Please see attached
Wk 1 Discussion – Title
Respond to the following in a minimum of 175 words:
· How have attitudes and approaches toward addiction and treatment have changed over time?
· What are the etiological theories of substance abuse?
· What are the biopsychosocial dynamics of dependency and addiction?
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Chapter 1 History and
Etiological Models of
Addiction
David Capuzzi
Walden University
Mark D. Stauffer
Walden University
Chelsea Sharpe
Multisystemic Therapy Therapist
Athens, Georgia
The specialists serving the highest proportion of clients with
a primary addiction diagnosis are professional counselors
(20%), not social workers (7%), psychologists (6%), or
psychiatrists (3%) (Lee, Craig, Fetherson, & Simpson, 2013,
p. 2)
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The history of addictions counseling, a specialization within
the profession of counseling, follows a pattern of evolution
similar to that witnessed in many of the helping professions
(social work, psychology, nursing, medicine). Early
practitioners had more limited education and supervision
(Astromovich & Hoskins, 2013; Iarussi, Perjessy, & Reed,
2013), were not licensed by regulatory boards, did not have
well defined codes of ethics upon which to base professional
judgments, may not have been aware of the values and
needs of diverse populations, and did not have access to a
body of research that helped define best practices and
treatment plans (Hogan, Gabrielsen, Luna, & Grothaus,
2003).
It is interesting to watch the evolution of a
profession and specializations within a profession. For
example, in the late 1950s, the profession of
counseling was energized by the availability of federal
funds to prepare counselors. The impetus for the U.S.
government to provide funds for both graduate
students and university departments was Russia’s
launching of Sputnik. School counselors were needed
to help prepare students for academic success,
especially in math and science, so the United States
could “catch up” with its “competitors.”
As noted by Fisher and Harrison (2000), in earlier times,
barbers who also did “bloodletting” practiced medicine,
individuals who were skilled at listening to others and making
suggestions for problem resolution became known as
healers, and those who could read and write and were skilled
1154339 – Pearson Education Limited ©
at helping others do so became teachers with very little
formal education or preparation to work with others in such a
capacity. Fifty years ago nursing degrees were conferred
without completing a baccalaureate (today a baccalaureate
is minimal and a master’s degree is rapidly becoming the
standard), a teacher could become a school counselor with
12 to 18 credits of coursework (today a two-year master’s is
the norm), and 20 years ago an addictions counselor was an
alcoholic or addict in recovery who used his or her prior
experience with drugs as the basis for the addictions
counseling done with clients.
Until the middle 1970s, there was no such thing
as licensure for counselors, and those wishing to
become counselors could often do so with less than a
master’s degree. In 1976, Virginia became the first
state to license counselors and outline a set of
requirements that had to be met in order t
1154339 – Pearson Education Limited ©
Chapter 3 Process Addictions
Laura J. Veach
Wake Forest School of Medicine
Jennifer L. Rogers
Wake Forest University
Regina R. Moro
Barry University
E. J. Essic
Professional Counselor
James W. McMullen
University of North Carolina at Charlotte
1154339 – Pearson Education Limited ©
Addiction may be further defined in terms of ingestive or
process addictions. Chemical dependence is classified as an
ingestive addiction due to the taking in of mood-altering
chemicals, like alcohol or other drugs (AOD), whereas
process addictions encompass behavior patterns (for
example, gambling or sexual addictions) or processes that
produce euphoria without the use of mood-altering AOD.
Addiction specialists rarely debate that addiction is a
biopsychosocial disease, but many continue to challenge the
nature of addiction with questions about substance versus
process addictions.
The term process addiction—an addiction to a behavior,
process, or action—is still contentiously debated. It was not
until the 1970s and 1980s that the addiction field began to
formally discuss the idea that a behavior could be diagnosed
as an addictive disorder. Sussman and Sussman (2011)
provide a review of addiction research studies since 1948 to
ascertain key elements in understanding addiction, whether
substance or process, and highlight the following: “[W]hen
contemplating addiction, one often thinks of it in terms of a
process” (p. 70). Hagedorn and Juhnke (2005) cite a need for
a universal definition of an addictive disorder to “[create a]
common clinical language, a legitimization of the disorder for
the purposes of third-party reimbursement, and a step
toward a standardized treatment protocol” (p. 194). Past
research on addiction focused on the presence of physical
dependence to the substance or behavior as demonstrated
by tolerance and withdrawal, but current research claims
physical dependence is no longer necessary to diagnose an
addiction to a substance or behavior (Hagedorn & Juhnke,
2005). In fact, the older Diagnostic Statistical Manual (4th ed.,
1154339 – Pearson Education Limited ©
text rev.; DSM-IV-TR) explicitly states that “neither tolerance
nor withdrawal is necessary or sufficient for a diagnosis of
Substance Dependence” (American Psychiatric Association
[APA], 2000, p. 194). In addition, newer research using
sophisticated brain imaging techniques continues to add
compelling evidence that the brain reward and inhibitory
systems of process addicts resemble brains of ingestive
addicts (Ahmed, Guillem, & Vandaele, 2013; Clark &
Limbrick-Oldfield, 2013). Yet researchers and experts
continue to debate whether a behavior can be diagnosed
under the same criteria as a substance use disorder.
A number of addiction specialists, including the International
Association of Addictions and Offender Counselors
Committee on Process Addictions, advocated that the newly
published Diagnostic and Statistical Manual (DSM-5; APA,
2013) i
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