Chapter 22-Teaching Substance Abuse/Addictions Counseling

Question 1

RE: addictions counseling course, the first class will ask questions like, What comes to your mind when you hear the word addict ? How about addiction ? substance use ? substance dependence?
Why are these questions asked?

Answer 1

1. Makes students aware of personal biases

2. Clients do not fit any one pattern

Question 2

What three constructivist theories that can be used when working with addictions population?

Answer 2

1. solution-focused brief therapy
2. motivational interviewing
3. narrative therapy

Question 3

How does constructivist addictions counseling function?

Answer 3

1. Creates language of change, particularly related to solutions.
2. Deconstruction of the client’s definition of the problem.
3. Breaks addiction down into its component parts, who, what, where, when, and how of the contributing circumstances that keep the addiction going.

Question 4

How is constructivist addiction counseling different from reshaping or reframing?

Answer 4

The process that heals is collaborative conversation rather than finding answers to questions.

Question 5

Who developed Solution-Focused Brief Therapy (SFBT)?

Answer 5

Steve de Shazer, Insoo Kim Berg, and associates at the Brief Family Therapy Center

Question 6

When applied to treating addictions, what are the tenets of constructivist epistemology?

Answer 6

Counselor and client co-construct effective solutions to bring about preferred living.

(a) Clients are experts on themselves
(b) awareness of exceptions to the problem, times when the addictive behavior is not happening

Question 7

In solution-focused counseling, in many of the techniques, counselors highlight:

Answer 7

sustainable change based on the belief that change is constant and inevitable.

Question 8

What are examples of techniques in solution-focused counseling?

Answer 8

1. scaling
2. rating
3. the miracle question

Question 9

Who developed Motivational Interviewing (MI)?

Answer 9

William Miller and Stephen Rollnick

Question 10

Describe Motivational Interviewing

Answer 10

1. Nonjudgmental, nonconfrontational, and nonadversarial

2. Goals: establish rapport, elicit change talk, and establish commitment from the person with addictive behaviors.

Question 11

Motivational Interviewing is based on what 5 principles?

Answer 11

1. Express empathy
2. Develop discrepancy
3. Roll with resistance
4. Support self-efficacy
5. Avoid argumentation

Question 12

What have studies shown for MI vs. confrontational interviewing and cognitive behavioral interventions?

Answer 12

Significant differences in better treatment effects over the long term

Question 13

Who developed Narrative Therapy?

Answer 13

Michael White and David Epston

Known through their book: Narrative Means to Therapeutic Ends

Question 14

Describe Narrative Therapy.

Answer 14

1. Respectful, nonblaming conversations in which clients can safely explore the stories of their lives.
2. Explore the stories, or narratives, that have led to addictive issues.

Question 15

Describe “deconstructive questioning.”

Answer 15

1. Counselors and Clients investigate the influence of the problem on the life and relationships of the addicted.
2. EX of question: “When was the problem nonexistent?”
3. Through “real talk,” destructive beliefs become changeable interpretations.
4. Externalizing the problem-the problem is the problem; the client is not the problem

Question 16

Once the problem is deconstructed, describe “landscape.”

Answer 16

The “landscape” of preferred living can be co-constructed.

Question 17

What are examples of techniques in narrative therapy?

Answer 17

1. deconstructive listening
2. questioning
3. externalizing
4. identifying coping abilities support systems
5. seeking unique outcomes

Question 18

Why is an addictions course and/or program important in any counseling course?

Answer 18

1. In 2007, an estimated 19.9 million or 8% of Americans 12 and older were current illicit drug users.

Question 19

What learning objectives are important in the addictions course?

Answer 19

1. Students will learn assessment according to the DSM and the Patient Placement Criteria established by American Society of Addiction Medicine (ASAM).
2. Students will understand the term treatment is usually associated with court-ordered clients, while the term counseling is reserved for those who volunteer to make changes in their substance

Question 20

What other learning objectives are important in the addictions course?

Answer 20

3. Students will understand constructivism and the challenge of integrating constructivist theory with traditional addictions treatment programs.
   Students will discover the contemporary view of substance abuse treatment

Question 21

Why is it difficult to define addiction?

Answer 21

Theorists and counselors have yet to agree on one universal definition of this phenomenon.

Question 22

As part of examining definitions of addictions, what can the instructor teach about the historical perspectives?

Answer 22

1. Explore historical and multicultural perspectives on substance use.

Question 23

Describe the can activity that can engage students in the discovery of addiction’s meaning to them.

Answer 23

1. Instructor distributes cards containing the terms drunk, drug addict, sex addict, junkie, etc.
2. Students work in pairs and discover differences in how individuals look at people with addictions.
3. Instructors ask students how they might work with a client with one of the addictions listed.

Question 24

Some questions to pose to students about working with addictions clients include:

Answer 24

1. “Have you thought about working with an addicted client?
2. If so, do you believe that ‘cure’ happens as the result of an individual merely stopping the behavior?
3. Do you believe that stopping is always a choice?

Question 25

Assignments and projects for the addictions course can include:

Answer 25

1. online discussions
2. immersion project at a treatment facility
3. outside reflection projects
4. final examination

Question 26

Describe The Abstinence Project and Journal.

Answer 26

1. Students refrain from a substance or behavior that brings them a lot of joy for the duration of the course.
2. Students reflect on:
   A. the meaning of the behavior for them
   B. addressing thoughts and behaviors when behavior is halted
   C. how they cope when they stop the behavior
   D. what happens when they relapse