This book describes psychosocial working conditions that negatively impact the mental and physical well-being of employees of various "assistance-related" professional groups, as well as individuals whose work is related to contact with demanding clients. It offers concepts and research on the causes and effects of emotional burden (most often manifested as stress and burnout) when working with patients, children, and clients. The book provides a detailed analysis of various aspects of emotional burden at work. It includes a description of studies carried out in 5 different professional groups that were exposed to emotional burden during emotional work and emotional labour. The book discusses the application of known and international diagnostic methods and provides an intercultural comparison. The current diagnosis of stress and burnout, as well as physical and mental health of individuals performing emotional work will be covered, as well as offering practical solutions on assistance for individuals based on the diagnosis of their health. This book is for any professional or aspiring professional in the field, including postgraduate students. Scientists and practitioners in the field of work and health psychology, management, occupational health and safety, and HR will find this book of interest. Employers of assistance and services sectors, authorities formulating employment laws, lawyers, and occupational medicine physicians are also among this book's top audience.

Based on research in camps in Iraqi Kurdistan and among refugees in Germany, this book addresses the challenges, strategies and support systems that exist for the rehabilitation and reintegration of Yazidi women recovering from human trafficking. Through in-depth interviews, focus group discussions and case studies, it gives women trafficked by ISIS their own voice to express their experiences during captivity, whilst offering an overview of the forms of support and protection available and necessary for survivors. An examination of the experiences and needs of refugee women who have undergone traumatizing experiences, Trauma and the Rehabilitation of Trafficked Women will appeal to scholars and policy makers with interests in gender studies, feminist thought, sexual violence during war, human trafficking and trauma recovery.

This important book presents a unique, personal account of the impact a mild traumatic brain injury can have. It tells the story of Pauline, who was 33 when a late football tackle caused a bleed in her brain which went undiscovered for 18 months. The account includes descriptions of hidden symptoms of concussion and post-concussion syndrome, pitfalls in diagnoses, the uneven progress of recovery and the effect of the varied reactions which others have to an acquired brain injury. The author incorporates memories alongside extracts from clinic notes, diary entries and emails to reflect the disjointed progress of diagnosis and recovery as- although similar- no two head injuries are the same. Through this book, the reader gains an appreciation of the confusion experienced by many brain injury survivors, which sheds light on why some may develop unusual behavior or mental health issues, and how such issues can be alleviated. Brain injuries are poorly understood by the general public and this can lead to difficult interactions. Moreover, complications in diagnosis means some may not realize they have this milder form of brain injury. This book will enlighten brain injury survivors and affected families and allow professionals an insight into their patients' experiences. As concerns grow over the risks which contact sports pose, this book shows how even mild brain injuries can wreak havoc with careers, relationships and one's sense of self, but that a happy life can still be found.

This edited book focuses on the role and use of VR for healthcare professions in both health and rehabilitation settings. It is also offers future trends of other emerging technology within medicine and allied health professions. This text draws on expertise of leading medical practitioners and researchers who utilise such VR technologies in their practices to enhance patient/service user outcomes. Research and practical evidence is presented with a strong applied emphasis to further enhance the use VR technologies within the community, the hospital and in education environment(s). The book may also be used to influence policymakers on how healthcare delivery is offered.

Identity (Re)constructions After Brain Injury: Personal and Family Identity investigates how being diagnosed with acquired brain injury (ABI) impacts identity (re)construction in both adults with ABI and their close relatives. To show how being diagnosed with ABI impacts identity (re)construction, this book investigates key patterns of identity construction. Discourse analysis, especially on the concept of positioning, provides an understanding of the changes and developmental processes in these self-narratives. These narrative (re)constructions point to a developmental change of identity in the course of the different phases of the recovery process for both persons with ABI and their relatives, including conflicting voices from society, service providers, relatives, and other adults with ABI. In addition, the (re)construction process is characterized by much ambivalence in both ABI survivors and relatives. Three perspectives are triangulated: (1) an insider perspective from ABI survivors; (2) an insider perspective from relatives; and (3) an outsider perspective from the researchers. This allows us to see how identities are negotiated and constructed in concrete situations. This innovative book will be required reading for all students and academics working in the fields of disability studies, rehabilitation psychology, sociology, allied health, and social care.

Adventure and extreme sports are increasing in popularity and it is not surprising that commercial adventure tourism and the accompanying life style and fashion, have become increasingly important to world economy. These unique sports involve not only major physical endurance and mental challenges but interaction and bonding with nature. They also tend to attract and excite audiences, both at the event and in the media. They are exciting to watch and redraw the boundaries of human achievement with the accompanying risks of injury and death. Adventure sports are usually performed in beautiful, exciting and remote locations or in extreme environments far away from medical assistance. Extreme sports usually involve an element of increased risk. These risks are highlighted by the media, usually after a reported accident or fatality but may vary according to the involvement of the participant; the weekend recreational adventure sports athlete or the experienced professional. A wide variety of sports fall into the category of adventure and extreme sports and with an increasing number of disciplines, this field is ever expanding. Sports are performed in contact with the "ground"; mountain running and biking, rock climbing, ice climbing and mountaineering. In the air: skydiving and base jumping. On water: surfing, white water kayaking and rafting, board sailing and diving. And also involve mechanical vehicles and animals! Some sports may be performed as a combination of few disciplines, such as water and air, e.g. kite surfing, and as so involve very unique mechanisms of injury. Sports events can also be merged to form a multi-sport race comprising many disciplines lastly from single to multi day races. Sports may involve competition with others, against the environment or with oneself, frequently the most ferocious adversary. Adventure sports are becoming increasingly popular in the general public and a few take these sports to an extreme level with the accompanying risks. Those that do, bring such time and dedication that they become professional in terms of training, preparation and finance. More and more people are enjoying adventure sports and unfortunately increased numbers are becoming injured as a result. Future research is progressing alongside the sport development, to allow the sport mechanisms, injury patterns and predisposing factors to be better understood. It is the hope of all researchers to make the sports safer without detracting from their adventurous nature. The aim and scope of our book would be to bring the sports medicine involved ineach of these sports into one volume. We would explain each sport including subtle similarities and differences, the common injury mechanisms, patterns of injury and treatment options. Additional chapters would include the mental characteristics of adventure racers and extreme sports athletes, together with the complexities of competing in hot and cold extreme environments. The book will present chapters focussing on the sports listed below, concentrating on published literature and newly formed studies by experts in the fields of injury epidemiology, prevention, management and rehabilitation.

This issue of Physical Medicine and Rehabilitation Clinics, guest edited by Drs. John L. Lin, will discuss a number of important topics around Spinal Cord Injury. This issue of one of four issues selected each year by series Consulting Editor, Santos Martinez. Topics discussed in this issue include, but are not limited to: Updates for the International Standards for Neurological Classification of Spinal Cord Injury, Approaching Prognosis for Recovery after SCI, Cognitive Dysfunction in Persons with Spinal Cord Injuries, Spinal Cord Injury Pain: updated for the 21st century, Pulmonary management in patients with spinal cord injury, Therapeutic interventions to improve mobility with spinal cord injury related upper motor neuron syndromes, Neurogenic bowel management using trans-anal irrigation by persons with spinal cord injury, Heterotopic Ossification: beyond etidronate, Orthopedic Surgical Management of Upper Extremity Dysfunctions in Pediatric Populations with Spinal Cord injury, and Vocational Rehab and employment after spinal cord injury, among others.

Originally published in 1993, the previous decade had seen considerable development in the field of neuropsychological rehabilitation following brain damage, and the use of computerized methods attracted attention and stimulated controversy. This practically-oriented text reviews representative examples from the literature at the time relating to the training of cognitive systems with the emphasis on studies describing the use of computerized methods. The topic is discussed in context and the contents include sections on cognitive change in neurological disorders, assessment techniques, the interaction between cognition and behaviour and the advantages and disadvantages of the use of microcomputers. The authors describe the evaluation of a computerized cognitive retraining programme run at the Regional Neurological Centre in Newcastle-upon-Tyne and draw on their experience of running such programmes to give practical guidance to those wishing to set up cognitive retraining programmes.

Originally published in 1989, presenting a new perspective on cognitive therapy in neuropsychology, these papers examine a cognitively-oriented, single-case methodology in neuropsychological rehabilitation. The recommended strategy is in-depth analysis of the precise nature of the impaired as well as the preserved processing components in the individual patient. The objective is to design a therapeutic course based on individual patient needs that is justified by the theoretical interpretation of the location of the deficit in his or her cognitive architecture.

Cancer diagnosis and treatment doesn't have to be a passive experience, and it shouldn't be. Dr. Kathryn Schmitz's Moving Through Cancer introduces a 21-day program of strength training and exercise for cancer prevention and recovery. Go from diagnosis to thriving with this empowering guide to using strength training and exercise to improve your mental and physical health before, during, and after cancer diagnosis and treatment. This groundbreaking program will show you how to use exercise and movement to: Recover more quickly from surgery Withstand chemotherapy (or other drug treatments) or radiation with fewer side effects Bounce back to daily life following cancer treatments Prevent loss of function or fitness due to treatment Return to work more quickly or stay at work throughout treatment Protect against late side effects of treatment that come years after diagnosis Leading exercise oncology researcher Dr. Kathryn Schmitz shows you how to prepare for cancer treatment and begin regularly exercising in just 21 days using five key steps: Move, Lift, Eat, Sleep, and Log. Both informative and practical, Moving Through Cancer explains the science of healing and prevention and delivers a paradigm-shifting message for patients, doctors, and caregivers about using exercise to live with and beyond cancer. FOR READERS OF: Anticancer Living and The Cancer-Fighting Kitchen. A PRACTITIONER AND CAREGIVER: Dr. Kathryn Schmitz is a pracademic (practitioner + academic) and a caregiver: In 2010, the publication of one of her trials in The New England Journal of Medicine and the Journal of the American Medical Association overturned years of entrenched dogma and conventional wisdom that told breast cancer survivors to avoid upper body exercise. In 2016, Dr. Schmitz's wife, Sara, was diagnosed with stage 3 squamous cell carcinoma-she is currently NED (no evidence of disease) and cancer free. Moving Through Cancer is inspired by Dr. Schmitz's professional and personal experience with cancer. HELPS PATIENTS AND CAREGIVERS TO COMBAT THE POWERLESSNESS OF THE CANCER JOURNEY: Dr. Schmitz's empowering message will not only resonate with anyone who has been diagnosed with cancer but with their family and loved ones as well. Dr. Schmitz is able to give life back to readers by providing results that include better sleep, better sex, less chemo brain, reduced nausea, and improved recovery. PARADIGM-SHIFTING PROTOCOL: Moving Through Cancer is the center of Dr. Schmitz's campaign to have doctors prescribing exercise to cancer patients as common practice by 2029. THE FIRST MAINSTREAM EXERCISE-FOR-CANCER BOOK: Until now, exercise-for-cancer books have been limited to academic approaches or one-cancer-specific (breast) or one-exercise specific (yoga, pilates) books. Moving Through Cancer is for all cancer patients and survivors and their caregivers. GREAT FOR THE CLASSROOM: Students and teachers will want to use these techniques in their classrooms to provide a better understanding of how to treat cancer patients. Perfect for: 18+, Health enthusiasts, rehab, exercise, academia, medical professionals

This book aims to bring to the reader an overview of different applications of brain-computer interfaces (BCIs) based on more than 20 years of experience working on these interfaces. The author provides a review of the human brain and EEG signals, describing the human brain, anatomically and physiologically, with the objective of showing some of the patterns of EEG (electroencephalogram) signals used to control BCIs. It then introduces BCIs and different applications, such as a BCI based on ERD/ERS Patterns in rhythms (used to command a robotic wheelchair with an augmentative and alternative communication (AAC) system onboard it); a BCI based on dependent-SSVEP to command the same robotic wheelchair; a BCI based on SSVEP to command a telepresence robot and its onboard AAC system; a BCI based on SSVEP to command an autonomous car; a BCI based on independent-SSVEP (using Depth-of-Field) to command the same robotic wheelchair; the use of compressive technique in SSVEP-based BCI; a BCI based on motor imagery (using different techniques) to command a robotic monocycle and a robotic exoskeleton; and the first steps to build a neurorehabilitation system based on motor imagery of pedalling together an in immersive virtual environment. This book is intended for researchers, professionals and students working on assistive technology.

This issue of Medical Clinics, guest edited by Dr. David A. Lenrow, is devoted to Physical Medicine and Rehabilitation. Articles in this issue include: Therapeutic Exercise; Rehabilitation of Patients Post-CVA; Traumatic Brain Injury; Amputee Care; Rehabilitation of Complex Medical Patients; Cancer Rehabilitation; Care of the Patient with Spinal Cord Injury; Back and Neck Pain; Musculoskeletal Rehabilitation; Sports Medicine; Geriatric Rehabilitation; and Determination of Post-acute Hospitalization Level of Care.

Life and Suicide Following Brain Injury tells the story of Tom, a 43 year-old man who acquired a brain injury from a road traffic accident at the age of 22. Tom survived but went on to take his own life 20 years later. As a vulnerable adult with mental health issues and long-term difficulties with substance misuse, this book tells Tom's story from his early childhood through to his death. In telling Tom's story, the author- a researcher in the brain injury field and Tom's sister- identifies the multiple suicide risk factors as well as the lack of understanding and inadequate service provision for people with complex needs following TBI. His story serves as a harrowing example of what can go wrong when timely intervention and support is not forthcoming, identifying a multitude of risk factors and possible points of intervention to improve care in the future. This book provides insight to professionals and academics across health and social care in the risks of suicide associated with TBI. It also provides support for those who have experienced the grief of losing a survivor to suicide, or those struggling to support a survivor who is suicidal.

Geriatric Rehabilitation addresses the fact that this is an age in which individuals have increasing longevity, better health care, education and expectations of health care which present new, increasing and even radical challenges to health care providers. The care of our older patients in rehabilitation settings demands the broad understanding of the key differences in strategies to care for older adults. The combined skills embraced in rehabilitation and geriatrics are presenting unprecedented opportunities for both fields to make substantive and even ground-breaking improvements in the lives of millions of older adults who entrust their lives to us. Rarely in one's medical career are such opportunities so evident and achievable. Geriatric Rehabilitation edited by Dr. K. Rao Poduri, MD. FAAPMR draws on a distinguished group of authors who are the front-line providers of care to the older adults. This book presents the full spectrum of the unique care needs of older patients who need the combined skills of physical medicine and geriatrics. It provides an easily accessible means of acquiring and improving these new skills for all those involved in geriatric care.

This book contains a comprehensive overview of all current uses of robots in rehabilitation. The underlying principles in each application are provided. This is followed by a critical review of the technology available, of the utilization protocols, and of user studies, outcomes, and clinical evidence, if existing. Ethical and social implications of robot use are also discussed. The reader will have an in depth view of rehabilitation robots, from principles to practice.

The book provides readers with a comprehensive overview of the state of the art in the field of gait and balance rehabilitation. It describes technologies and devices together with the requirements and factors to be considered during their application in clinical settings. The book covers physiological and pathophysiological basis of locomotion and posture control, describes integrated approaches for the treatment of neurological diseases and spinal cord injury, as well as important principles for designing appropriate clinical studies. It presents computer and robotic technologies currently used in rehabilitation, such as exoskeleton devices, functional electrical stimulation, virtual reality and many more, highlighting the main advantages and challenges both from the clinical and engineering perspective. Written in an easy-to-understand style, the book is intended for people with different background and expertise, including medical and engineering students, clinicians and physiotherapists, as well as technical developers of rehabilitation systems and their corresponding human-compute interfaces. It aims at fostering an increased awareness of available technologies for balance and gait rehabilitation, as well as a better communication and collaboration between their users and developers.

This issue of Neuroimaging Clinics of North America focuses on Spine Intervention and is edited by Dr. Majid Khan. Articles will include: The Spine: Embryology and anatomy; Osteoporosis and tumoral spine involvement: Overview and diagnosis; Hot and cold spine tumor ablations; Vertebral compression fractures treatment with cement augmentation procedures; Sacral fractures and sacroplasty; Conventional image guided procedures for painful spine; Advanced image guided procedures for painful spine; Image guided percutaneous treatment of lumbar stenosis and disc degeneration; Overview, diagnosis and treatment of spinal CSF leak; Overview, diagnosis and treatment of Spine vascular malformation; Rapid onsite evaluation (ROSE) for spine biopsies; and more!

The book provides an accessible introduction to many of the current theoretical perspectives on disability; enabling readers to challenge the taken-for-granted nature of traditional knowledge and assumptions within the rehabilitation, health and community care industries, and encouraging a more critical approach both to the nature of rehabilitation following injury or illness and to the 'problem' of physical difference and disability. Through its interrogation and exploration of new theoretical perspectives on disability and rehabilitation, this book provides a unique text for students and practitioners of nursing, occupational therapy, physiotherapy and social work and for educators and researchers in these fields. Although rehabilitation practitioners claim to aspire to client-centred practice and advocate participatory modes of research, rehabilitation theory remains curiously estranged both from theoretical perspectives developed by disabled/disability theorists and from critical perspectives on 'disability' that are emerging from other academic disciplines. Thus immune from alternate views, rehabilitation practitioners fail to question the premise that their professional assumptions are correct or 'right'. Contemporary theorists raise important questions, for example, about professional power, concepts of normality, independence and the physical body - issues central to rehabilitation - as well as to the role of the cultural environment in producing prejudice, the role of the social environment in creating disadvantage; and to issues of power and privilege and of the systemic oppression of disabled people. This book provides an introduction to the expanding body of critical work on disability by theorists from a range of perspectives, illustrating ways in which their theories and insights contest or support assumptions within rehabilitation theory. The book argues for a cross-fertilisation of ideas and challenges hierarchies of power in which nurses and therapists privilege their own assumptions, perspectives and knowledge while overlooking or ignoring the perspectives both of disabled people and of other theorists.Provides an accessible introduction to current theoretical perspectives on disability Demonstrates how these theoretical perspectives can inform a practitioner's approach to rehabilitation Relevant for all the rehabilitation and health care professions

This book provides an overview of attentional impairments in brain-damaged patients from both clinical and neuroscientific perspectives, and aims to offer a comprehensive, succinct treatment of these topics useful to both clinicians and scholars. A main focus of the book concerns left visual neglect, a dramatic but often overlooked consequence of right hemisphere damage, usually of vascular origin, but also resulting from other causes such as neurodegenerative conditions. The study of neglect offers a key to understand the brain's functioning at the level of large-scale networks, and not only based on discrete anatomical structures. Patients are often unaware of their deficits (anosognosia), and often obstinately deny being hemiplegic. Diagnosis is important because neglect predicts poor functional outcome in stroke. Moreover, effective rehabilitation strategies are available, and there are promising possibilities for pharmacological treatments. Attention Disorders After Right Brain Damage is aimed at clinical neurologists, medics in physical medicine and rehabilitation, clinical psychologists and neuropsychologists. It will also be useful for graduate students and medical students who wish to understand the topic of attention systems and improve their knowledge of the neurocognitive mechanisms of attentional deficits. In addition, clinical researchers in neuropsychology and cognitive neuroscience will find in this book an up to date overview of current research dealing with the attention systems of the human brain.

Individuals' responses to their chronic illness or disability (CID) vary widely. Some are positive and productive, some negative and self-defeating, and some have elements of both. Coping with Chronic Illness and Disability synthesizes the growing literature on these coping styles and strategies by analyzing how individuals with CID face challenges, find and use their strengths, and alter their environment to fit their life-changing realities. The book's first section provides readers with the major theories and conceptual perspectives on coping, with special emphasis on social aspects and models of coping with different types of CID. In Part Two, an array of specific medical conditions is covered. Each chapter supplies a clinical description, current empirical findings on coping, effective medical, physical, and psychological interventions, employment issues, and social concerns. conditions, such as cancer, heart disease, diabetes, arthritis, spinal cord injuries, and traumatic brain injury; in-depth coverage of HIV/AIDS, chronic pain, and severe mental illness; coverage of therapeutic modalities adopted for treatment of people with CID; review of the current state of coping theory and research; and, an appendix of instruments frequently used in assessment of coping. The editors' skillful balance between theoretical and practical material will help rehabilitation specialists (particularly psychologists, counselors, social workers, and health-care providers) develop new insights into promoting successful coping, and discern new means of changing its less effective forms. Students in the helping professions, as well as individuals experiencing CID, may also find this multifaceted book useful for understanding some of the psychosocial dynamics of living with CID.

Muscle strength is an important topic for ergonomics practitioners and physiologists to understand, especially as it relates to workplace injuries. Muscle strength and function is at the heart of many injuries that lead to reduced productivity and economic strain on the worker, the company, and society as a whole. This comprehensive source of information and data relating to muscle strength is the first to present such information in a single source. Muscle Strength explains the general determinants of muscle strength such as gender, age, and muscle type. It illustrates physical data in the context of theoretical background and examines the protocols, techniques, devices, and data used to record muscle strength in various parts of the body. This is followed by a discussion of overexertion, strength prediction, strength and endurance, torque and EMG relationship, and muscle fatigue. Finally, the material is applied to the use of muscle in jobs, to product design, and to studies of job accommodation and the effect of disability on strength. Professionals in ergonomics, biomechanics, sports science, and physiology will find that this unique text provides insight and data on an important subject in their field.

The second edition to this successful textbook is for all physiotherapy students and newly qualified physiotherapists working in orthopaedics at both undergraduate and postgraduate levels. The authors have drawn on their many years of experience and clinical work in various orthopaedic settings to help students with clinical reasoning when faced with apparently diverse patient problems. The content of this book moves from normal to abnormal and from simple to complex. Case studies and self-assessment sections encourage participation by the reader to help students develop a reasoned and logical approach towards the management of their orthopaedic patients. Chapter summaries emphasize key areas of importance. Case studies illustrate problem-solving approaches and demonstrate how to manage specific client groups. Objectives and prerequisites are included for each section, alerting readers to what they should know before and after reading. Reading and practice assignments include recommended prerequisite knowledge and experience. Well-illustrated text includes line diagrams, photographs, and radiographs to clarify important concepts. New chapters on Hydrotherapy and Gait present current knowledge on these areas. Chapters have been updated to include more information on the upper limb. Chapters on Decision Making and Clinical Reasoning in Orthopaedics and Gait Analysis in the Clinical Situation have been thoroughly updated and revised.

Spirituality is an important aspect of occupational therapy theory and practice, yet it remains little understood. This timely book adds to the current debate by exploring the meaning of spirituality within occupational therapy and by outlining evidence which supports this area of practice. Beginning with the three stances surrounding spirituality for the common good and the theology of occupation, throughout its 10 chapters the book goes on to cover topics such as: Spirituality of caring; Theories of spiritual development; Definition of spirituality from occupational therapy literature; Differences between assessing spirituality and religion; Spirituality and ethics; Spiritual and cultural diversity in the occupational therapy clinic; Therapeutic self. By the end of the volume the reader will have the toolset required to consider spiritual concepts and their application to health principles. Occupational Therapy and Spirituality is written in an accessible format and is designed for occupational therapy and occupational science academics, researchers, and graduate students.

Advanced therapies and technologies, new service delivery methods, and care upgrades in underserved areas are translating into improved quality of life for millions with disabilities. Occupational therapy parallels this progress at the individual level, balancing short-term recovery and adaptation with long-term independence and well-being. This Second Edition of the International Handbook of Occupational Therapy Interventions builds on its ground-breaking predecessor by modelling current clinical standards rooted in scientific evidence-based practice. Its interventions are applied to a diverse range of client disabilities, with many new or rewritten chapters on workplace and vehicle accommodations, smart home technologies, end-of-life planning, and other salient topics. New introductory chapters spotlight core competencies in the field, from assessing client needs and choosing appropriate interventions to evaluating programs and weighing priorities. And for increased educational value, interactive case studies allow readers an extra avenue for honing clinical reasoning and decision-making skills. Of particular note is a new chapter providing a taxonomy-the Occupational Therapy Intervention Framework-and a validation study of its categories and concepts, delineating the occupational therapist's roles and the expected outcomes. Intervention areas featured in the Handbook include: Adaptive interventions, OTs manage and facilitate clients' adaptations. Learning interventions, OTs teach and the clients learn or relearn. Enabling interventions, OTs enable clients to be meaningfully occupied. Preventing interventions, OTs prevent ill-health and promote clients' ability to sustain health in daily life. The Second Edition of the International Handbook of Occupational Therapy Interventions is career-affirming reading for all members of rehabilitation teams, including occupational and physical therapists and rehabilitation nurses. Students intending to enter this growing field and professionals working toward its continued improvement will find it useful and inspiring.

This book approaches the treatment process from a new and yet old perspective. Eleven men who successfully desisted from substance abuse and offending were interviewed to determine how their significant therapeutic relationships facilitated this life change. Data is integrated with a new psychodynamic framework, relational analytic theory, which focuses clinical attention on the qualities and processes of the therapeutic relationship. A therapy model is developed which addresses how to attain and maintain therapeutic engagement, treat client symptoms, and utilize therapeutic conflict to develop client capacity for internal conflict and personal agency, functions critical to resolving addictive behavior. Societal and cultural obstacles to treatment are addressed including group stigmatisation, a lack of funding, and our current manual and group-based treatment protocols.