In extreme cases, the separation may be due to the substance-related death of the parent from overdose, motor vehicle accident, or medical complications due to substance abuse. The significant increase in out-of-home child placements in the 1980s and 1990s closely paralleled the pandemic drug addiction in the United States during those decades (Jaudes & Edwo, 1997). Any long-term separation will have a negative impact on the child’s ability to attach, regulate affect, and can lead to a trauma response of numbing or hyperarousal (inability to discriminate and respond appropriately to stimulus). These impairments in the psychological emergency response system are directly related to, and substantially increase, subsequent traumatic victimization. Maltreated children of parents with a SUD are more likely to have poorer physical, intellectual, social, and emotional outcomes and are at greater risk of developing substance abuse problems themselves (USDHHS, 2003). Homeostasis refers to the idea that it is the tendency of a system to seek stability and equilibrium (Brown & Christensen, 1986).
- However, other family-focused mutual-aid groups are available in some areas and online, including Families Anonymous and SMART Recovery Family and Friends.
- Of course, applying addiction theories to clinical practice is not without its challenges.
- Substantial empirical support indicates that TSF treatment is at least as effective in contributing to abstinence and other positive alcohol-related outcomes as MET or CBT (Babor and Del Boca, 2003; Ouimette et al., 1997).
- Unlike food cravings, food addiction includes the loss of control of eating behaviours and consistent excess food consumption, which is the definition of addiction.
A Less Structured Approach
CBT and alternative treatments that do not explicitly focus on teaching coping skills (such as MET, TSF, and interaction-focused group treatment) tend to be equally effective in increasing self-efficacy and alcohol-specific and general coping skills (e.g., see Litt et al., 2003). For example, Sober living home in the Marijuana Treatment Project, a combined CBT and MET intervention devoted five sessions to teaching coping skills, but was no better at improving coping than was MET alone. Although it is usually presumed that better coping skills increase self-efficacy, MET may work by enhancing self-efficacy, which contributes to an increase in coping skills (Litt et al., 2005).
Animal-Assisted Therapy for Addiction Treatment
- Organized inpatient and partial hospital treatment programs may use systems of rewards and penalties, called contingency management techniques, to reinforce appropriate client behaviors.
- It is not necessarily the responsibility of the leader to resolve these blocks, or even to point them out to group members, but to ensure that such struggles do not hinder the development of the group or any member of the group.
- Most families in MDFT studies have been from low-income, inner-city communities; adolescents in these studies have ranged from youth in early adolescence who are at high risk to older adolescents with multiple problems, juvenile justice involvement, and co-occurring SUDs and mental disorders.
- Additionally, problemsolving groups are directed from a cognitive—behavioral framework.
- The process of learning and incorporating new skills, however, may be difficult, especially if the previous approach has been used for a long time.
- Developing and maintaining relationships with providers in the counselor’s area can help them develop strong connections in the community as well as learn about opportunities in the community to support health and wellness for individuals in recovery from substance use–related problems.
MI has been used in counseling for a wide variety of SUDs, smoking cessation, gambling disorder, eating disorders, anxiety, depression, co-occurring disorders (CODs), and medication and treatment adherence. The Recovery Environment Risk Index (RERI) provides a broader model that focuses on risk factors in patients’ recovery environment. The RERI is able to predict the likelihood of post-treatment substance use and substance-related problems. Counselors could use this type of integrated measure to regularly assess the recovery environment and shape interventions to address areas in which key resources are lacking.
Overview of Family-Based SUD Treatment Methods
The importance of adolescence in the development of both attachment and SUD calls for early interventions designed for this age group. Among other things, this will need a family systems framework Lewis (in this Frontiers Research Topic). Family treatments give a chance to treat attachment-related disorders in the context in which they have developed. Family therapy approaches for adolescent substance abusers are among the best evaluated treatments (83, 84). To date, there are two explicitly attachment-based approaches, attachment-based family therapy (85) and mentalization-based family therapy (MBFT) (86). Although neither of these focuses on SUDs, it seems possible to integrate attachment-focused work into family therapy approaches for SUDs (87).
Cognitive theories: maladaptive thinking patterns 🔗
In the following sections, a review of literature focuses on the associations between the protective resources that flow from these social processes and remission from substance use disorders. Understanding what motivates people to drink abusively involves knowing their drinking behaviors and patterns and their perceptions, or cognitions, about themselves and about alcohol. Cognitive-behavioral psychology incorporates all of these elements, expanding the basis of traditional behavior theory beyond an exclusive focus on observable behaviors to include thoughts and emotions. Although it has broadened the scope of behavior theory, this perspective still employs many behavioral techniques to help clients who have psychological problems to change. As applied to alcoholism,1 the cognitive-behavioral approach (see box; Kazdin 1982) views the etiology and persistence of pathological drinking as learned behavior (discussed below) and has led to the application of learning-based clinical methods to alcoholism treatment.
- Alongside what we now know of the neurological processes involved in addiction and their links to social affiliative systems, this justifies the need for an attachment approach to such family-based treatments.
- In some cases, addiction may develop because the person feels compelled to conform to the behaviors of their peers or cultural group.
- Outlined below are steps counselors can take to help clients receive healthcare services that meet their personal needs.
- Conversely, research consistently shows that parental monitoring and parent-child communication about substance use reduces the risk of early initiation of substance use and lowers rates of adolescent substance use (Hernandez, Rodriguez, & Spirito, 2015).
This stage takes place in the basal ganglia, a part of the brain that contains the caudate nucleus, putamen, and globus pallidus. It is also in charge of a person’s involuntary behaviours, such as tremors (Cleveland Clinic, 2022). The importance of a multifaceted approach to understanding addiction cannot be overstated. Just as a diamond’s beauty lies in its many facets, the true nature of addiction reveals itself only when viewed from multiple angles. Peer cluster theory focuses on the influence of social groups, particularly in adolescence. It’s like being caught in a riptide – the pull of peer pressure can sweep even the strongest swimmers into dangerous waters.
HSSR Studies
Practice should include a wide variety of role-play scenarios to broaden the skills’ applicability. Likewise, homework assignments may be given to foster use of the skills in real-life situations. Frequent reviews of previously taught skills will enhance the clients’ mastery and help to counter problems they may have in retaining the skills.
Carter and McGoldrick (1989) identify eight stages of the family life cycle and corresponding developmental tasks. SUDs can disrupt these developmental tasks depending on who has the SUD and at what developmental stage the family is in when the SUD develops. Table 1 substance abuse counseling definition is an adaptation of Carter and McGoldrick’s family life cycle stages as applied to families with SUDs. When families do not move through the life cycle and get stuck, individual members can exhibit clinical symptoms. It should be noted that blended families with stepparents and stepchildren have their own developmental needs that are impaired by SUDs as well, but those are not detailed in this table.
