Julie uses heroin for her reported chronic pain. She states that if she does not take something for her pain, she becomes depressed and suicidal. She has agreed to see a counselor. She has also stated that she does not know anything about her treatment options but is willing to try any method to overcome her addiction and depression.Based on what you have learned in this module, explain to her the advantages and disadvantages of the following techniques as well as the possible outcomes:12-step programGroup therapyBehavioral contractingPharmacotherapyRelapse preventionOnce you have posted, review at least two of your classmates’ posts. Read over their advantages/disadvantages and outcomes. Do you share the same? Discuss which options you think would be the best for Julie.To complete this assignment, review the Discussion Rubric document
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Response to Lisa L
12-step programs (also referred to as self-help) focuses on providing practical and emotional support
while sharing information through participation in discussion. These groups were traditionally held in
person, but internet groups have been growing in popularity (Capuzzi & Stauffer, 2016). The most wellknown 12-step program is Alcoholics Anonymous (AA) which was founded in 1935 by Dr. Robert
Holbrook Smith and Bill Wilson. There have been many offshoots from AA since this time such as AlAnon (supports loved ones of addicts), Co-Dependents Anonymous (CoDA) which also supports those in
relationship with addicts to have a more healthy relationship, Narcotics Anonymous (NA) supporting those
with a chemical addiction, and Alateen for teenagers affected by relationships with addicts (Capuzzi &
Stauffer, 2016). These groups adhere to the message that the person is powerless over the substance
and must rely on a higher power to aid in recovery, that they must admit their wrongs, accept
responsibility, and ask for forgiveness where needed. Prayer and/or meditation is a large part of these
programs. There is a pledge of confidentiality and only first names are used in the program. They
believe that one is never “cured” of the addiction but is in “recovery” through abstainence (Capuzzi &
Stauffer, 2016). The advantage to these programs is the possibility of creating strong bonds with those
that have experienced the many of the same issues including sponsorship by a member that has
progressed through the program. A disadvantage might be for someone who doesn’t believe in a higher
power (God) and the fact that the groups are run by lay-persons and not licensed professionals (Capuzzi
& Stauffer, 2016).
In group therapy, the focus is on combining education and self-understanding using a “planned
framework” to suit the clientele. The counselor bears the responsibility for the goals of the group and the
path the group takes (Capuzzi & Stauffer, 2016). This puts a lot of oneness on the counselor and could
be seen as a negative. The counselors are professionals or paraprofessionals and trained in addiction
treatments which is a positive (Capuzzi & Stauffer, 2016). Group therapy also allows the members to
learn from each other and gain helpful tools by talking about what has worked for them (Capuzzi &
Stauffer, 2016).
Behavioral contracting is an individual therapy that uses “if-then” scenarios like “if you do X, then I
will do Y” to get the desired behavior. This targets behavior that can be modified by the individual and
provides incentives to do so. Having to sign a mutually agreed upon contract can hold the addict to a
level of accountability. The contract can increase a client’s motivation and motivation is important when
dealing with an addiction (Alcohol Rehab, 2019). The downside of this type of therapy is that this type of
contract is non-binding and relies on the willingness of the client to keep the contract and this may be
difficult when dealing with a substance addiction.
The use of a legal and “safer” drug in the treatment of substance addiction is called
pharmacotherapy. This can be a controversial approach because many feel that treating a drug with a
drug is counterproductive or a “crutch” (Capuzzi & Stauffer, 2016). The benefit of pharmaceutical
assistance is to help with the cravings of addiction. This helps with the physical symptoms of addiction
but doesn’t help with the mental side of addiction (Capuzzi & Stauffer, 2016).
Mindfulness-based relapse prevention is the practice of “noticing, accepting, describing, and not
judging one’s immediate perceptual experience” (Capuzzi & Stauffer, 2016). There is a focus on being
present in the moment and using your senses and breathing to center one’s self. Dialectical behavior
therapy (DBT) is a rising evidence-based approach which uses MBRP at its core (Capuzzi & Stauffer,
2016). There are many positives to this approach and many studies have shown its effectiveness
although it may not be enough to use on its own and may benefit from another co-therapy method where
addiction is concerned.
References
Alcohol Rehab. (2019, January 25). Behavior Contracting and Alcohol Rehab. Retrieved from
https://alcoholrehab.com/alcoholism/behavior-contracting-and-alcohol-rehab/
Capuzzi, D., & Stauffer, M. D. (2016). Introduction to addictions counseling. In Foundations of
Addictions Counseling (3rd ed.). Retrieved from
https://mbsdirect.vitalsource.com/#/books/9780133998726/cfi/6/6!/4/2/32/4/2@0:0
Response to nicole E
Julie has numerous options available to treat her addiction. Determining the correct treatment and what
will or won’t work specifically for her will depend on various factors. It is, however, a promising sign she’s
willing to see a counselor and discuss her treatment options! It is crucial that Julie enters an addiction
treatment program that will be the best fit for her individual needs. It should also be noted that some
treatments can be combined to work in conjunction with others such as a client attending both individual
and group counseling (Deeds, 2015).
1. 12-Step Program:
The 12-step is one of the most popular and widely used addiction treatment method and has
been utilized by millions of people (The Recovery Village, 2019). 12-step groups also help addicts
struggling with other addictions such as gambling or sex (Capuzzi & Stauffer, 2016 ). The foundation of
this treatment approach puts the responsibility of sobriety on the client and promotes accountability for
one’s own actions (The Recovery Village, 2019). These groups are deeply rooted in the belief that there
is a higher spiritual power and encourages making amends with themselves and others they may have
harmed. According to the National Institute on Drug Abuse (2019), “three key ideas predominate” in 12step programs which include, “acceptance, surrender, and active involvement” in the meetings.
The advantages include its popularity and widespread use which makes it extremely easy and
convenient to locate meetings and attend on a regular basis (Capuzzi & Stauffer, 2016 ). Sponsorship
support can help addicts receive one-on-one mentoring and there is no cost to join (small donations are
collected by some groups). The method has proven to be successful with countess people. In addition,
most aftercare support for addicts is notoriously underfunded and because these groups are provided at
no cost, people can continue to attend them even if their insurance company has denied them for other
post treatment services (Capuzzi & Stauffer, 2016).
There are drawbacks to the 12-step program. These can include things such as a lack of
participation and/or engagement by the client, the reliance on a higher power may not coincide with their
personal beliefs or comfortability level with strangers, and it’s not an empowerment model so 12-step
programs can be less effective for women. (DrugRehab.org, 2019). This program takes motivation and
dedication on the part of the attendee because they are the ones that generally initiate contact and
continue to engage themselves.
#2 Group Therapy:
Another common form of addiction treatment includes group therapy. According to our text, as
many as 94% of treatment facilities in this country regularly employ group therapy as a treatment for
substance abuse (Capuzzi & Stauffer, 2016 ). Group counseling would involve Julie meeting with other
addicts in a group-like setting where they can express their thoughts and feelings together. Our text
states, “interpersonal treatment approach emphasizes an expression on thoughts and feelings geared
toward insight and behavioral change” (Capuzzi & Stauffer, 2016 ). There are many advantages
associated with this type of treatment including the social support a person receives and the ability to be
able to relate to someone else experiencing similar circumstances, people can gain valuable
communication and social skills, and the treatment is very low cost so nearly anyone can do it (Deeds,
2015). Disadvantages may include a lack of confidentiality and social anxiety such as a reluctance to
speak up (Deeds, 2015).
#3 Behavioral Contracting:
This type of therapy utilizes an approach that’s based on the “theory of behavioral economics that
posits behavior is chosen because of the immediate and tangible rewards it provides, including monetary
reward” (Capuzzi & Stauffer, 2016 ). In essence, it’s a reward-based type of therapy that assists in
reinforcing positive behavior (Stauffer & Capuzzi,). The behavior that’s intended is described (usually in
the form of a written contract) to the addict with a date set for that specific “task completion.” Both the
counselor and the client sign the contract and it’s used as a motivator and incentive (Capuzzi & Stauffer,
2016 ).
The advantages using this method is that it helps to reinforce positive behaviors and the addict
receives “prizes” intermittently which can keep encouraging the good that they’re accomplishing (Capuzzi
& Stauffer, 2016 ). The disadvantages for this approach may not be comprehensive enough though and
many physicians and providers refuse to embrace it as they feel that clients shouldn’t be rewarded for
abstinence (Capuzzi & Stauffer, 2016). Furthermore, it may also be considered too expensive to
implement (Capuzzi & Stauffer, 2016 ).
#4 Pharmacotherapy:
Pharmacotherapy is basically the treatment of an addiction with medication prescribed and
monitored by a physician (Recovery Research Institute, n.d.). These medications can help mitigate
withdrawal symptoms in an addict, reduce cravings, and help lessen the odds that an addict will relapse
(Recovery Research Institute, n.d.).
The advantages of pharmacotherapy include a more humane way to treat a client suffering from
acute withdrawals, an improvement in their survival and far higher chances the client will remain in
treatment (Recovery Research Institute, n.d.). Disadvantages can include the dilemma of treating an
addict with yet another medication that could also be possibly addictive (Recovery Research Institute,
n.d.). This method is still fairly uncommon as well, and far more research is needed to assess the longterm outcomes these medications have and how people react to them (Recovery Research Institute, n.d).
Just a few to mention would be suboxone, vivitrol injections and methadone.
#5 Relapse Prevention:
Relapse Prevention is a crucial intervention for someone suffering from substance abuse disorder.
They need to know that relapse is very common in therapy and it’s vital, they’re provided with the tools
necessary to identify the signs and seek help if they need it. Mindfulness-based relapse prevention or
MBRP is designed to foster “increased awareness of triggers of substance use, habitual patterns of using,
and “automatic” reactions that seem to control person’s daily living” (Stauffer & Capuzzi, ). I am a firm
believer in preventative care.
References:
Capuzzi, D. & Stauffer, M. (2016). Foundations of Addictions Counseling, 3rd Edition.
[VitalSource]. Retrieved from
Deeds. (2015, April 07). Addiction Treatment Options – Pros and Cons. Retrieved February 7,
2019, from https://www.choosehelp.com/topics/addiction-treatment/the-pros-and-cons-fordifferent-treatment-options-for-addiction
DrugRehab.org. (2019). Pros and Cons of 12 Step Recovery Programs for Addiction Treatment.
Retrieved February 7, 2019, from https://www.drugrehab.org/pros-and-cons-of-12-step-recoveryprograms-for-addiction-treatment/
National Institute on Drug Abuse. (2019). 12-Step Facilitation Therapy (Alcohol, Stimulants,
Opiates). Retrieved February 7, 2019, from https://www.drugabuse.gov/publications/principlesdrug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-todrug-addiction-treatment/behavioral-4
Recovery Research Institute. (n.d.). Pharmacotherapy – Medications. Retrieved February 7, 2019,
from https://www.recoveryanswers.org/resource/pharmacotherapy-medication-assistedtreatments/
The Recovery Village. (2019, January 09). 12-Step Drug Treatment Pros and Cons. Retrieved
February 7, 2019, from https://www.therecoveryvillage.com/treatment-program/aftercare/12-steppros-cons/#gref

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