Theories on Counseling FINAL EXAM ADDICTIONS and EATING DISORDERS

Any non-food chemical substance that, upon entering the body, alters the way the mind and/or body functions.

Denial.”

“dysfunctional thinking.”

Genetic Inheritability, Set Point, Social Learning, Behavioral, and Biospychosocial.

Emerged in late 1980s, sees addiction as a complex, progressive behavior having biological, psychological, sociological, and behavioral components. These systems interact in development and treatment of addictive behaviors. This model provides metatheoretical framework that assumes total addictive experience emerges from web of interrelated and interdependent agents, including biological, pharmacological, psychological, situational, and social components.

STAGE 1:Evaluation: members of the treatment team meet with client to assess and make recommendations with regard to client’s needs.
STAGE 2: Goal setting: treatment team meets and recommendations made to client’s case manager (who is usually chemical counselor). Client, family, others client interacts with, can participate in treatment planning meeting, free to make recommendations. From this meeting recommended/appropriate treatment plan is agreed upon by team.
STAGE 3:Developing a formal treatment plan: Case manager and client enter this stage together. Treatment plan includes (a) identification of specific problem areas (medical, psychological, social, recreational, and spiritual); (b) outline of behavioral objectives, short- and long-term; (3) established of ways to measure progress; (e) setting of target dates for each goal.:

Belief that substance use and abuse arises from history of observing and partaking in addictive behaviors. Behavior increases in frequency, duration, and intensity for the perceived psychological benefits it offers. For some, drinking can be part of growing up in a culture where social influence of family and peers shape beliefs, behavior, expectations. Use and abuse are acquired behaviors maintained by reinforcement, modeling, conditioning, responding, expectations about alcohol effects, and physical dependence.

Body has a number of “thermostats” to keep it running smoothly and work to protect the body (i.e., weight set point—drop below it, metabolism slows, appetite increases). Individuals have different set points that determine their vulnerability to drugs or alcohol. Some break down toxins more efficiently than others. Small amounts of a drug or alcohol in someone with low set point can put that person on path to addiction.

CENAPS (Center for Applied Sciences) based on biopsychosocial model of addictive disease. Chemical addiction causes brain dysfunction that disorganizes personality and causes social and occupational problems. Total abstinence as well as personality and lifestyle changes are essential for recovery.

Principle 1: Self-regulation Procedure: Stabilization through Detox. Five-day “dry-out” and 28-day Detox, established daily structure for client. Diet, exercise, stress management, medical intervention, counseling, meetings (NA or AA), etc. Principle 2: Understanding recovery relapse stages Procedure A: Self-assessment with increasing awareness of recovery process, including warning signs of relapse and high-risk situations. Procedure B: Relapse education sessions to offer information about recovery, relapse, and prevention planning. Principle 3: Identification of relapse warning signs Procedure: general description of warning signs put on emergency sobriety card. Principle 4: Management of relapse warning signs Procedure: warning signs management through mental rehearsal, role play, and therapeutic assignments. Principle 5: Recovery Plan Procedure: Develop recovery plan including warnings, small steps, family time, diet, exercise, AA/NA meetings, counseling, hobbies, journaling, management methods, sobriety cards. Principle 6: Daily Inventory Procedure: Take things one day at a time and keep a log of how the plan is working; at end of day, review progress discuss results, troubleshoot the day. Principle 7: Significant other/family involvement Procedure: Loved ones are brought into treatment when appropriate. Services and education provided. Principle 8: Relapse prevention plan update Procedure: Relapse most likely to occur within first 6 months. Follow up after initial care to update treatment plan. Principle 9: Thinking in principles Procedure: requires identification of core issues and mistaken beliefs that create irrational thinking, unmanageable feelings, and self-destructive behavior that result in dysfunction during recovery.

Sesssion 1: understand the relapse process Session 2and3:Identifying/handling high-risk situations Session 4: Identifying/handling urges or cravings Session 5: Identifying/handling social pressure Session 6: Anger management Session 7: Handling boredom and using leisure time Session 8: Stopping actual relapse

Pathological gamblers go through seven stages, three to addiction, and four to recovery. Pre-gambler is not yet a compulsive gambler but has potential characteristics (such as hopelessness, boredom, low self-esteem).

STAGE 1:gambling is sporadic, with some positive rewards, done for “fun.” Usually designate a particular amount of money. May get positive feedback from friends/family who shares in “good luck.” Losses are tolerable when compared to winnings. They believe they have everything under control.STAGE 2: Begins when gambler increases the amount and frequency of gambling, gambles compulsively. Losses outstrip winnings, family becomes worried. Gambler starts lying, loses trust of family. Gambler

• Experiences prolonged losing episodes
• Thinks continually about gambling
• Tries to cover up gambling
• Gets into heavy legal and illegal borrowing
• Turns to friends and family members for bailouts, to get money for more gambling
• Experiences personality change, anxiety over losing, excitement over abnormal belief in luck

1. STAGE 3: Main focus is coming up with money to support gambling habit. Gambling has taken over, is out of control. Person is angry, depressed, frustrated, and afraid. Gambling is fundamental concern.

STAGE 4:Gambler recognizes destructive behavior and makes decision to regain control of her life. Admits to addiction, often happens after hitting “rock bottom.” Wants to stop.
STAGE 5: Gambler reaches out to friends, family, or therapy. Learns about compulsive gambling, how to watch for signs of relapse, work on self-esteem, hopelessness (pre-gambling characteristics), friends/family educated about the compulsion via Gamblers Anonymous.
STAGE 6: Putting into practice everything learned in stage 5. Recognizes signs and triggers, has a support system, has coping skills.
STAGE 7: New “quality of life” attained, without gambling compulsion. Person will have to continue working on issues of pre-gambling phase, and continue revisiting last three stages (“cycle of health”) to ensure they do not relapse.

1. Action gamblers are addicted to the thrill of risk-taking. Gambling itself is their “drug.” They usually gamble with others, since part of the rush is beating the house or other gamblers. Action gamblers usually prefer games of skill, such as card games, craps, and sports betting. They may also play the stock market. 2. Escape gamblers gamble to escape emotional pain, worries, and loneliness. Rather than gambling to feel a rush, they gamble to feel numb. Escape gamblers prefer more isolated activities such as slot machines, bingo, and online poker. They also prefer games that don’t require much thought, so they can “zone out.”

1) characterized by a prolonged refusal to eat, resulting in severe weight loss.
1A) relies of self-starvation for weight loss
1B) fluctuates between binging and starving
2) Binge eating followed by purging, by laxatives or self-induced vomiting
3) Downy hair on face, arms, and back