Assessment In Early Childhood Education

Assessment In Early Childhood Education

CHAPTER 4: Theories of Substance Abuse Etiology Substance Abuse Counseling: Theory and Practice Fifth Edition Patricia Stevens Robert L. Smith Prepared by: Dr. Susan Rose, University of the Cumberlands Overview of Chapter Understanding Theory Overview of ATOD Theories Moral Theory Disease Theory Genetic Theories Behavioral Theories Sociocultural Theories An Integrated Approach Stevens/Smith. Substance Abuse Counseling: Theory and Practice, 5e 2013, 2009, 2005, 2001, 1998 by Pearson Education, Inc. All Rights

4-2 Understanding Theory Each major theory is examined through the aspects of: 1. Initiation: Why people begin to use drugs 2. Continuation: Why people continue to use or abuse drugs 3. Addiction: Why some people escalate to dependence on drugs and others do not 4. Recovery: Why some people quit using drugs and others do not 5. Relapse: Why some people remain clean and/or sober and others do not

Stevens/Smith. Substance Abuse Counseling: Theory and Practice, 5e 2013, 2009, 2005, 2001, 1998 by Pearson Education, Inc. All Rights 4-3 Moral Theory Belief that those who cannot hold their liquor have a lack of willpower and are morally corrupt. Aspects of Use Addressed by the Moral Theory Initiation o o o Moral deficiencies (Personal needs) under this theory include: A means to cope with painful and threatening emotions Childhood factors

Self-regulation (Under-regulation or mis-regulation) Stevens/Smith. Substance Abuse Counseling: Theory and Practice, 5e 2013, 2009, 2005, 2001, 1998 by Pearson Education, Inc. All Rights 4-4 Moral Theory Aspects of Use Addressed by the Moral Theory cont. Continuation Perceived rewards perpetuate the continued use of the drug Use masks the underlying physical or emotional problems Addiction Sign of addiction is the absence of choice the user has over the drug use Stevens/Smith. Substance Abuse Counseling: Theory and Practice, 5e

2013, 2009, 2005, 2001, 1998 by Pearson Education, Inc. All Rights 4-5 Moral Theory Aspects of Use Addressed by the Moral Theory cont. Recovery Relapse User must develop alternative rewards to replace the gratification of the drug experience Occurs when the needs and the lifestyle of the addict are not addressed when the drug use is ceased Conclusion

Moral theory purports that addiction can be cured Stevens/Smith. Substance Abuse Counseling: Theory and Practice, 5e 2013, 2009, 2005, 2001, 1998 by Pearson Education, Inc. All Rights 4-6 Disease Theory Belief that alcoholics suffer from an illness. Theory began with Alcoholics Anonymous (AA) Jellinek chart (Figure 4.1, page 102) Aspects of Use Addressed by the Disease Theory Initiation This theory does not address why an individual chooses to drink, however Jellineks Pre-Alcoholic Phase describes use as being socially motivated

This theory postulates that individuals with the disease of addiction do not know they have it until they start using. Stevens/Smith. Substance Abuse Counseling: Theory and Practice, 5e 2013, 2009, 2005, 2001, 1998 by Pearson Education, Inc. All Rights 4-7 Disease Theory Aspects of Use Addressed by the Disease Theory cont. Continuation Prodomal Phase: Individual uses alcohol to relieve physical or emotional pain, tension from job or family, or other stress Crucial Phase: Visible changes occur Addiction Chronic Phase: Total loss of control/Loss of a choice to drink

Stevens/Smith. Substance Abuse Counseling: Theory and Practice, 5e 2013, 2009, 2005, 2001, 1998 by Pearson Education, Inc. All Rights 4-8 Disease Theory Aspects of Use Addressed by the Disease Theory cont. Recovery o o Relapse In this theory, an alcoholic or addict is never consider cured, only in remission, recovering, or a nonpracticing alcoholic or addict. Recovery is focused on abstinence Initial detoxification is followed by cognitive behavioral treatment

Seen as failure, but also viewed as part of the recovery program Conclusion Having a disease removed the social stigma, making it easier for someone to seek treatment. Stevens/Smith. Substance Abuse Counseling: Theory and Practice, 5e 2013, 2009, 2005, 2001, 1998 by Pearson Education, Inc. All Rights 4-9 Genetic Theories Studies demonstrated that genetic factors contributed between 50% - 60% of the variance of risk for alcoholism. Dependence on illicit drugs estimates genetic heritability ranging from 45% - 79% Aspects of Use Addressed by Genetic Theories Initiation o o o

More likely to be environmental and to co-occur with tobacco use Other important factors: History of parental drinking, smoking, or drug use The degree of life stability Personality traits Stevens/Smith. Substance Abuse Counseling: Theory and Practice, 5e 2013, 2009, 2005, 2001, 1998 by Pearson Education, Inc. All Rights 4-10 Genetic Theories Aspects of Use Addressed by Genetic Theories cont. Continuation May involve a combination of social and biological factors

Antisocial behavior is also linked with substance abuse Addiction o o A variety of genetically influenced factors create a predisposition toward alcoholism Protective factors Risk factors Stevens/Smith. Substance Abuse Counseling: Theory and Practice, 5e 2013, 2009, 2005, 2001, 1998 by Pearson Education, Inc. All Rights 4-11 Genetic Theories Aspects of Use Addressed by Genetic Theories cont. Recovery

Addiction is a process. Relapse o Heritability and molecular changes in individuals that lead to dependence, withdrawal and relapse: Multiple neuronal pathways in the brain such as systems related to dopamine, serotonin, and opiate receptors Can be induced by antagonists such as stress, environmental cues, and by the use of alcohol High comorbidity rate with other psychiatric diagnoses Concurrent use with other substances Stevens/Smith. Substance Abuse Counseling: Theory and Practice, 5e 2013, 2009, 2005, 2001, 1998 by Pearson Education, Inc. All Rights 4-12 Behavioral Theories Three modes of behavioral control: Pavlovian approach Goal-directed action

Habit Aspects of Use Addressed by the Behavioral Theory Initiation Social Learning Theory: Substance abuse is a function of positive norms, expectations, and modeling from family members and peers May occur when an individuals coping abilities are overwhelmed Stevens/Smith. Substance Abuse Counseling: Theory and Practice, 5e 2013, 2009, 2005, 2001, 1998 by Pearson Education, Inc. All Rights 4-13 Behavioral Theories Aspects of Use Addressed by the Behavioral

Theory cont. Continuation Generally seen as dependent on a positive experience or other reward Chemicals themselves can act as reinforcers, ie.: Self-medicate Addiction Maintained by habit Maintained by reinforcement Stevens/Smith. Substance Abuse Counseling: Theory and Practice, 5e 2013, 2009, 2005, 2001, 1998 by Pearson Education, Inc. All Rights 4-14 Behavioral Theories Aspects of Use Addressed by the Behavioral Theory cont.

Recovery Involves a behavior change o Replace rewards gained by continued use Break the habit o Relapse Situational antecedents Cognitive behavior processes Triggers Conclusion

Addiction and substance abuse are seen as the result of learning patterns. In treatment, goals are easily formulated because behaviors are easily observed and measured. Stevens/Smith. Substance Abuse Counseling: Theory and Practice, 5e 2013, 2009, 2005, 2001, 1998 by Pearson Education, Inc. All Rights 4-15 Sociocultural Theories Environmental support for heavy drinking is an important sociological variable contributing to alcoholism. Attitudes toward alcohol consumption and abuse vary form culture to culture Aspects of Use Addressed by the Disease Theory Initiation

Social factors can contribute to the introduction of the first use of a drug. Stevens/Smith. Substance Abuse Counseling: Theory and Practice, 5e 2013, 2009, 2005, 2001, 1998 by Pearson Education, Inc. All Rights 4-16 Sociocultural Theories Aspects of Use Addressed by the Disease Theory cont. Continuation Positive initial experience Existence of a drug-using peer group Pressure to conform/fit-in System Maintained/System Maintaining

Addiction Confluence of sociological and cultural factors contribute to the proliferation of addiction. o Example: Cultures where alcohol has been present for several centuries and is an accepted part of daily life tend to have a lower rate of alcoholism than cultures where alcohol is a fairly recent phenomenon. Stevens/Smith. Substance Abuse Counseling: Theory and Practice, 5e 2013, 2009, 2005, 2001, 1998 by Pearson Education, Inc. All Rights 4-17 Sociocultural Theories Aspects of Use Addressed by the Disease Theory cont. Recovery

Relapse While replacing pro-drug socialized peer activities with nonusing peers is an important goal in recovery, social and cultural tolerance may be a limiting factor in maintaining recovery. If broader systems are not addressed, chances of relapse are increased. Conclusion Several components of culture and the environment affect the likelihood of substance abuse. Stevens/Smith. Substance Abuse Counseling: Theory and Practice, 5e 2013, 2009, 2005, 2001, 1998 by Pearson Education, Inc. All Rights 4-18 Sociocultural Theories Factors that appear to protect youngsters: Bonding Goal-direction

Monitoring from family, peers, religion, etc. Participating in rewarding activities and prosocial behaviors Selecting and emulating individuals who model temperance or shun substance use Increased self-confidence and coping skills. Stevens/Smith. Substance Abuse Counseling: Theory and Practice, 5e 2013, 2009, 2005, 2001, 1998 by Pearson Education, Inc. All Rights 4-19 An Integrated Approach Researchers are beginning to view addiction as more than a one-dimensional process that be explained by one single theory. Researchers are beginning to postulate a model that is an amalgamation of genetics, environment, and learned behavior. Integral Quadrant Model Interior

Exterior Individual Interior Individual Exterior Individual Collective Interior Collective Exterior Collective Stevens/Smith. Substance Abuse Counseling: Theory and Practice, 5e 2013, 2009, 2005, 2001, 1998 by Pearson Education, Inc. All Rights 4-20 Comparing Etiological Theories of Substance Abuse Stevens/Smith. Substance Abuse Counseling: Theory and Practice, 5e 2013, 2009, 2005, 2001, 1998 by Pearson Education, Inc. All Rights 4-21 Discussion

Is substance abuse an act caused by a weak moral character? Is substance a disease? Is substance abuse a result of heredity? Is substance abuse a learned behavior? Is substance abuse caused by environmental factors? Stevens/Smith. Substance Abuse Counseling: Theory and Practice, 5e 2013, 2009, 2005, 2001, 1998 by Pearson Education, Inc. All Rights 4-22

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