Addiction Counselor Exam Review
Models of Treatment
Objectives
Models of Treatment
• Psychological (self-medication) Model
• Addiction and mental health issues result from deficits in learning, thinking or emotion regulation
• Treatments
• Behavioral self-control
• Individual and group counseling (Multiple EBPs)
• Pharmacotherapy for mental health issues
Psychological: Behavioral Self Control
• Goals
• Strengthen internal mechanisms (self-awareness)
• Establish external controls
• Coping skills
• Goal setting
• Behavioral contracting (What would you contract for?)
• Trigger management (What are MH triggers)
• Functional Analysis (of behaviors NOT diagnosis)
• Relapse prevention (What are relapse prevention strategies for MH? Addiction?)
Psychological: Psychotherapeutic
• Dialectical Behavior Therapy
• Why
• Clients unintentionally rewarded ineffective treatment while punishing their therapists for effective therapy.
• The sheer volume and severity of problems presented by clients made it impossible to use the standard CBT format.
• Clients found the focus on change inherent to CBT invalidating. (How might this be true in addiction?)
• Clients felt their suffering was being underestimated, and therapists were overestimating their helpfulness
• “You are doing it, or feeling incorrectly.”
Psychological: Psychotherapeutic
• Dialectical Behavior Therapy
• Over Riding Themes
• Mindfulness (wise mind)
• Distress tolerance
• Emotion regulation
• Interpersonal effectiveness & problem solving
Psychological: Psychotherapeutic
• Matrix Model for Stimulant Use
• A 45 session treatment program
• Goals:
• Learn about issues critical to addiction and relapse
• Receive direction and support from a trained therapist
• Become familiar with self-help programs.
• The therapist functions simultaneously as teacher and coach, fostering a positive, encouraging relationship
Psychological: Psychotherapeutic
• Motivational Enhancement Therapy
• Helps resolve ambivalence about treatment & abstinence
• This therapy consists of:
• Initial assessment battery
• Followed by 2-4 individual sessions with a therapist
Psychological: Psychotherapeutic
• Motivational Enhancement Therapy
• This therapy consists of (cont…):
• First treatment session (FRAMES)
• Feedback about the initial assessment
• Responsibility
• Elicits self-motivational statements
• Strengthens motivation and builds a plan for change
• Advice: Coping strategies for high-risk situations are suggested
Psychological: Psychotherapeutic
• Motivational Enhancement Therapy
• This therapy consists of (cont…):
• First treatment session
• Menu of Options
• Empathy
• Self-Efficacy
• Subsequent sessions: therapist monitors change, reviews change strategies being used, encourages change
Psychological: Psychotherapeutic
• Family Behavior Therapy (FBT)
• Demonstrated positive results in both adults and adolescents
• Addresses not only substance use and mental health problems but other co-occurring issues (i.e. conduct disorders, child mistreatment, family conflict, and unemployment)
• FBT involves the patient along with at least one significant other such as a cohabiting partner or a parent
Psychological: Psychotherapeutic
• Family Behavior Therapy (FBT)
• FBT combines behavioral contracting with contingency management.
• Therapists seek to engage families in applying the behavioral strategies taught in sessions and in acquiring new skills to improve the home environment.
• Seeking Safety
• Present-focused therapy for trauma/