An Examination of Holistic Treatment for Substance Abuse

Literature Review PresentationRobert JensenArgosy University, Seattle

Introduction

As understanding of addictive disorders shifted from moral weakness to medical condition, and again to a disease that affects all aspects of the addict and their loved ones lives treatment styles have also shifted.

In today’s addiction treatment field professionals have learned the importance of approaching recovery in all aspects of the addicts life and relationships. It is from this understanding that holistic treatment first began to grow.

Why is this important?

It is important to understand the current state of the addiction treatment field, its history, and the direction it is headed.

Gaining an understanding of models of addiction gives us an appreciation for this disorder.

As research progresses in the field holistic treatment models become more relevant.

Understanding the current state of those models gives us a good foundation of how to improve treatment.

Improving treatment allows us to give the client the best opportunity to enter and continue with recovery.

What is AddictionNarcotics Anonymous describes addiction in their basic text as “a physical, mental, and spiritual disease that affects every area of our lives” (p. 20). “complete spiritual, mental, and emotional bankruptcy” (p. 7).

In the DSM-IV-TR addiction is described as “a cluster of cognitive, behavioral, and physiological symptoms indicating that the individual continues use of the substance despite significant substance related problems” (p. 192)

What addiction is to you depends on the model you use to approach understanding it.

Three of the models of addiction

Addiction is a choice. It results from bad decisions and is indicative of character flaws and weak morals. The sinfulness of addiction begins here.

Addicts are genetically predisposed to addiction, and initial substance use will trigger the genes.

Addiction results from multiple causes such as physiological, social, environmental, psychological, and spiritual.

MoralModel

DiseaseModel

Multi – Causal

Taken from Capuzzi and Stauffer

Addictions are not limited to alcohol or other substances. There is a classification of process addiction which includes activities that become an addiction in themselves with the same symptoms.

Process addictions can include anything from running to other forms of exercise, gambling, shopping, or even sex.

There is still a lot of debate surrounding process addictions among professionals, especially when it comes to sex. The important thing to remember in those cases is that it would not be considered an addiction until it becomes an obsession that overrules everything else in the life of the addict.

Taken from Capuzzi and Stauffer

Addiction is a family disease that touches the lives of everyone involved with the addict.

Children, spouses, siblings, parents, and even close friends can be just as hurt by a loved ones addiction.

Child and spousal abuse and neglect are common occurrences in homes touched by addiction.

Co-Occurring Disorders

Co-occurring disorders have become more prevalent lately. This is not due to an actual rise in the disorder as much as a rise in its recognition, and an understanding between the mental health and substance abuse fields.

• Originally considered primary and secondary conditions• Then came Dual-Diagnosis• Shift to co-occurring in recognition of the number of conditions usually found

in this population.

Taken from G. Woody

What makes a successful treatment program?

• Duration of program– The longer the program the more successful the client is

• Access to multiple services– Access to medical, dental, and other types of services outside of

counseling have increase success ratios.

• Exposure to material– The more frequently the client is exposed to the material in some form

the higher the success rates have been.

• Motivation– The ability of a treatment program to increase internal motivation,

and internalize the external motivation is important to treatment retention and success. (Connor, Longshore, & Anglin, 2009)

Taken from Walker

What is Holistic Treatment

Holistic treatment encourages growth through self-exploration and appropriate expression of feelings, recognition of different emotional states, and learning more adaptive ways to soothe and comfort the mind, body, and spirit. (Breslin, Reed, & Malone, 2003, p. 247)

These holistic treatment models combine counseling, psycho-education, medical care, healthy lifestyle education and promotion, and social and environmental development.

The Veteran’s Administration Medical Health Care System (VAMHCS) of Baltimore Uses a unique form of holistic treatment for substance abuse and co-occurring disorders. They give their clients access to non-traditional forms of treatment that increases retention, compliance, and success in recovery among this population. This system has not been empirically tested.

• Tai Chi• Yoga• Meditation• Leisure and life activity skills training• Stress reduction techniques• Nutrition education• Individualized treatment plans• Specialized groups• Vocational rehabilitation• Dance /movement therapy• Art therapy

Taken from Breslin, Reed, & Malone

Recovery and Relapse Prevention

What is the goal of recovery?

• More than just abstinence

The most common model of relapse prevention used today was developed almost thirty years ago by Terrence Gorski and Merlene Miller in 1986. It is a mostly cognitive based model for relapse prevention planning.

Drake, Wallich, and McGovern (2005) call for an expansion of relapse prevention planning due to the increasing co-occurring disorder population.

Conclusions

New research should be done into research into models of treatment that are similar to those used at the VAMHCS. There should also be research in combining treatment with existential therapy as suggested by Rogers and Cobia(2008) in lieu of AA and NA, or perhaps in addition to those meetings.

References

• American Psychiatric Association (2000). Diagnostic and statistics manual of mental disorders, fourth edition, text revision. American Psychiatric Association: Washington, D.C.

• Amodia D. S., Cano C., & Eliason M. J. (2005). An integral approach to substance abuse[dagger]. Journal of Psychoactive Drugs, Vol. 37(4), pp. 363-371. doi: 982390941

• Anonymous (1982). Narcotics anonymous, sixth edition. Narcotics Anonymous World Services, Inc: Chatsworth, California.

• Breslin, K, Reed, M, Malone, S. (2003). An holistic approach to substance abuse treatment. Journal of Psychoactive Drugs, Vol. 35(2), 247. doi:386762221

• Capuzzi, D, and Stauffer, M (2008). Foundations of addictions counseling. Pearson Education, Inc.: Boston,MA.

• Conner, B, Longshore, D, Anglin, M (2009). Modeling attitude towards drug treatment: the role of internal motivation, external pressure, and dramatic relief. The Journal of Behavioral Health Services & Research, Vol. 36(2), pp. 150-160. Retrieved from EBSCOHost database.

• Drake, R, Wallach, M, McGovern, M (2005). Future directions in preventing relapse to substance abuse among clients with severe mental illness. Psychiatric Service, Vol. 56(10), pp. 1297-1302. Retrieved from ProQuest database.

• Gorski, T., and Miller, M. (1986). Staying sober a guide for relapse prevention. Herald House/Independence Press: Independence, MO.

• Rogers, M, Cobia, D (2008). An existential approach: an alternative to the AA model of recovery. The Alabama Counseling Association Journal, Vol. 34(1), pp 59-77. Retrieved from EBSCOHost database.

• Walker, M (2009). Program characteristics and the length of time clients are in substance abuse Treatment. Journal of Behavioral Health Services & Research, Vol. 36(3), pp. 330-345. Retrieved from EBSCOHost database.

• Woody, G. (1996). The challenge of dual diagnosis. Alcohol Health and Research World, Vol. 20(2), pp. 76-80. Retrieved from ProQuest database.