Addiction Counseling Methods - Research Paper Example

?Running Head: Psychology A Review of Addiction Counseling Methods An Analysis Paper Introduction Treatment for addiction has become popular for several reasons. First, there is an emergent idea that treatment is effective; second, it is believed that treatment aids in curbing crime rates as there is a widespread assumption that drug and alcohol addiction causes criminal behavior (Weegman & Leighton, 2004). Burdened by the growth in substance addiction and the evident negative behavior it brought about, the response of the government has been to look for alternative treatment programs. A substance abuser whose dependence is uncontrollable perhaps requires intensive and lengthened treatment. High-risk substance abusers have a tendency to be high-risk criminals, but treatments generate remarkable decrease in the frequency of criminal acts (Ford & Russo, 2006). This paper reviews existing treatments or counseling approaches for addiction. Psychological Treatments for Addiction Several potential treatments founded on psychological theories and models have been formulated recently. One type of treatment which has been verified to be effective is contingency management. Founded on the premises of operant condition, contingency management views addiction as being reinforced by environmental and other contributing factors, and as having the capacity to change by modifying its effects (Elk et al., 1997). According to Stitzer and colleagues (1989), contingency management “organizes treatment delivery, sets specific objective behavioral goals, and attempts to structure the [drug user’s] environment in a manner that is conducive to change” (as cited in Elk et al., 1997, 625). This approach offers a mechanism of rewards and punishment which are intended to make sustained substance abuse less appealing and self-restraint more appealing. Contingency management methods can be successful in curbing addiction among methadone clients and has been discovered to be a valuable kind of therapy for ‘non-responsive’ (Elk et al., 1997) clients who fail to recover. Motivational therapy has been well-known and medically successful recently. The initial description of motivational interviewing is related with alcohol abusers (Chanut, Brown, & Dongier, 2005). It has been discovered to be a valuable instrument in several treatment phases but especially for drug abusers who remain at an initial phase of complying with the treatment or to modifying their attitudes and activities. Motivation is theorized as the outcome of an interpersonal mechanism where in the therapist’s behavior has significant effect on the consequent behavior and attributes of the patient (Chanut et al., 2005). The objective of the treatment is to enhance cognitive dissonance levels in order to attain a significant level of motivation (Schneider, Casey, & Kohn, 2000), as a result of which the patient is eager to take into account change options. One weakness of the above addiction treatments is that they suppose substance abusers’ previous compliance to change. This change is frequently quite unstable, and in several instances it could be almost completely concealed (Schneider et al., 2000). For instance, motivation therapy or interviewing openly presumes that the substance abuser is prone to be hesitant about their addiction. Motivational interviewing, according to Miller and Rollnick (1991), is “an approach designed to help clients build commitment and reach a decision to change” (as cited in Tubman, Montgomery, & Wagner, 2001, 295). With regard to this, motivational therapy is different from several other counseling techniques in the sense that it prevents attempting to persuade the patient to act in response to their addiction (Tubman et al., 2001), but tries to administer a decision making process where in the patient chooses. Motivation is viewed, as stated by Miller and Rollnick (1991), “a state of readiness… to change, which may fluctuate from one time or situation to another. This state is one that can be influenced” (as cited in Breiner, Stritzke, & Lang, 1999, 197). With regard to this, motivational therapy, particularly, motivational interviewing, questions the notion of ‘denial’ as a trait of substance abusers, and questions treatment methods rooted in forceful encounter (Breiner et al., 1999). For instance, denial is viewed not as a characteristic of the substance abuser, but as an outcome of the manner in which the therapist confronts the patient. Miller and Rollnick, in the most compelling contention of this assumption, argue that the resistance or non-compliance of a patient is a counselor dilemma. The duty of the counselor is to promote the active participation of the patient in the process of problem identification and in the scrutiny of a wide array of existing alternatives for chronic addiction or change in accordance to the advantages and disadvantages of various treatment approaches (Tubman et al., 2001). The method is designed to boost the essence of individual accountability and the inner performance of control and decision making, and the counselor should aid the patient in preventing treatment failures caused by denial, poor self-management, and low self-confidence. Even for severe addiction it is comparatively simple to discontinue substance abuse. It is more complicated and burdensome to stay sober, and the difficulties related with preventing a relapse are at the core of treatment approaches for addiction. The difficulty of preventing a relapse rests on the continuance of habit modification (Carroll & Onken, 2005). Hence, the relapse management and treatment is vital to the cure of addiction. Relapse prevention treatments have informed quite a few treatment methods (Flynn, 1998). Earlier assumptions of relapse as simply an indication of failed treatment have been substituted by a perception of relapse as a mechanism which can be identified, predicted and deterred (Linton, 2005). Relapse prevention has offered an idea for treatment approaches and provided clarity and goal to treatment in the daily medical context (Flynn, 1998), particularly by demonstrating how evaluation should be carried out and aimed at major problems. The primary elements of relapse prevention are naming high-risk conditions for degeneration; self-assessment and behavioral examination of addiction; training in and practicing coping mechanisms; and preparing for failures and crises (Ziedonis et al., 2006). High-risk circumstances could be mood states, objects, occurrences, or situations which have become related with relapse or substance abuse (Ziedonis et al., 2006). According to Stenius and colleagues (2010), they may involve favorable emotional states, unfavorable physical conditions, interpersonal problems, social pressure, peers, and unhelpful mood states. Risk factors usually arise simultaneously. Patients are trained to identify the specific factors which enhance the possibility of their degeneration to the pathological behavior and to deter or to deal with these factors. In order to sustain commitment to change, relapse prevention techniques necessitate the creation of definite coping mechanisms to manage high-risk circumstances (Kadish, 2002). These may involve, according to Freed (2007), the formulation or establishment of more general coping techniques that deal with problems of daily life inequity and precursors of relapse. Group Therapy Teamwork has been referred to as the epitome of choice in treatment approaches for addiction due to its inherent advantages. Nevertheless, most patients are not informed of those advantages when they go into a treatment course hence they normally defy participation in the group therapy (Freimuth, 2000). Furthermore, patients may view some features of group work, like becoming conscious of unidentified emotions in the past and open and clear communication, are harmful and a risk to their recovery (Weegman & Leighton, 2004). Several conceptual or theoretical perspectives and models aid in identifying patients’ necessity of and involvement in the group process (Freimuth, 2000). These models, which are explained in the next section, are verified to be the most pertinent to addiction issues; nevertheless, they may be integrated into other group approaches to offer other options, usually supplementary models of group process. One model of group therapy is group mutual aid. The mutual aid approach is founded on an idea that communicating shared objectives, interests, and experiences can grant respite and comfort to participants (Bhattacharya, 1998). The objective in forming a mechanism of mutual aid is to handle general interpersonal risk factors and to take part in a favorable interaction with the environment to reduce outside risk factors. Mutual aid results in an improvement of the efficiency of the innovative problem solving of the group by giving patients diverse helping and support systems (Kirby et al., 1997). Aside from resolving issues connected to personal and environmental pressures, according to Kirby and colleagues (1997), a mutual aid mechanism is assumed to deal with social relationships and competencies, educational requirements, behavioral modification, and certain activities connected to agreed group goals. Issues of confidence or trust are a major component in this approach. Members of the group confront each other, primarily with low-risk issues, afterwards with more private issues, particularly if they are uncontrolled patients (Stenius et al., 2010). As patients become involved and determine whether they can trust or confide with each other, the mechanism of mutual aid turns into a self-enabling and give-and-take process. The shared pre-group encounters of the members and the determined effort they share throughout group tasks can result in rapport and unity, which frequently boosts their group involvement (Bhattacharya, 1998). With regard to addiction, individuals should take part in continuous attempts to control or recover from addictive behaviors. One of the main instruments for this continuous mechanism is mutual aid, which is used in social networks, prevention and education organizations, counseling groups, and self-help teams. Formulating a mutual aid process in their self-help, deterrence, and rehabilitation groups offers patients with details of their natural settings where in to carry out recovery task and similar concerns (Kirby et al., 1997). Because patients have usually encountered and committed trust breaches, the paradigm of mutual aid regularizes the task in which participants perform as expected and normal (Tay, 2007). Mutual aid’s five foci, generally, are therefore pertinent to drug and alcohol abuse patient groups. These five foci are (Bhattacharya, 1998, 169): (1) educate clients about collaboration, trust, addiction-related stigma, resistance to substances, and other issues; (2) help them to change maladaptive behavioral patterns that reinforce substance abuse and enabling; (3) encourage them to reestablish key social connections and processes that can prevent addiction or that have been disrupted by their addiction; (4) share common concerns, experiences, interests, and goals related to their addiction and recovery; and (5) provide resources for problem-solving tasks related to personal, interpersonal, and environmental barriers to recovery and other life issues. Similar to the paradigm of mutual aid, social objectives and social action assumptions stress empowerment, motivation, and the strengthening of participants’ resources for coping with personal and environmental concerns (Ryan, 2004). Social objectives models put emphasis on the role of the member in improving individual learning, enhancement, and growth through the exercise of free involvement in the quest for social action (Flynn, 1998). Social action, according to Kadish (2002), comprises an emphasis on community development, founded on the integration of previous community building models into this approach. Furthermore, the mechanism of collective social action, education, knowledge improvement, and planning is in agreement with social action and social objectives models. The four-stage empowerment model of Freire (1984 as cited in Robinson & Kennington, 2002, 164) focuses on the importance of average individuals as experts and the value of their personal awareness in setting off systemic change. Several therapists have incorporated this empowerment model into the theoretical paradigms of social action and social objectives and have used this consolidated model to group process. For example, according to Robinson and Kennington (2002), the exercise of the consolidated social action-empowerment group model of cultural concerns has additionally improved this sector of theory development. As discussed by Ford and Russo (2006), in the prevention and rehabilitation of addiction, the objective is to aid individuals in understanding their strengths and to aid them in productively tapping their community, family, group, and personal capabilities. Education about general constraints and weaknesses is assumed to build cohesion among members of the group and to minimize their social seclusion. It is also assumed to improve their awareness of the institutional causes of several of their dilemmas. The improvement of collective awareness or education strategies controls the power imbalance and social anxiety that normally face patients and deters those situations from persisting as limitations to social action. Patients have to continue essential social functions and enhance their group- and self-worth by becoming efficient in adapting to evolving traumatic environmental circumstances as a group. They are presumed to become socially conscientious, to tender community services, in order to compensate the community for the damages their addiction has brought about (Ford & Russo, 2006). Some scholars propose employing peer groups as teams for policy reform. Patients in prevention and rehabilitation courses can take advantage of groups to reform social and organization rules linked to traumatic circumstances within the therapy environment (Ford & Russo, 20060. Moreover, they can frequently successfully deal with stressful situations in other larger environments that could be hampering their prevention and treatment attempts. An array of other teams is also required to assist patients’ mutual aid and social action tasks in substance addiction interventions. Empowered interventions like those discussed above should collaborate with rehabilitation initiatives, which function as the theoretical core for a range of group processes supported by substance abuse intervention and deterrence initiatives, mental health organizations, health promotion groups, academics, cultural centers, religious institutions, and twelve-step courses (Weegman & Leighton, 2004). Rehabilitation initiatives can aid in guaranteeing that these supported groups, at one with their group conceptual perspectives, are intended for the maximization of patients’ control and participation (Freimuth, 2000). Social action and mutual aid approaches are two paradigms that enhance patients’ control through consciousness raising and competency development in an array of special-needs and core rehabilitation teams. Lifelong competency development takes place in such segments as advocacy, education, awareness, open and expressive community, relapse deterrence, exercise of decisive assessment and assistance, group dynamics, stress management, and power evaluation (Freimuth, 2000). These gains from rehabilitation teams reflect the current idea about self-help groups, that is, a favorable feeling of personal power and self-value is vital for patients taking part in self-help groups. The comradeship element enables patients to produce and perform a wide array of essential life capabilities (Ford & Russo, 2006). Moreover, these teams also lessen the stigma and remorse linked to addictions and relapse while boosting the self-efficacy and control of patients. Prevention teams provide supplementary assistance by reducing the seclusion of patients in communities and by linking them with power sources that offer distractions from alcohol and drugs (Ford & Russo, 2006), such as mutual aid, support, constructive role models, expert prevention awareness, and abilities to refuse. Conclusions This analysis of the strong points and opportunities given by empowered treatment approaches to addiction emphasizes the distinctive input the empowerment and motivation models can tender for services to vulnerable groups. Racial groups, women, and the have-nots usually encounter overwhelming obstacles to their motivation, empowerment, and treatment in the larger environments and direct contexts. Hence, rehabilitation and prevention initiatives that involve an empowerment focus can improve outcomes with vulnerable groups, community members, and the general public. Further investigation is required to explain what these people know and can give back to knowledge about effective treatment approaches to addiction from an empowerment and motivation model. Qualitative study can enable a joint and productive patient-researcher examination of these problems. Nevertheless, there could be a risk in presuming that an empowerment and motivation paradigm is what is required to develop efficient addiction treatment courses. Empowerment and motivation models should be merely a component of the effort for attaining enhanced success, because there cannot be a single solution or model to resolving any issue. A more helpful technique is to examine what motivation and empowerment can contribute to a more environmental, ecological, and inclusive paradigm that takes into account diverse concerns and processes with respect to the efficiency of intervention programs. 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