Unit 15: Addictions Counselling And Psychopharmacology Flashcards
What are nine symptoms of addiction?
- Persistent and frequent thinking about the activity throughout the day
- Significant interference with enjoying other important aspects of life
- Inability to control, cut back, or stop the behavior, even after becoming aware of debilitating effects
- Restlessness or irritability when attempts are made to cut back on the behaviour
- Feelings of anxiety or agitation if behaviour is stopped for a period of time
- Use of the addiction to escape or avoid other responsibilities
- Dishonesty or exaggerations when reporting the incidence of behavior, minimizing the problem to self and others
- Engaging in high-risk behaviour that jeopardizes emotional or physical safety
- Intense mood swings associated with the activity, ranging from euphoria to shame, guilt, and depression
Any substance ingested into the body that produces an altered state of consciousness or change in body chemistry
Drug
Programs designed for adolescents with little or no experience with substances
Primary prevention programs
Programs that target beginning users of drugs
Secondary prevention programs
Programs that work with the experienced, highly abusing, or dependent teen (drugs)
Tertiary prevention program
The diagnostic criteria for Internet addiction are similar to those for substance-abuse. What are questions counsellors could ask to assess Internet addiction?
- Are you preoccupied with thoughts about going online?
- Are you spending increasing amounts of time online?
- Have you unsuccessfully trying to cut back your hours online? If you do cut back, do you feel moody, depressed, or irritable?
- Is your Internet use jeopardizing your relationships, schoolwork, or job performance?
- Are you lying to others about how much time you spend on the net?
- Do you go online as a way to escape other problems?
In a cyber-society, what are the implications for counsellors regarding Internet addiction
- counsellors need to help users reduce access to their computers
- counsellors must help their clients recognize they have a problem, and make the cybersex or Internet addiction a central focus of their treatment
- counters can explore with them to find out if the Internet is being used to self medicate for depression or anxiety and address these if issues if that is the case
- counsellor should bring in the family so they can be part of the recovery and support effort
- counsellors can help client explore their sexuality and find other means of expressing it and seeking gratification
This type of model for addictions is related to biological causes
Medical model
For example, alcoholism is viewed as a disease. Jean studies have indicated that some individuals may be born with a propensity for becoming alcoholic, and research in brain chemistry has suggested that substance abuse or’s may have lower levels of neurotransmitter dopamine receptor sites than the normal population and therefore may have an innate propensity for experiencing pleasure from certain addictive substances.
The abuser is help through a detoxification program that may include forced abstinence, intensive psychotherapy, family support groups, social skills training, and possibly medications to help with withdrawal symptoms. The medical model approach absolves the client of responsibility for his or her condition and the counsellor works intensively on issues related to self-control and compliance to the prescribed program.
A model of addiction that uses a 12 step approach where the abuser is labelled as helplessly addicted forever unless complete withdrawal is initiated. Also views substance abuse as a spiritual problem characterized by an addict’s false pride, self-absorption, sense of entitlement, and, most prominently, determination to deny the very fact of addiction
Alcoholic anonymous/narcotics anonymous model or 12-step model
Somewhat compatible with the medical model in that the abuser is labelled as hopelessly addicted, but unlike the medical model, views substance abuse as a spiritual problem as well
These programs are similar to therapy groups, participants speak from the heart about their struggles with addiction and receive support from group members.
Steps one through three: addicts must accept their helplessness against the disease of addiction, appeal to a higher power for help with recovery, and honestly knowledge their personal limitations
Steps four through seven: addicts must undergo rigourous self-examination, making a personal inventory of all the ways they have harmed partners, family, friends, and coworkers and must begin to own the feelings that they had used substances to suppress and self medicate.
Steps eight and nine: addicts actually make amends to those they have heard, thereby restoring damaged relationships and relieving shame and guilt that may underlie the addiction
Steps 10 to 12: addicts must regularly attend group meetings and need daily affirmations to assist in their lifelong process of recovery
A therapeutic model of addiction that is a brief, humanistic, non-adversarial, client centred approach. Presumes that many alcoholics can successfully reduce their consumption to moderate levels. Stand squarely in opposition to the AA model, which demands total abstinence.
Presumes that the substance abuse or will only change when motivated to do so and that abusers remain addicted out of choice, they prefer the benefits of substance-abuse to sobriety but at the same time they have dreams and goals in life, which they can never achieve so long as they continue their substance abuse.
Motivational interviewing
The role of a counsellor is to assist them in resolving this conflict by helping abusers recognize these hopes and goals, and appreciate how their addiction holds them back.
Emphasizes that the counsellor cannot push or confront clients into giving up their addiction; only clients can take responsibility for changing their lives, and they cannot do so until they are ready to change, wanting to accomplish their goals more than they want their alcohol or drugs
The motivational interviewing approach has a natural theoretical link with the process of change model. What are the five stages of change that clients must pass through in order to alter behaviors?
- Precontemplation: individuals in this stage do not recognize themselves as having a problem, and only come for counselling because they are pressured by a spouse or employer, or mandated by a judge
- Contemplation: substance abusers recognize they have a problem and are beginning to weigh the pros and cons of their addictive behaviors. They are not ready to change, but are giving the idea serious consideration
- Preparation: individuals in this stage intend to take action and change their behaviors, but still haven’t committed to taking the major steps necessary
- Action: reflects overt behavioural changes, with successful alteration of their addictive behaviors. They feel like they’re actually doing something about their problem
- Maintenance: substance abuse or’s have been abstinent for more than six months and are trying to avoid relapsing, which for some will be a lifelong process
In this therapeutic model of addiction, the underlying premise is that it is normal for substance abuse or’s to return to some of their old patterns following treatment. The initial setback is termed a “lapse”, and when the setback evolves into a complete return to substance-abuse, the individual is said to have “relapsed”. Advocates of this model reframe relapses as opportunities to learn more effective coping strategies. This approach was designed because substance abuse or’s often end up getting caught and vicious cycles where they’s blame themselves for using again which increases the likelihood that they will use drugs and alcohol to relieve their distress, resulting in a full relapse.
Relapse prevention
Unlike the AA model, where relapse is seen as failure, relapse prevention advocates reframe relapses as opportunities to learn more effective coping strategies
What are the steps that counsellors would take in the relapse prevention model of addiction
- Assess the high-risk situations the client is likely to encounter that would facilitate a lapse
- Challenge the clients expectations that using the substance will be a positive experience
- Educate the client about the nature of lapses and relapses, to remove some of the shame associated with lapses and reduce the likelihood of using substances to relieve the shame
- If the client has experienced a lapse, assess whether he or she sees it as a personal failure and, if so, help normalize it and minimize feelings of decreased self-efficacy
- Design a program of cognitive behavioural interventions aimed at helping the client cope effectively with high-risk situations
- Encourage the client to make significant lifestyle changes that include relaxation techniques
- Teach the client to replace negative addictions with positive ones like aerobics at a gym or regular running
These are the most commonly prescribed medications for both major and moderate depression. Operates by increasing the transmission of the neurotransmitter serotonin across neuronal synapses. Influences mood regulation, sleep and arousal, and regulation of physical pain.
Selective serotonin reuptake inhibitor’s or SSRIs
There are side effects such as dry mouth, tiredness, constipation, weight gain, insomnia, lack of sexual drive. Some clients report an unpleasant flattening out of their emotional lives and for others experiences of agitation, anxiety, and the feeling describe is jumping out of my skin.
A persistent, chronic, and intense focus on a single behaviour pattern that feels or is out of control
Addiction
