LAUSR

“Treating Impulsive, Addictive, and Self-Destructive Behaviors: Mindfulness and Modification Therapy” by Peggilee Wupperman tackles the challenging task of treating multiple forms of highly resistant, dysregulated behavior. The book describes Mindfulness and Modification Therapy (MMT) for the treatment of any dysregulated behavior that clients have extreme trouble resisting despite long-term harmful consequences. The MMT protocol is well-grounded in evidencebased principles and Dr. Wupperman provides a wealth of clinical wisdom along with step-by-step guidance on the implementation of MMT. The book has 13 chapters divided into three parts that leave therapists well-prepared for what to expect when helping clients overcome their dysregulated behavior on their destination towards a more satisfying, fulfilling life. The standard MMT protocol consists of 20 weekly individual sessions focused on mindfulness-based exercises to develop awareness of emotions, sensations and thoughts while increasing distress tolerance and acceptance of life situations. Four flex sessions respect therapist clinical judgment to determine the focus. Each session has the same structure, which helps clients know what to expect. Modified 16-week and 12-week versions are available if needed and MMT can be conducted without time limits. The hybrid MMT protocol integrates key principles and techniques from the following six treatments with evidence for modifying dysregulated behavior: Motivational Interviewing; Mindfulness-Based Relapse Prevention; Dialectical Behavior Therapy; Acceptance and Commitment Therapy; Cognitive-Behavioral Therapy and; Mentalization-Based Psychotherapy. Although MMT draws from these evidencebased treatments, there are a number of key differences including that every MMT session involves mindfulness with structured home practices. There are guided audios, a client-friendly set of skills that build on each other successively and all of the interventions are focused on the goal of decreasing dysregulated behaviors. Preliminary MMT findings suggest that strategically selecting key principles and techniques from existing treatments with evidence for modifying dysregulated behavior to target primary contributing factors and common constructs that underlie multiple dysregulated behaviors appears feasible and effective. The book was written for mental health professionals. Some form of mindfulness training is required for MMT and therapists are encouraged to maintain their own mindfulness practice but this is not required. MMT workshop training opportunities can be found on the MMT website (mindfulnessandmodificationtherapy.com). There are few limitations of MMT which can be applied to a broad range of dysregulated behaviors that fit the conceptual model. The use of motivational interviewing techniques in MMT allows intake of clients actively involved in dysregulated behavior. At the same time, this may limit treatment to those behaviors on the Harmful Behavior Continuum that can be decreased gradually and are not so severe that they require abstinence for outpatient admission. Strengths of the MMT protocol include addressing a number of important contemporary issues in harmful behavior-specific treatment. In strategically selecting principles and techniques that have been found effective with multiple types of dysregulated behavior, MMT addresses the harmful behavior comorbidity problem (i.e., that the referral dysregulated behavior is often not the only dysregulated behavior). This makes the need to implement other behavior-specific treatments for co-occurring dysregulated behaviors unnecessary. The need for increased intervention intensity to modify * James M. Yokley [email protected]