Etiological Theories and a Special Bonus

Transcription

1 Etiological Theories and a Special Bonus W. Bryce Hagedorn, PhD, LMHC, NCC, MAC Moral Model the result of and moral degradation [that] can be cured with willpower and a desire to abstain Be prepared to that the cause is ALL about choice/moral weakness The power of personal choice (from this point forward) The necessity for addressing during treatment Physiological Model Also called the Disease and/or Medical Model Genetic Predisposition Theory (twin studies, human genome project, allergic reactions) Serotonergic/opioidergicpathway g p y( (related to pain regulation) Mesolimbic dopamine pathway (related to pleasurable sensations) Monoamine oxidase (MAO) levels (degeneration of dopamine and serotonin) Most prevalent in the 12 step ( ) and Medical ( & ) communities Has been used to conceptualize other s MHS

2 Physiological Model Its not about advocating responsibility Two key features: and Inability to abstain Whereas there was a choice at the beginning, now its more than just not using (an illness doesn t just go away ) Primary Progressive Prolonged Potentially Fatal Positively Treatable Treating it like any other (6 P s) intentionality Integrate the Addictive Cycle discussion Psychological Model Conscious and unconscious processes that lead to the escape of existential suffering Behavioral models AOD/behavior use will reach addictive levels if they are positively or negatively Reasons that sustain behavior: attention, avoidance, tangible reward, and sensory stimulation Self medicative hypothesis using chemicals/behaviors to out (escape/self medicate pain) Co morbid psychiatric disorders (dual diagnosis) Addictive personality Once an addict, always an addict (switching addictions) Self versus the Addict : a split and adversarial relationship Stunted Psychological Model Clients and families often grasp these principles easily A B C triggering emotions, events, or interactions used to cope with the event (e.g., ingestion of a chemical, placing a bet on a game, looking at pornography) a pleasurable/encouraging reinforcement (e.g., the individual gets high ) or an avoidant reinforcement (a reduction in pain, tension, or stress) With time, the motivating factor of pleasure decreases while the motivating factor of pain reduction (e.g., dealing with withdrawal symptoms or alleviating frustrating relationship issues) increases Relapse Triggers Lecture MHS

3 Environmental Models Sociological Theory interaction between human behavior and the environment. availability of substances, lack of social restraint, and the presence of role strain/transition Socio Cultural Theory the impact of culture (broadly defined); social feedback mechanism Social Learning Theory addiction occurs as an interaction between: Observing Maintaining attractive and reinforced behaviors Choosing actions that best fit one s needs Environmental stressors Environmental Models Addictive disorders rarely develop Clients can identify their environmental influences Helps in recognizing that the is (acceptance of powerlessness) Investigate the role of people, places, and things Which people do/don t support your recovery? Identify potential Role play methods to defuse social pressures Bio Psycho Social Spiritual Model A way to bring together earlier discussions related to Physiological Theory, Psychological Theory, and the role of the environment Spirituality is impacted by, and can be used in the recovery from, an A disorder resulting from failed attempts at (meaning and connectedness) Substances/behaviors provide temporary feelings of wholeness and fulfillment Spirituality is effective in preventing addictions and is a protective factor in alleviating cravings/risk taking Spirituality is connected to MHS

4 Bio Psycho Social Spiritual Model the physical aspects that have impacted/been impacted by the the psychological troubles that preempted/are exacerbated by the key relationships that have influenced/been influenced by the the spiritual practices (or lack thereof) that have an impact on the recovery process A focus on creative combinations of meaningful wellness (with periodic evaluation) The approach to recovery Other Models Characterological Model addictions develop as a consequence of personality abnormalities Model addictions exist due to the availability of addictive substances Conditioning Model addictions arelearned, therefore counter conditioning is necessary Public Health Model addictions result from an interaction between an agent, a host, and the environment Model addictions result from a lack of information Other Models Theory (FCP) The end of the path (addiction) can be reached through multiple combinations of unique circumstances Unlike the bio psycho social spiritual model, addiction can result solely fromoneone factor, a combination ofthree factors, or even an interaction of five or more factors Helps explain why s of race, culture, gender, socioeconomic background, family constellation, psychological disposition, and/or spiritual practice MHS

5 Conclusions Unlike the need for intentionality in the application of treatment models, discussions of etiological models can Move from one theory to another to determine which pathway y each client s unique circumstances Ask clients/families which theory best helps them to understand Whereas a guiding theory is crucial to developing prevention efforts and in guiding empirical research When it comes to clinical practice, each theory has merit and value: the value lies in how effectively it MHS