Discussion 1 For this first discussion post, review the following videos of Gabor Mate, Marc Lewis, and Maia Szalavitz discussing their research on the addictive process. For each interview, assess and describe your reactions to the material being presented. How does what is being discussed fit or not fit with your current ideological/philosophical conceptualization of the addictive process and addiction recovery? Provide adequate reasoning behind whether or not you agree or disagree with their arguments. How do your personal, professional, and academic experiences align with or contradict the arguments being presented? Discussion 2 Discuss how the themes in The House I Live In have shaped addiction treatment in the United States. Address the following ideas throughout your post: • Which etiological model(s) best explain how addiction is understood and treated based on the content of the film? • How might we go about restructuring addiction treatment in light of the recent systemic shifts to radically transform policing and law enforcement? • What additional factors need to be considered when working with clients from marginalized groups based on race, class, ethnicity, gender, sexual orientation, political orientation, religion, etc.? Discussion 3 Becoming connected to the self and others is an important part of healing. For some people, connection to a single, secure relationship can provide them the experience they need to radically transform their own relationship to others and the self. This is what the basics of attachment theory tell us. For some, the experience of connection within larger group and community contexts provide the transformation needed. Process groups and self-help groups (such as AA, NA, SMART Recovery, etc.) are an example of how we have utilized groups in the formal and informal treatment of addiction. What are the differences between these kinds of groups? What are the benefits and drawback of each? What are the potential therapeutic effects for each kind of group and how does each effect relate specifically to the treatment of addiction? Discussion 4 For this last discussion post referring to discussion 3, propose a new modality for treatment based on the information you have learned this semester as well as your own personal and professional experiences with addiction and/or mental health. Argue for the efficacy of this treatment modality and identify its limitations. Your modality can be considered either primary, secondary, or complementary. Discussion 3 format example The difference between process groups (therapeutic and educational) and selfhelp groups lies in the goal of the group. Process groups main goal seems to be more treatment oriented than self-help groups, while self-help groups seem to be more support-oriented. Each of these groups provide the social support that some find necessary in the treatment of addictions. Capuzzi and Stauffer emphasize three types of groups with distinctions mainly in two categories. These include psychoeducational groups, psychotherapeutic groups, and self-help groups. Self-help groups differ drastically from psychoeducational and psychotherapeutic groups (2020). Psychoeducational groups are groups where the main goal is simply to educate in a structured, planner manner. These groups may educate about the process of addiction or even teach new skills to use outside of the group. The structure is very much emphasized as a strong suit in psychoeducational groups. In psychotherapeutic groups, individual therapy can be enhanced or replaced, with the added benefit of new perspective, relatedness, and social support. A main goal of this type of group is learning new skills and coping mechanisms for the downfalls of addiction one experiences. These groups are not as structured as psychoeducational groups, but they allow for flexibility on pertinent, relevant topics for the members. Self-help groups are slightly different from the other two groups. The main goal for these groups is relatedness and gaining social support. There are often groups like these for family members of the addicted individual as well. Capuzzi and Stauffer emphasize this group's importance on “reciprocal helping” (2020). The 12-Step groups will mainly fit in this category. Psychoeducational and psychotherapeutic are more formal means of addiction treatment, whereas self-help or mutual-help are more informal means of treatment. With this formality comes less accessibility and increased costs, giving some advantage to self-help groups. A major source of controversy surrounding self-help groups surrounds the importance placed on a higher power and on abstinence. Recent and ongoing discussion about the efficacy of harm reduction techniques are faring well compared to the long-standing focus on abstinence in the treatment of addiction and self-help groups. I personally am a huge proponent for harm reduction, so this is a valid concern of mine for selfhelp groups. A major concern is that the abstinence piece of self-help groups discourages some from getting group help due to the low costs and accessibility. According to McKeganey, harm reduction and abstinence services do not need to be separate, and it may take a shift in our ideological perspectives on addiction (2011). A study done to test the efficacy of Alcoholics Anonymous and Narcotics Anonymous found that these groups are better as an after-care resource, although they do show substantial efficacy in remaining abstinence over longperiods of time (Gossop, Stewart, and Marsden, 2008). The accessibility of these mutual-help groups allows for longer-lasting support, in comparison to higher costing alternatives. Self-help groups generally also have more members, paving the way for either more support or less needed attention gained from the group. Although each of these group types have their drawbacks, they are all substantial means of support. Self-help groups may be more effective with formal treatment prior to membership. Group membership in the treatment of addictions, regardless of abstinence efficacy, provides much needed social support and relatedness that is important for addiction recovery. Resources Capuzzi, D. & Stauffer, M. D. (2020). Foundations of addictions counseling (4th ed.). Pearson. Gossop, M., Stewart, D., & Marsden, J. (2008). Attendance at Narcotics Anonymous and Alcoholics Anonymous meetings, frequency of attendance and substance use outcomes after residential treatment for drug dependence: a 5year follow-up study. Addiction (Abingdon, England), 103(1), 119– 125. https://doi.org/10.1111/j.1360-0443.2007.02050.x McKeganey, N. (2011). Abstinence and harm reduction: Can they work together? The International Journal of Drug Policy, 22(3), 194– 195. https://doi.org/10.1016/j.drugpo.2011.04.001 less Discussion 4 format example Based on the information I have learned throughout this semester as well as my own personal professional experiences with addiction, my modality would be person-centered, complementary treatments that are self-paced, as to not rush the person in treatment. I would propose a modality that combines complementary treatment with prevention research and exposure to trauma because I believe what someone has gone through has a lot to do with their addiction as learned in the book “In the Realm of Hungry Ghosts.” Person-centered therapy is talk therapy where the client does most of the talking. I feel like this is the best way to go about addiction, is by having the individual discuss their struggles rather than throwing a book at them. Therapists that are person-centered do not judge or try to interpret what the client says, and I feel like that is an important aspect in helping someone who is struggling with addiction. It already took them a lot to admit they need therapy so being judgmental of their past or what they have done will get you nowhere nor will it help them. Person-centered therapy techniques put an emphasis on the client as an expert and the therapist lets the client lead. “It posits that people strive toward a state of self-actualization and therapy can help a client reach self-awareness. It is a therapist’s job to create the proper surroundings for a client to become a “fully functioning person”. While some may argue that a person-centered therapist does not use techniques as much as they develop a therapeutic atmosphere, there are certain behaviors a therapist must perform to create the optimal environment.” When it comes down to it, the client is the expert on their own lives; the therapist is there to be a non-directive equal collaborator, to help them through the struggles they face. One of the most important aspects of the person-centered therapy technique is that the therapist must show unconditional positive regard for the client. They accept and care for their client as they are and accept them for who they are which is very different from other approaches. Individuals and treatment professionals look for additional therapeutic approaches to increase well-being and improve treatment outcomes. These additional therapeutic approaches have become known as a complementary treatment or alternative medicine. Complementary treatments are additional to primary treatments that focus on other aspects such as nutrition, mediation, art, and ecotherapy whereas primary is strictly based on inpatient and outpatient programs. I believe complementary would be more efficient than primary treatment based on what I have learned in this class and what I have experienced in my own life. If someone replaces a drug or alcohol with healthy food, meditation, or working out, they will get back to enjoying life without the substance they desire, and they will have a lesser chance to turn to that drug. Why get high and sit in your room doing absolutely nothing – wasting the day away – when they can get a runner’s high or get out and about doing things they love? I feel like addiction starts or continues to progress in some cases because of general boredom. It is important to show the client the world does not revolve around their addiction; they can be happy without it. Complimentary modalities have been defined as treatment techniques whose goals are to evoke healing by taking into account the body-mind-spirit connection of every individual. A form of complementary treatment that I particularly like is Ecotherapy. “Ecotherapy is an approach that rests on the idea that people have a deep connection to their environment and to the earth itself. In this same line of thinking, failing to nurture this connection can take a toll on your well-being, particularly your mental health.” (Google, 1) I believe Ecotherapy could help someone who is struggling with addiction in many ways. If they get a craving, instead of turning to their drug of choice, they turn to exercise or meditation. Exercise alone can improve sleep and other aspects of physical health in addition to having a positive impact on mental health. “When you spend time in a natural environment, you’re more likely to use your senses to experience your surroundings. Calming sounds, like birds chirping or the rustling of leaves, can help you detach from traffic, work conflict, and ordinary stressors of everyday life. Turning your attention toward the scenery can also help you practice focusing on the present instead of mentally cycling through worrisome thoughts. By spending more time in nature, you might even unintentionally build a mindfulness habit.” (Raypole) There is no downside to this complementary form of treatment! I believe combining person-centered, complementary treatments that go at the client’s pace factoring in trauma from one’s past, and being well educated in prevention research would be the best new modality for treatment. Citations: Person Centered Therapy Techniques. teletherapy software. (n.d.). https://www.theraplatform.com/blog/338/person-centered-therapytechniques. Google search. (n.d.). Retrieved April 06, 2021, from https://www.google.com/search?q=ecotherapy&rlz=1C5CHFA_enUS75 3US753&oq=ecotherapy&aqs=chrome.0.0i355j46j0l8.1104j0j4&sourceid=ch rome&ie=UTF-8 Capuzzi, D., & Stauffer, M. D. (2019). Foundations of addictions counseling (4th ed.). Boston, MA: Pearson. Maté, G. (2010). In the realm of hungry ghosts: Close encounters with addiction. Berkeley, CA: North Atlantic Books. Raypole, C. (2020, August 31). Ecotherapy and the Healing Power of Nature. Retrieved April 05, 2021, from https://www.healthline.com/health/mentalhealth/ecotherapy#evidence less
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