efficacy of the intervention (Marsden, Goetzm Meyen et al., 2018; doi.org/10.1016/j.ebiom.2018.01.039).
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