Abstract
Throughout this paper we will talk about substance abuse counseling and the techniques used to help an addict overcome their addiction. We will talk about the effectiveness, goals of therapy or steps a counselor uses. We will also look at the pros and cons of each and the growth shown for the clients. We will also look at some areas where improvement or development can be made.
According to the Merriam-Webster dictionary, substance abuse is defined as an excessive use of a drug such as narcotics, alcohol, or cocaine without a medical justification (merriam-webster). Not only does the over use of drugs lead to addiction, they also impair your vision, allow for various mood swings, distort your judgement, and can cause severe brain damage. Damage to ventral areas of the brain region can interfere with the ability of a person to accurately distinguish right from wrong in a socially acceptable manner, which can lead to socially inappropriate behaviors (Volkow, 2011). Addiction is a hard thing to overcome, but there are several strategies and methods to help achieve the goal of abstinence.
What is Substance Abuse/Addiction Counseling?
A substance abuse counselor is a mental health counselor who specializes in treating patients who have a chemical dependency on drugs or alcohol (human services guide). There are several routes a counselor may take to help a client overcome their addiction. Among impatient and outpatient treatment, counselors also opt for individual and group therapy as being successful. Addiction to substances is a chronic brain disease that affects judgement and behavior by altering cognitive functions such as learning, memory formation, and impulse control (Mennis, 2016). A counselors’ goal is to help guide a client in the right direction and give tools to positive change dealing with stressors, behaviors, and actions. The purpose of substance abuse counseling is to improve or maintain health by changing behaviors that are causing present or potential harm to the user and others (encyclopedia).
How Substance Abuse/Addiction Counseling Works
Substance abuse counseling is way more than just treating the addiction itself. It has to do with behavior and the client from within him/her self. Substance abuse counseling is based off of a persons’ circumstance. Everyone with an addiction has their own issues that that need help for. The first job of the counselor is to meet with the person or client and see where they are at with their addiction. Several things lead a person to substance abuse, such as environmental factors, peer pressure, depression, anxiety, stress and etc. They will ask a series of questions to find out what lead a client to substance abuse in the first place. A lot of the times a counselor will work one on one with a treatment center and therapist. A counselor will also give out referrals or suggest inpatient/outpatient help along with Narcotics anonymous and or alcoholics anonymous.
Counselors use various types of therapy to help a client open up and to build a relationship with them. Sometimes a counselor will opt for individual therapy, group therapy, or both. One very common type used is called Cognitive Behavioral Therapy. There is consistent evidence that CBT is effective at reducing substance use and mental health issues (Korchmaros, 2018). The key here is that substance abuse users have a mental health issue or issues that lead to their usage or addiction. A counselors’ main goal is to find out what these issues are and work on them. Yalom states CBT therapists attempt to access and illuminate these thoughts through probing, Socratic questioning, and the encouragement of self-examination and self-monitoring (Yalom, 2005, p.513). The goal of CBT therapy is have a change in perception and how a user sees their life. It helps to change the thinking process of a substance abuse user to a more positive way, helps come up with coping mechanisms and strategies, and ideas and strategies to overcome potential stressors that a client has. CBT therapy is used in an individual or group setting as well as among family therapy.
A lot of the time it is a good idea to get the family involved with counseling as well, for it leads to a better support group and success rate. Individual counseling works well but a client still needs to learn how to be social among other people. Within group counseling a client is more able to use the skills learned within the group, make the skills productive, and then use them outside the group. Multidimensional Family Therapy is another type of treatment used to help behaviors and has good results also. MDFP intervention effects were examined at post treatment. The cases showed greater gains for increased self-concept, family cohesion, bonding to school, and decreased antisocial behaviors by peers (Faw, 2005). These cases show that support leads to higher success rates.
In a study done several female offenders were asked what they needed to be successful in the outside world versus jail. Several of these women said that they wanted counselors to care about their personal lives, to do what they have to, to help and not just because of a paycheck (Laux, 2008). Having a connection between counselor and client, or client and client is one of the most important things. One of the most important factors of SUD treatment is the quality and relationship between client and clinician (Carswell, 2018). Lots of times a substance abuse user already feels as if they have failed everyone, not connected to the world, or think lowly of themselves. No matter the type of therapy used in counseling whether it be individual, group, or family- the connection gives a client the sense of hope, feeling they are not alone, and possibly support they have been denied in the past.
Length of Substance Abuse/Addiction Counseling
The length of counseling in any situation let alone substance abuse is different within any case. You have to put several things in perspective such as the severity of a persons’ addiction, mental health issues, and how much effort and willingness a person has to change their behaviors. Also you have to consider the different options a person may be doing. If a client is going to Narcotics Anonymous and doing outpatient therapy they may be more advanced than a client doing just counseling. Depending on the approach taken by the client is a factor to considering the length of time spent. Tests were conducted among individual sessions, group sessions, and telephone sessions. Though costly group sessions offered greater help due to more group support, the telephone sessions produced higher abstinence rates overall during a 24 month period (Shepard, 2016). Money also is a key factor, for counseling is costly.
There are other options to counseling such as rehab programs. These programs are typically 3,6 or 9 months. However, continuing care over a protracted period of up to 12 months appears to be essential if a reasonable expectation of robust recovery is desired (Proctor, 2014). Depending on the needs and how well a client progresess determines how long the counseling process will take. According to an article in psych central, CBT counseling is usually considered short term with therapy sessions lasting 50 minutes and continuing for 5-10 months (Martin, 2019). Some people elect to do counseling for much longer depending on how much effort they want to put into it and considering the cost as well.
Effectiveness of Substance Abuse/Addiction Counseling
When looking at the effectiveness of substance abuse counseling, several things need to be considered, such as the time spent, the quality, and the approach used. Impatient care seems to be more effective versus out patient care. High dropout rates and monitoring of clients between visits identified as top priorities in outpatient treatment by 44 and 42% of respondents (Carswell, 2018). This is due to environmental factors. During outpatient care your surroundings are the same and users have easier access to substance, while impatient clients are monitored around the clock and can concentrate more on just their recovery process. In one article, several tests were done on Behavioral Family Counseling versus Individual Based Treatment. The outcome showed that Behavioral Family Counseling patients remained in treatment for a much longer period, reduced substance abuse use within patients and an increased abstinence rate (OFarrell, 2009). Group sessions over individual sessions seem to be more effective. Overall Substance abuse counseling could be effective depending how much effort, work, and time you put into it.
Growth and Development
Substance abuse starts at such a young age. In one study conducted, it showed the need for more counseling services in schools. According to the 2002 National survey on drug use and health, it showed 9% of 12-17 year olds were classified as dependent on or abusers of alcohol or illicit drugs (Terry-McElrath, 2005). This is a huge area were growth is needed. According to another survey done (monitoring the future survey), 39% of college students used an illicit drug in the previous year, 35% engaged in heavy drinking in the previous 2 weeks, and 43% were drunk in the previous month (Giordano, 2016). This again shows the need for more resources and counseling tools available throughout students and schools. Out of 36 providers, 32 of them have never heard of PrEP, which is a pharmacological approach to HIV prevention (Spector, 2015). With more resources available, there may be a decrease within substance abuse. Possibly more education for providers as well would help.
Much of the development of substance abuse counseling is the same. The development starts with impatient/outpatient care. Typically these programs are granted through the courts in the criminal system. Some clients elect to do a treatment program on their own. Though cost is expensive and sometimes overbearing, individual and group counseling is the way to go. Substance abuse counseling works on more than just the addiction itself. It works on what lead up to the addiction, whether it be environmental factors, family problems, behavioral, or self-esteem issues. Growth in certain areas have succeeded such as CBT therapy used for substance abuse and other interventions that go way beyond the substance abuse itself. Individual, family, and group counseling has developed over the years, but development in different approaches is still needed. For example in one article it stated, “the lack of understanding of spiritual differences can often lead supervisors to avoid spiritual issues in supervision and focus more on the development of core competencies and skills ( Ogden, 2011). Most substance abuse users are at their ultimate low, hopeless, and feel unwanted or meaningless and turn to their substance of choice to interact these feelings. In turn spirituality and healing through the grace of God gives the peace a user is looking for. Though cognitive skills are important throughout any substance abuse counseling, incorporating spirituality is important also. No temptation has overtaken you except what is common to mankind. And God is faithful; He will not let you be tempted beyond what you can bear. But when you are tempted, He will also provide a way out so that you can endure it (1 Corinthians 10:13).
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