Levy family – Assessing Clients With Addictive Disorders

To prepare:

  • Review this week’s Learning Resources and consider the insights they provide.
  • Review the Levy Family video Episodes 1 through 5.

The Levy family – Assessing Clients With Addictive Disorders  Assignment

In a 2- to 3-page paper, address the following:

  • After watching Episode 1, describe:
    • What is Mr. Levy’s perception of the problem?
    • What is Mrs. Levy’s perception of the problem?
    • What can be some of the implications of the problem on the family as a whole?
  • After watching Episode 2, describe:
    • What did you think of Mr. Levy’s social worker’s ideas?
    • What were your thoughts of her supervisor’s questions about her suggested therapies and his advice to Mr. Levy’s supervisor?
  • After watching Episode 3, discuss the following:
    • What were your thoughts about the way Mr. Levy’s therapist responded to what Mr. Levy had to say?
    • What were your impressions of how the therapist worked with Mr. Levy? What did you think about the therapy session as a whole?
    • Informed by your knowledge of pathophysiology, explain the physiology of deep breathing (a common technique that we use in helping clients to manage anxiety). Explain how changing breathing mechanics can alter blood chemistry.
    • Describe the therapeutic approach his therapist selected. Would you use exposure therapy with Mr. Levy? Why or why not? What evidence exists to support the use of exposure therapy (or the therapeutic approach you would consider if you disagree with exposure therapy)?
  • In Episode 4, Mr. Levy tells a very difficult story about Kurt, his platoon officer.
    • Discuss how you would have responded to this revelation.
    • Describe how this information would inform your therapeutic approach. What would you say/do next?
  • In Episode 5, Mr. Levy’s therapist is having issues with his story.
    • Imagine that you were providing supervision to this therapist, how would you respond to her concerns?
  • Support your approach with evidence-based literature.

Transcript of video Levy Family:

Episode 1

Program Transcript

[MUSIC PLAYING]

FEMALE SPEAKER: You‘re not dressedYou‘re going to be late for work.

MALE SPEAKER: I‘m not going to work. I‘m sick.

FEMALE SPEAKER: Of course you‘re sick. You‘re hungover. I don’t want the boys to see you like this. Go back to bed.

MALE SPEAKER: See me like what? I told youI’m sick.

FEMALE SPEAKER: Well, what do you call it when someone is sick almost every morning, because they drink every night while they sit in the dark watching TV?

MALE SPEAKER: You calling me a drunk?

FEMALE SPEAKER: What do you call it?

MALE SPEAKER: I call it, leave me the hell alone.

FEMALE SPEAKER: Baby, you need to stop this. It’s tearing us up. The drinking, the anger– you’re depressed.

MALE SPEAKER: You said, for better or worse.

FEMALE SPEAKER: My vows don’t cover this. You were never like this before.

You’ve changed. I want us back, the way we used to be.

MALE SPEAKER: That way is dead. It died when I went to Iraq

Levy Family: Episode 2

Program Transcript

FEMALE SPEAKER: I want to thank you for getting me this Levy case. I think it’s so interesting. Just can’t wait to meet with the client.

MALE SPEAKER: What do you find interesting about it?

FEMALE SPEAKER: Well, he’s just 31. Usually the vets I work with are older. If they have PTSD, it’s from traumas a long time ago. But Jake, this is all pretty new to him. He just left Iraq a year ago. You know, I was thinking he’d be perfect for one of those newer treatment options, art therapy, meditation, yoga, something like that.

MALE SPEAKER: Why?

FEMALE SPEAKER: Well, I’ve been dying to try one of them. I’ve read a lot of good things. Why? What are you thinking?

MALE SPEAKER: I’m thinkingyou should really think about it some more. Think about your priorities. It’s a good idea to be open-minded about treatment options, but the needs of the client have to come first, not just some treatment that you or I might be interested in.

FEMALE SPEAKER: I mean, Iwasn’t saying it like that. I always think of my clients first.

MALE SPEAKER: OK. But you mentioned meditation, yoga, art therapy. Have youseen any research or data that measures how effective they are in treatment?

FEMALE SPEAKER: No.

MALE SPEAKER: Neither have I. There may be good research out there, and maybe one or two of the treatments that you mentioned might be really good ideas. I just want to point out that you should meet your client first, meet Jake before you make any decisions about how to address his issues. Make sense?

FEMALE SPEAKER: Yeah.

Levy Family: Episode 2

Additional Content Attribution

© 2016 Laureate Education, Inc.

 Levy Family: Episode 3

Program Transcript

JAKE LEVY: We’d be out on recon in our Humvees, and it would get so hot. We used to put our water bottles in wet socks and hang them right outside the window just so the water would cool off of a bit, and maybe then you could drink it.

Man, it was cramped in there. You’d be drenched, nowhere to breathe. It’s like riding around in an oven. And you’d have your helmet on you, 100 pounds of gear and ammo. I swear, sometimes I feel like it’s still on me, like it’s all still strapped on me.

FEMALE SPEAKER: How many tours did you do in Iraq?

JAKE LEVY: Three. After that last recon, I just– There were 26 of us. Five marines in the Humvee I was in. I remember I was wearing my night vision goggles. We passed through a village and everything was green, like I was in a dream or under water. And then there was a flash, bright light just blinded me. There was this explosion. Ican’t– Ican’t–

FEMALE SPEAKER: It’s OK, Jake. Take it easy. I understand this is difficult.

There’s something I;d like to try with you. It’s called exposure therapy, and it’s a treatment that’s used a lot with war veterans, especially those struggling with anxiety and PTSD.

JAKE LEVY: Exposure therapy?

FEMALE SPEAKER: Yes. It’s to help someone like yourself to confront your feelings and anxieties about a traumatic situation that you’ve experienced. It’s a– It’s meant to help you get more control of your thoughts, to make sense of what’s happened, and to not be so afraid of your memories.

JAKE LEVY: Put that in a bottle and I’ll buy 10 cases of it.

FEMALE SPEAKER: Well, one part of it is learning to control your breathing. And when you practice that, you can learn to manage your anxiety, to get more control of it, not let it control you, to protect yourself. Do you want to try it?

JAKE LEVY: Right now?

FEMALE SPEAKER: Sure.

JAKE LEVY: Why not?

Levy Family: Episode 3

FEMALE SPEAKER: OK. Well, I know this sounds crazy, but a lot of people don’t breathe properly. And it really comes from bad habits. When they inhale and exhale, all the effort is here in their chest and shoulders. And the problem with that is you get a really short, shallow breath. And that really increases the stress and anxiety in your body.

Instead, a more natural breath should always involve your diaphragm, right here in your abdomen. When you breath in, your belly should expand. And when you breath out, your belly should fall. OKJAKE LEVY: OK.

FEMALE SPEAKER: So, let’s practice. Close your eyes. Now, I want you put one hand on your abdomen and the other across your chest. Good. Good. Now, I just want you to take a few breaths, just like normal. What are you feeling?

JAKE LEVY: I feel my chest moving up and down. But my belly, nothing.

FEMALE SPEAKER: OK. So that’s what I was just talking about. That’s OK. Let’s try this. I want you take a breath. And this time, I only want you to allow your abdomen to expend when you breathe in and to fall when you breathe out.

OK, let’s try it. Breathe in. Breathe out. Breathe in. Breathe out.

You feeling better? More relaxed?

JAKE LEVY: Yes.

FEMALE SPEAKER: And the more you practice it the easier it will become. So when you find that stress and anxiety coming on, just do your breathing. You can keep yourself from getting swept by all those bad thoughts. OK?

JAKE LEVY: Yes. Thank you.

FEMALE SPEAKER: So, do you want to try to go back to what you were telling me about before?

JAKE LEVY: I can try. It was night. We were out on recon. It was my third tour in Iraq

© 2016 Laureate Education, Inc. 1

Levy Family: Episode 5

Program Transcript

FEMALE SPEAKER: It was such an intense story. I just kept seeing things the way he did, you know. The weird green of his night-vision goggles, his sergeant screaming for Jake to kill him. I just keep seeing it all in my head.

[MUSIC PLAYING]

MALE SPEAKER: Why, do you think?

FEMALE SPEAKER: Why what?

MALE SPEAKER: Why do you think you keep thinking about this story, this particular case?

FEMALE SPEAKER: I don’t know, maybe because it’s so vivid. You know, I went home last night, turned on the TV to try to get my mind off it. And a commercial for the Marines came on, and there was all over again– the explosion, the screams, the man dying. Such a nightmare to live with, and he’s got a baby on they way.

MALE SPEAKER: Could that be it, the baby?

FEMALE SPEAKER: Maybe. That’s interesting you say that. I mean, the other vets I work with are older, and they have grown kids. But Jake is different. I just keep picturing him with a newborn. And I guess it scares me. I wonder if he’ll be able to deal with it.

Levy Family: Episode 5

Additional Content Attribution

MUSIC:

Music by Clean Cuts

Substance Abuse Addiction. In Their Own Words

Program Transcript

NICOLE: My name is Nicole. And May 30, I will have five years in recovery.

RICKY: My name is Ricky. I’ve been in recovery for 10 years.

GRETCHEN: My name is Gretchen. And I’ve been in recovery for about three

years.

JASON: Myname’s Jason, and I’ve been in recovery for five months.

ODESSA: My name is Odessa, and I have been in recovery for six years.

SHANE: My name is Shane, and I have 11 years clean.

FEMALE SPEAKER: Six addicts, six remarkable stories of addiction, treatment, and recovery in their own words.

GRETCHEN: My addictions are prescription pain pills and alcohol. I’m a survivor of childhood sexual trauma, so that’s– and my parents are addicts. And my parents always used around me. Their friends always used around me.

I grew up thinking that was normal. I grew up thinking chaos was normal and negative type behaviors. My mother had breast cancer, and my mother has other health issues. And she’s addicted to her pain pills.

I would try and reach out to her for help, and she would just say, you know, go get me a bottle or go getme a beer or go get this. And she would take those pain pills with that alcohol. When you sit there and you watch your mother do that and not help you and not support you and not listen to you, and the whole time I was there I was telling her I needed to get help.

I needed help. I needed counseling. I needed treatment. I needed something. In the worst stage of my addiction, I just kind of went off the deep end with it all. I just realized that I couldn’t handle it anymore and I didn’t know how to fix it. So I just self-medicated and drank, and drank, and drank, and took pills and drank.

And some things happened that just caused me to realize that I was going to die if I didn’t reach for help.

JASON: I snuck into a Casino with a fake ID at 14 and won $1,000 playing Blackjack, and then it was like my whole life went this way. It was like college, that all canwait, because there’s no way I can make this much money. So it was just off to the races from then.

© 2016 Laureate Education, Inc. 1

In Their Own Words

I can remember one time I cashed out my 401k, took out like $30,000, went straight to the casino. Doubled that and didn’t leave. And then lost $40,000.

I think I got the same feeling losing or winning. It was as long asI was gambling. It didn’t matter. It’s the same. It’s the rush. I would go to the casino. And, of course, they’d give me a room for a week or two weeks, whatever I wanted. I would stay there literally. I just wouldn’t go to work.

And of course, no employer’s going to put up with that. I pretty much just lost everything. And I knew it was time to do something.

RICKY: My daddy, when I finished high school, he passed away. So that just, that left me, the oldest son, on the farm. So I had to drop everything. There was a lot of pressure. There was a lot of disappointment, and the only way I could cover that up was by drinking.

NICOLE: My addiction began when I was a child. I was ADHD, always bouncing off the walls. And that’s when I first got my first experience with pills. And I remember that chemical feeling of feeling relaxed, and I liked it. And throughout my adolescence I experimented with marijuana, pills, alcohol, whatever. I had a schedule where I would drink at noon, and then I would drink at 2:00. You know I had this whole schedule of– it was really silly. It’s funny how you have this whole mindset and you can trick yourself. And you’re thinking in addiction is absolutely crazy.

My addiction got really bad. I was in an abusive marriage. I had a heart attack during that time. And anyway, it was just really, really bad. And basically, I just wanted to numb the bad feelings.

ODESSA: Addiction started for me at an early age, probably around eight-years old, nine-years-old. My grandparents made homemade wine, and I would like taste it. So that’s where I think it actually started for me. It started with alcohol, marijuana, and cocaine, and then later crack cocaine. For most of my 20s and 30s, I was an active addict. I could stop for many years and then start back. But every time I would start back, the addiction would get worse and worse.

Once I got to a point in my life where things were falling totally apart. Foreclosure on homes, repo of vehicles, family dynamic totally destroyed, living on the streets, prostituting, doing whatever I had to do to get drugs. That’s when I realized I needed help.

© 2016 Laureate Education, Inc. 2

In Their Own Words

SHANE: I found my drug of choice right out of high school, which was

methamphetamine. When I found my drug of choice, nothing else really mattered

to me. It was just the getting and using and finding ways and means to get more.

Through that period of life I got married a coupletimes, but one thing was clear, I

stayed married to methamphetamine. Ididn’t have the ability to get away from it.

It became a normal part of life for me.

And I called myself being a functioning addict, because Ihad the ability to go to

work. Ihad the ability to be an energetic father, and all these lies I kept telling

myself, because I was able to function in everyday society. That addiction cost

me two marriages. It almost cost me my family. And it pretty much destroyed my

relationship with my kids.

First treatment center I went to they brought a guy by me in a straight jacket, and

I left out after about three hours, because I knew that if I talked to somebody that

they were going to know I was crazy. Because I knew the things that were

happening in my head were not supposed to be in my head. SoI ran. Told them I

needed to get a bag out of the car, and I was gone.

I guess some of the first events that happened to me that allowed me to begin to

open my eyes was, first of all, was a suicide attempt. I had a pistol in the truck,

and Icouldn’t pull the trigger. I had it to the roof my mouth, and I had that blink of

something’s wrong and I need help. I can’t do this on my own. And I want to die. I

just couldn’t do it.

Second glimmer was I had hit– I had gotten arrested. And I can remember laying

there in that jail cell, and looking up at that ceiling, being on suicide watch in a

paper suit, not really thinking the substance was a problem, but thinking that

something was a problem.

I am not meant to be in this cell. Something’s wrong, and I need to get some

help. That time, they released me straight out of jail into treatment. All those

things came flooding back up, and I just wanted to live right back in that denial

again and blame it on everybody else but myself. But that was the start.

The steps that helped me the most from my addictions counselor’s standpoint is

the ability to sit down and talk to me like a human being. I guess I had a definition

of myself when I got to treatment the last time from being in jail and being called

a convict that I was just trash and that I’d never amount to anything.

And thenyou hear all the rumors of when somebody’s an addict, they’re always

an addict. And there’s no help for people like us. That addictions counselor

actually treated me like a human being, and he asked me a point blank question.

What do I want to do with my life?

© 2016 Laureate Education, Inc. 3

 

In Their Own Words

And hereI was a 28-year-old man that didn’t have a clue what he wanted to do

with his life. That was the starting point that hey, this guy wants me to do

something. So maybe I should start thinking about my dreams again.

Everybody had dreams as a child. But I had lost mine somewhere. I had gotten

into this monotonous life of getting high, going to work, that didn’t work anymore.

What was I going to do with my life?

He built me up. He gave me confidence to walk into a 12-step meeting, to walk

into a public place and actually talk.

ODESSA: I had to relapse several times to understand that Icouldn’t do this by

myself. Icouldn’t beat this thing. The first step, I had to admit that I was an

addict. For years, Ididn’t want to accept that, because I had been so productive

for so long.

And the second thing was for me to be able to surrender to something. It’s hard

to surrender to something that youdon’t know anything about. So to be able to

trust someone in recovery was like foreign land to me.

RICKY: If Idon’t do anything about this, I’m going to die. And I had to come out of

this denial stage and realize that. I began to come open-minded to suggestions,

because Iwasn’t living. I was trying to survive. Iwasn’t living.

JASON: The first 30 days, 35 days or so, it was like extensive group therapy

every morning of the week, where you get in groups with a bunch of people,

maybe 10, 15 people with my addiction. We talk about it, talk about what we’re

going through, and what not, what’s on our mind, just whatever, and just be open.

And then you have these classes that you deal with about the addiction. And

then, of course, the meetings at night, 12-step meetings. After the 35 days,

another 60 days of the same thing, but a little bit more freedom, not so intense,

but staying around people in recovery and not just going back out there to where

I came from.

I’ve been in treatment four times. And I’ve always gone back. Gotten out and

gone back to where I came from. It does help to kind of relocate and then be

around people that are trying to do what you’re doing for sure.

Because every time I would go back to that old environment– of course, I’m with

my old friends. They don’t have that problem, but they’re going to do it. And then

here you are getting dragged back into it.

NICOLE: This lady who had been my cousin’s sponsor, her name popped into

my head. And so I called her and I said, Idon’t know what’s going on with me. I

said,I tried to quit drinking.

© 2016 Laureate Education, Inc. 4

 

 

 

In Their Own Words

But I feel like if Idon’t get a drink, I’m going to die. And I know that that means

something is wrong. And she was like, well, I’m going to chair a meeting tonight,

a narcotics anonymous meeting. Why don’t you come?

And I was like, well, Idon’t need a meeting. I’ve never done cocaine or shot

needles in my arms. I don’t need a meeting. And so I got through the afternoon

by the grace of my higher power somehow. And I was throwing up. I was so sick.

And I was like, no, I’m not going. Yes, I’m going to go. No, I’m not going to go.

And finally, I went. And I’ll never forget that day.

And I walked in, and it was full of people. And I’m so scared. And when they did

the readings at the meeting, I was like, it just got chills. And I knew I was home.

GRETCHEN: I would not suggest to anybody to do it the way I did. I would

suggest someone maybe in my position to get medical detox, which I didn’t do. It

could have killed me. But I detoxed at home.

I was very violently ill. And I just kept telling myself, God doesn’t want me to

forget what this feels like. He doesn’t want me to forget this time.

And the people at my church and the people in my meetings, they helped me.

They helped me through it. They helped me to understand that I was going to be

all right and that even though it didn’t seem like that there was going to be a

better day, there was.

And I just reached out to every resource I could find to get information on why I

might be doing the things I was doing or feeling the way I was feeling and what to

do about it. And I’m still doing that, and I’m not going to stop. Nothing stopped me

when I was in my addition, and now, nothing’s going to stop me in my recovery.

JASON: The best program out there for me is the 12-step program. I meet a lot

of people that are coming into the program, and they think once they go to

church and get saved, and all this kind of stuff, they’ll be fine. Which if it works for

them, good. But for me it didn’t, because I wasn’t around those people with the

same problems that I had. So the 12-step program has definitely been the most

beneficial to me.

SHANE: I think the most successful treatment that helped me would be cognitive

behavior. It allowed me to see that the problem wasn’t the problem. It was the

thought about the problem. I would think it, and then all of sudden, it became a

problem, because it would be rethought, and rethought, and rethought before it

becomes this monstrous mountain I can’t get through.

SoI was beginning to see that if I just dealt with my problems as they came

along, they didn’t become these monsters. They were just life. And then of

© 2016 Laureate Education, Inc. 5

 

 

In Their Own Words

course, the motivational interviewing, the being able to sit down right where I am,

and meetme there, and then walk from me there was just amazing to me.

Of course, the 12-steps played a monstrous role. And I continue working the 12

steps today. It is part of the maintenance program that I utilize day in and day

out. Those three things are probably the most powerful things that happened in

my life and some of the things that I’m the biggest proponent of today.

RICKY: Connecting with God, spirituality. When that clicked in, it was on. All of it

began to make sense, all of it. I made that connection. And Idon’t think I would

have made that connection without the 12 steps. Iwouldn’t be sitting here to be

honest with you. It saved my life. Literally, it did. I made that connection with

God.

ODESSA: 12 steps was the most helpful for me. It gave me an outlet. And not

only with people that are just like me, but people that were totally opposite.

People that you could say that youwouldn’t think would be there were there, the

support. They understood.

NICOLE: 12 step was really the only I’ve– I mean it worked. We started a

women’s only group, which has been great, a coupleyears ago. And that’smy

home group. And so I go to a couple a week. I’m always working on step work,

and I will be the rest of my life.

GRETCHEN: I just kind of winged it myself. But that’s dangerous. I realize that

now. I mean I knew I was sick when I was withdrawing. I knew, but I didn’t know

what physically could have happened to me really. I’m here now.

RICKY: The most successful thing that I learned that guarded me against relapse

was seeing the people coming to treatment and realizing that it’s still out there,

bigger than ever, badder than ever. And allI had to do is take that one slip and

that’s it.

JASON: The most successful things I’ve learned to guard myself against relapse

would be like triggers. Certain kinds of music is a trigger for me, as weird as it

sounds. Or definitely talking about it, entertaining glory stories of, man, one time I

went, and I won this amount of money.

Entertaining that thought, and then my blood is flowing, and that becomes my

obsession in my head. So just realizing the fact that I’ll never be able to gamble

again, not keeping that reservation in the back of my mind that, well, maybe one

day if I’ll be able to manage it.

ODESSA: Cravings still come, thoughts of using. Just driving past a place that

you’re familiar with. To be able to pick up the telephone and call someone and

© 2016 Laureate Education, Inc. 6

 

In Their Own Words

tell them about the things that you’re thinking. That was a hard, hard thing for me

to do.

And to ask for help from others, it is was just almost unheard of. But that was the

main thing that helped me to start my road to recovery.

SHANE: Some of the things that I learned in treatment that allowed me to begin

to see what some barriers would be or what would be some walls that I could put

up to stop me from relapsing, of course, was the ability to talk to people. When I

was able to share those sick thoughts, then they dissipated. They would leave

me.

I can remember the very first time I did that with an individual, the first person I

called, my sponsor. And I reached out and I said, here’s the craziness that I’m

thinking, that I could go out and use just one time, that I could be successful with

it this time, or just use on the weekends.

And he said, man, do you know how crazy that sounds. And it hit me. He did. He

knew how crazy that sounds because he had thought the same thing. That

connection was the beginning of being able to trust people again. And that there

were people just like me.

NICOLE: To make a cake you have to have all the ingredients. And if you leave

out one of those ingredients, the cake’s not going to turn out. So to prevent

relapse, you have to have all the ingredients, which is have a sponsor go to

meetings and learn the steps with your sponsor.

GRETCHEN: I’ve watched other people die. I’ve watched other people relapse.

And I came to a place inside of my addiction, where I could have really died. I

knew I was going to. I knew I was. if I didn’t stop it.

And now I’m seeing it happen to other people, and everybody thinks it’s not going

to happened to me. Yes, it happens. It can happen to you. And it scares me. I’m

scared.

But my last relapse, just all the events that took place, really reality hit. And I

became very afraid, and my fear of it seems to keep me, it seems to drive me

towards recovery, more and more every day.

SHANE: I still go to 12-step meetings. I still have a sponsor. I still talk to my

sponsor if not every day, but every other day, because those sick thoughts will

come back. And that beast is waiting on me.

JASON: Man, how am I going to enjoy football or sports without betting on them.

I even told myself for a little while that maybe I’ll do it again one day, but just not

© 2016 Laureate Education, Inc. 7

In Their Own Words

today. I’m going to, just today, I’m not going to think about gambling. I’m not

going to gamble. I’m not going– I’m just going to be.

GRETCHEN: It’s kind of like you’re in a boat with a pale, and you’re throwing the

water out of the boat, and youdon’t want to give your pale to anybody, because

you know you’ll sink. But at the same time, you know you are trying to help others

as well.

Ihave to remember that I’m still in recovery, and I have to take care of me first.

Or I’ll be a disaster, and Iwon’t be able to take care of anybody else.

RICKY: What I do now, I’m an alcohol and drug counselor. It feel good to know

you’re helping others in the same predicament that you were once in. And I’m

going to continue doing that, because I know what it’slike.

SHANE: One of the counselors had a mirror in his office, and he said, go look in

that mirror. And I walked into that mirror. And he said, now, look straight in the

eyes of the person that’s looking at you in that mirror and say, if that’s not the

problem, there is no solution, because Ican’t change anything else but that.

And that scared me. It scared me, because I was the one destroying everybody

around me, including myself. It’s like I was OK with dying. I was afraid of living.

And boy, it impacted so much in my life. It’s one of the things that still draws me

to recovery today.

And I want tear up thinking about it right now, because it’s one of the powerful

things that keeps me going. And that addictions counselor doesn’t know how

much he’s helped me.

NICOLE: An addiction counselor helped me and pushed me to go back to school

and back to college. And I graduated with honors, and I would have never even

tried it if it weren’t for him. And we got married. And he’s my husband today.

ODESSA: For so many years, I only believed in me and what I was incapable of

doing. But no man is an island. And I’ve learned that. And reaching out to others

and working in a 12-step program and being held accountable has made my life

successful. Matter of fact, all the years that I thought I was productive, Iwasn’t at

peace. Today, I’m at peace.

© 2016 Laureate Education, Inc. 8

Week 6: Psychotherapy for Addictive Disorders

“A long-standing debate has roiled over whether addicts have a choice over their behaviors. The disease creates distortions in thinking, feelings, and perceptions, which drive people to behave in ways that are not understandable to others around them. Simply put, addiction is not a choice. Addictive behaviors are a manifestation of the disease, not a cause.”

–Dr. Raju Hajela, former president of the Canadian Society of Addiction Medicine

A common misconception is that addiction is a choice, and addicts are often labeled as individuals who lack morals, willpower, or responsibility. However, addiction is a clinical disorder that must be treated with the support of a health care professional. Although many people who are exposed to potentially addictive substances and behaviors continue life unaltered by their experiences, some people are fueled by these experiences and spiral out of control. In your role as the psychiatric mental health nurse practitioner, you must be prepared to not only work with these individuals who struggle with addiction, but also help them and their families overcome the social stigmas associated with addictive behavior.

This week, as you explore psychotherapy for addiction, you assess clients presenting with addictive disorders. You also examine therapies for treating these clients and consider potential outcomes. Finally, you develop diagnoses for clients receiving psychotherapy and consider legal and ethical implications of counseling these clients.

Learning Resources

Required Readings

Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.

  • Chapter 7, “Motivational Interviewing” (pp. 299–312)
  • Chapter 16, “Psychotherapeutic Approaches for Addictions and Related Disorders” (pp. 565–596)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders(5th ed.). Washington, DC: Author.

Note: You will access this text from the Walden Library databases.

Albrecht, U., Kirschner, N. E., & Grusser, S. M. (2007). Diagnostic instruments for behavioral addiction: An overview. German Medical Science Psycho-Social-Medicine, 4, 1–11. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2736529/

Fisher, M. A. (2016). The ethical ABCs of conditional confidentiality. In Confidentiality limits in psychotherapy: Ethics checklists for mental health professionals (pp. 13–25). Washington, DC: American Psychological Association. doi:10.1037/14860-002

Walden University. (2016). ASC success strategies: Studying for and taking a test. Retrieved from http://academicguides.waldenu.edu/ASCsuccess/ASCtesting

Required Media

Laureate Education (Producer). (2013c). Levy family: Episodes 1 [Video file]. Baltimore, MD: Author.

Note: The approximate length of this media piece is 2 minutes.Laureate Education (Producer). (2013c). Levy family: Episodes 2 [Video file]. Baltimore, MD: Author.

Note: The approximate length of this media piece is 2 minutes.

Laureate Education (Producer). (2013c). Levy family: Episodes 3 [Video file]. Baltimore, MD: Author.

Note: The approximate length of this media piece is 6 minutes.

Laureate Education (Producer). (2013c). Levy family: Episodes 4 [Video file]. Baltimore, MD: Author.

 

Note: The approximate length of this media piece is 5 minutes.

Laureate Education (Producer). (2013c). Levy family: Episodes 5 [Video file]. Baltimore, MD: Author.

 

Note: The approximate length of this media piece is 2 minutes.

 

Laureate Education (Producer). (2012c). In their own words [Video file]. Baltimore, MD: Author.

 

Note: The approximate length of this media piece is 23 minutes.

 

Dronen, S. O. (2012). New research about Facebook addiction. Retrieved from http://www.uib.no/en/news/36380/new-research-about-facebook-addiction

Substance Abuse and Mental Health Services Administration. (2005). Substance abuse treatment for adults in the criminal justice system. Treatment Improvement Protocol (TIP) Series 44. Rockville, MD: Author. Retrieved from http://store.samhsa.gov/shin/content//SMA13-4056/SMA13-4056.pdf

Substance Abuse and Mental Health Services Administration. (2007). Problem gambling toolkit. Retrieved from http://store.samhsa.gov/product/Problem-Gambling-Toolkit/PGKIT-07

Substance Abuse and Mental Health Services Administration. (2013). Substance abuse treatment for persons with co-occurring disorders: A treatment improvement protocol. Treatment Improvement Protocol (TIP) Series 42. Rockville, MD: Author. Retrieved from http://store.samhsa.gov/shin/content//SMA13-3992/SMA13-3992.pdf

 

 

 

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