Complications to the Treatment Process. Dual Diagnosis. Hagedorn 5/13/2008 MHS The definition: clients with both disorders The challenges

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1 Process Addictions & the Dually Diagnosed Complications to the Treatment Process W. Bryce Hagedorn, PhD, LMHC, NCC, MAC Dual Diagnosis The definition: clients with both disorders The challenges It is VERY difficult to tease out the dual disorders why is this? The What reasons might someone have to not disclose Medication non compliance Dual Diagnosis Impacts on: The economy $300 billion Treatment Re hospitalization rates higher Considerations Treating both disorders simultaneously Screening, assessment, treatment planning Lack of specialty programs MHS

2 The Definition Process Addiction? What is that? Similar physiological responses in the brain Can anything become an addiction? Difficulties Many behaviors are by society Lack of diagnostic criteria Why is this Important? The connection between these behaviors and academic performance/problems The connection between addictions The new Shame/guilt leads to chemical use (to medicate ) Diagnostic Criteria Tolerance Withdrawal Greater quantity or intensity than intended Unsuccessful attempts at Time spent (preparing, engaging, recovering) Loss in other Continued despite significant consequences Elements of: Use as an escape Illegal activities MHS

3 Food Addiction Obesity, Anorexia or Bulimia million affected Obsessive with food, weight, calories, etc. Individuals id may experience Difficulties distinguishing between feelings/hunger Difficulties describing and labeling feelings The relationship represses: anxiety, depression, low self esteem, social anxiety, passivity Probability of recovery % Addiction to Gambling million affected Consequences: Loss of family, decreased self esteem, incarceration, loss of job, expulsion, li depression, suicidal iidlideation i (SI) Withdrawal results in restlessness and irritability Gamble to and relieve stress Sexual Addiction Sexually related, compulsive behaviors that and cause severe stress Individuals learn to rely on sex for comfort from pain, for nurturing, or to relievestress million affected Three levels compulsive masturbation, pornography, multiple sexual partners exhibitionism or voyeurism sexual acts that are abusive to others MHS

4 Addiction to Spending that becomes a primary response to negative events or feelings The purchase on credit mentality Common feelings: depression, anxiety, frustration, and low self esteem Possible consequences: financial destruction of the individual or their family, Addiction to Exercise Exercise encompasses thoughts and moods and Predispositions low self esteem, body dissatisfaction and eating disorders Individuals often Lie about their exercise patterns Disregard Experience withdrawal symptoms (anxiety, irritation, and depression) Internet Addiction million people addicted Addictions that co occur with this disorder include spending, gambling, and sexuality The Triple A Engine Includes elements of tolerance, withdrawal, craving, and negative life consequences MHS

5 Other Process Addictions Video Games Religion Tl Television ii Work Relationships Shoplifting Unique Qualities of Process Addictions Diagnosis DSM IV criteria Clinical criteria Does labeling help or hinder treatment? Holistic and concurrent treatment Critiques of Process Addictions These disorders are extensions of current DSM IV disorders and do not need new classifications The moral model: individuals to engage in these behaviors : labeling these diseases as addictions diminishes the disease model MHS

6 Proponents of Process Addictions These behaviors meet the when measured by DSM IV standards for these behaviors suggest they are as serious as AOD dependence An increase in focus and research on these problems may reduce stigma and provide a framework for treatment The $100,000 Question Does addiction to these processes predict future chemical addiction? Co morbid evidence Recovery evidence What is happening with today s youth? But is there something even deeper? Core addictions Addictions to Crisis and Chaos Emotions Addictions to Controlling people and events Addictions to Co dependency, people pleasing Suffering for others MHS

7 Prevention and Treatment Should have similar goals as AOD: ID behaviors and goals,, follow up and relapse prevention Focus on connection between client s inability to regulate tension and pattern of discharging tension through unwanted behavior, group and individual therapy whenever possible Encourage attendance Future Implications The connection between addictions Internet and Sexual Addiction Impacts on communication Impacts on offender rates Impacts on divorce rates Eating and Exercise Addictions SIBs and Chemical Addictions Counseling will need to include a thorough assessment for process addictions MHS