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 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 literatureTranscript of video Levy Family:
Episode 1
Program Transcript
[MUSIC PLAYING]
FEMALE SPEAKER: You’re not dressed? You’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 you, I’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 thinking you 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, I wasn’t saying it like that. I always think of my
clients first.
MALE SPEAKER: OK. But you mentioned meditation, yoga, art therapy. Have
you seen 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.
I can’t– I can’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: My name’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 get me 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 can wait, 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 as I 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-yearsold,
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 couple times, but one thing was clear, I
stayed married to methamphetamine. I didn’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 I had the ability to go to
work. I had 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. So I 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 I couldn’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 then you 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 here I 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 I couldn’t do this by
myself. I couldn’t beat this thing. The first step, I had to admit that I was an
addict. For years, I didn’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 you don’t know anything about. So to be able to
trust someone in recovery was like foreign land to me.
RICKY: If I don’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 I wasn’t living. I was trying to survive. I wasn’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, I don’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 I don’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, I don’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.
So I 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 meet me 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 I don’t think I would
have made that connection without the 12 steps. I wouldn’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 you wouldn’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 couple years ago. And that’s my
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 all I 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 you don’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.
I have to remember that I’m still in recovery, and I have to take care of me first.
Or I’ll be a disaster, and I won’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’s like.
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 I can’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, I wasn’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.
Photo Credit: Laureate Education
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
Assignment 1: 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 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.
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ADDITIONAL INSTRUCTIONS FOR THE CLASS
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We are a professional custom writing website. If you have searched for a question and bumped into our website just know you are in the right place to get help with your coursework.Do you handle any type of coursework?
Yes. We have posted our previous orders to display our experience. Since we have done this question before, we can also do it for you. To make sure we do it perfectly, please fill out our Order Form. Filling the order form correctly will assist our team in referencing, specifications, and future communication.Is it hard to Place an Order?
- 1. Click on “Order Now” on the main Menu and a new page will appear with an order form to be filled.
- 2. Fill in your paper’s requirements in the “PAPER INFORMATION” section and the system will calculate your order price/cost.
- 3. Fill in your paper’s academic level, deadline, and the required number of pages from the drop-down menus.
- 4. Click “FINAL STEP” to enter your registration details and get an account with us for record-keeping and then, click on “PROCEED TO CHECKOUT” at the bottom of the page.
- 5. From there, the payment sections will show, follow the guided payment process and your order will be available for our writing team to work on it.
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We will process your orders through multiple stages and checks to ensure that what we are delivering to you, in the end, is something that is precise as you envisioned it. All of our essay writing service products are 100% original, ensuring that there is no plagiarism in them. The sources are well-researched and cited so it is interesting. Our goal is to help as many students as possible with their assignments, i.e. our prices are affordable and services premium.
- Discussion Questions (DQ)
Initial responses to the DQ should address all components of the questions asked, including a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two-sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses.
- Weekly Participation
Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.
- APA Format and Writing Quality
Familiarize yourself with the APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition.
- Use of Direct Quotes
I discourage over-utilization of direct quotes in DQs and assignments at the Master’s level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source.
- LopesWrite Policy
For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for tips on improving your paper and SI score.
- Late Policy
The university’s policy on late assignments is a 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.
- Communication
Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.
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