Explain the key points of the disease theoretical model of addiction.
Explain two strengths and two limitations of this theoretical model.
Explain the major contributions of this theoretical model to the field of addiction treatment.
Explain whether the limitations that you identified may affect the applicability of the model in the treatment of addiction and why. Use Marge from the media piece as an example.
Counseling Session 1
Counseling Session 1 Program Transcript
Welcome to the first day of counseling for Marge, an alcoholic who has just been admitted to the addictions facility. Please carefully read the paperwork developed by a support staff member during Marges intake process earlier today. Marges husband, Ken, was also briefly interviewed during this time.
After reviewing this information, click the continue button to begin Marges first counseling session. Using your cursor, rollover buttons A and B to review your question options. Click what you think is the best question to ask Marge out of the two options offered. If you ask an effective counseling question, you will receive more information from Marge. If you ask an ineffective question, you will receive an equally unhelpful response. Choose wisely, because the better you counsel Marge, the better her treatment experience.
*Please keep in mind that the video has been made in a way that gives you a realistic vantage point from where you would sit and counsel your client in real life. A close up view of the individual has not been added because you, as a counselor, will not have varying angles of your client to work with.
Paperwork: Marge C. 41-year-old female Married Husband, Ken, works two jobs to make ends meet, so he is not home
much. Husband noted that he didnt know what else to do about his wifes drinking, and that he had brought her to the facility out of desperation.
Patient has three children, ages 10, 12, and 16 Patient was a teacher, but she lost job for alcohol-related reasons Patient had a one-car, alcohol-related accident three days earlier. She
received minor injuries and was issued a ticket for DUI. Husband, family members, and friends determined that they needed to intervene to prevent Marge from harming herself and/or others.
An intervention occurred earlier today, culminating in her being brought for treatment.
Patient will go through a week of detoxification during her first week in treatment to address the physical withdrawal from alcohol
[Opening scene: Marges admission into residential treatment. Her counselor is meeting with her for the first time and is conducting Marges initial assessment. Marge is disheveled, wears no makeup, and her eyes are red from crying. An adhesive bandage is on her forehead, and she has a black eye and abrasions from a one-car accident she had several days ago She was charged with driving while under the influence, her first such charge.
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Counseling Session 1
Her posture is closedarms crossed, turned away from counselor, and avoiding eye contact initially. She is tremulous throughout the interview due to impending physical withdrawal from alcohol. She tries to control her shakes but is not successful. Her mood is labile (up and down, unstable). She presents herself at the first part of the session as if she is the victim of an injustice and blames her husband. Shes initially defensive. This shell begins to melt quickly as the session moves forward and ends with a receptive, open Marge who seems to have surrendered to the fact that she may need help. Her body posture, facial expressions, and tone of voice reflect this change as it occurs through the session.]
Counselor: Marge, I will be your counselor. I want you to know Im glad youre here. I imagine this has been a hard day for you. Right now, I just want us to begin get to know each other better. I also want to know more about your drinking so we can begin to plan your treatment. Its natural to be anxious and upset right now. You look like you feel like that now. Are you?
Marge: Yes, of course I am! And furthermore, I dont want to be here; I dont need help.
Counselor: Hello, Marge. I will be your counselor. I want you to know Im glad youre here, and I want to help you in any way I can. I imagine this has been a hard day for you, and I know that you and your husband have already answered many questions during your admission process. Right now, I just want us to begin get to know each other better. I also want to know more about your drinking so we can begin to plan your treatment. Its natural to be anxious and upset right now. Tell me your thoughts and feelings right now.
Marge: Youre right, I am anxious, and Im more than that right now! Im hurt, Im scared, and Im furious at my husband Ken for dragging me to this place. I want you to know right now I am not here on my own; I am here only because he and my so-called friends threatened to have me committed involuntarily for my own safety, as they say, if I didnt agree to do it myself.
I know I drink too much, but I can handle it myself. I dont need to be put in this rehab and hid away from the rest of the world to do it. Im not like the other people you have here; they might need help, but I can do it on my own. I dont need help.
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Counselor: You dont need help?
Marge: No. I am strong willed. I know I drink too much, but I have to because of all the stress. Raising a family, and then when I was teaching it was double hard. I have diabetes on top of it all, and Im unemployed and now this damn DUI hangs over my head. Then, as if thats not enough, theres Roger, my 12-year- old son; hes always getting in trouble at home and school. Its never ending. I could go on and on.
Yeah, I admit. I drink too much, but I do it to deal with all my problems and my constant depression. You would too if you were me. No one understands that. But I can go to AA and go back to that counselor at the community mental health clinic and stop without all this ridiculous fuss of coming here. Ive tried it before; I just didnt give it all I had.
Counselor: I think youre wrong; I think you do need help, and I want to help you see that.
Marge: No, I dont; youre just like them. No one seems to want to listen to me; they just jump to their own conclusions about my life. Ive tried to stop on my own before; I just didnt give it all I had. Ill tell you again for the umpteenth time, I DONT NEED HELP!
Counselor: You say youve tried to stop drinking before, Marge. Please tell me more about that.
Marge: I could do it for a while. I went to AA and that counselor, like I said, and I went a month or two once. But always things would start piling up, and Id take a drink just in the afternoon after 5 like I used to, and then before I knew it Id be drinking all day again.
I just didnt try hard enough. I will now; I know I can do it. I feel guilty because Ive been too weak and just never tried hard enough. I know what alcoholism is, believe me, my father was one, so was my unclethey went to their graves drinking. I just need to get strong and build up my willpower to make my mind up
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to stop. I need to stop being such a weakling and an irresponsible mother and wife. Its almost immoral the way Ive been doing, but I can do it now. I just need a change. I need to go home.
Counselor: You said earlier that youve tried to stop drinking before but were not successful. That tells me you need to help. Dont you agree?
Counselor: Marge, let me share something with you that you may not know. We look at alcoholism and other addictions as a disease. Some people have a genetic predisposition for it. Its not a moral issue, Marge, or a matter of lack of will power. That puts a different light on your situation, doesnt it, Marge?
Counselor: Marge, I think I hear what youre saying. You admit you drink too much, and you seem to think you can stop on your own without coming here for 30 days. You think you just havent tried hard enough, and you feel that youre a weak and immoral person for that.
Let me share something with you that you may not know. We look at alcoholism and other addictions as a disease. Some people have a genetic predisposition for it. People who are genetically predisposed to the disease when faced with the right combination of conditions cant handle alcohol. They may start just drinking socially in a controlled way and then drink to deal with stress or other problems. Because of their genes, they need more and more and eventually need to drink just to keep from going into withdrawal. Its not a moral issue, Marge, or a matter of lack of willpower. What are your thoughts about what I just said?
Marge: (Marges whole demeanor has changed during this last exchange from the counselorshe begins to make eye contact with the camera/counselor and relax her defensive, closed posture. She begins to convey a sense of surrender combined with a touch of desperation).
(After a moments silence, reflecting on what the counselor said, then tearfully begins to talk after a moment of silence) I ..I never thought of it that way. Well, I guess I have, but (stammers) ..well , I , uh I can see how that
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could be. .A disease maybe? It could explain why even though I dont really want to be like this I am and that I though Ive really tried to stop I just havent known how ..(looks down staring at her hands now folded in her lap, the truth has sunk in).
When we first got married and began to have our children, I would have glass of wine several times a week with dinner, or maybe even with Ken when we both got home after a long day at work and the children had gone to bed. Then it was every day, then in the morning, and then I was hiding my drinking habits and drinking just to feel normal.
I was teaching, and it got to where I would drink vodka before I went to school. I thought no one would smell vodka, but it didnt work. I was fired. My life has spiraled since then, my children, my marriage, my health, everything. If I dont drink now I get horribly ill; you cant imagine how ill. I start feeling things on my skin or seeing things; its bad. I get crazy, just like my father and uncle used to get.
I know Ken has tried to protect me all these years. He means well. He would call the school when I was too drunk to go and tell them I was sick. Thats what hes always told the children, Your mothers ill, she cant help it. Oh help me, please
(Marge breaks down at this point, head in hands, sobbing out of control .LONG SILENCE as Marges sobs become more controlled.)
Counselor: Marge, you just turned the corner, and Im proud of you. Youve just made a giant step today, and youve just started on your road to recovery. What are your thoughts and feelings now as we conclude our first session?
Marge: (Marge has softened; shes beginning to feel relief that shes finally admitted she has a problem and that help is here. She is still hurt and maybe embarrassed perhaps.)
I guess I just feel grateful that someone is listening to me and understands. (Wipes her eyes, pauses, takes deep breath)
I feel so embarrassed .my husband has put up with so much, and I know the kids have needed me and I havent been around. I just wanted to take care of it by myself, do at least one thing without having to rely on someone else for help,
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you know? I should at least do that, since Ive messed up so much already. (Deep breath)
I dont want to leave the kids alone for 30 days, but .I guess Ive left them alone anyway. Im scared, but I am willing to try. If you really think you can help me, I promise Ill do my best. I have to make it work for my kids and for Ken.
Counselor: Marge, I know this is hard, but until you admit you have a problem, your drinking will only continue to get worse and cause you and your family more problems. I want you to think about that before we meet again, OK?
Marge: Yes, I will. Listen, I know you mean well ..but uh well uh I just dont think you or anyone else in my life hears me.
Final Text: Congratulations. You have now completed your counseling session with Marge.
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Assignment: Scholar Practitioner Project Assignment: The Disease Theoretical Model of Addiction
There are a number of theoretical models that explain addiction from a wide range of perspectives. It may be ideal to consider addiction from a broader perspective as a condition influenced by the interaction of all spheres of life: biological, psychological, sociological, and spiritual.
While no one model will be all-inclusive, the medical model is more widely accepted than others in the field. The medical model, also known as the disease theoretical model, is more comprehensive than other models and is currently the most applied model in the treatment of addiction. It is the model that you are most likely to encounter as a helping professional.
For this Assignment, review this week’s Resources. Focus on the strengths and limitations of the disease theoretical model of addiction as it applies to Marge from this week’s media piece. Consider the limitations in its applicability in treatments of addiction. This Assignment will inform your Scholar Practitioner Project (SPP) for this course.
In a 2- to 3-page APA-formatted paper, address the following:
· Explain the key points of the disease theoretical model of addiction.
· Explain two strengths and two limitations of this theoretical model.
· Explain the major contributions of this theoretical model to the field of addiction treatment.
· Explain whether the limitations that you identified may affect the applicability of the model in the treatment of addiction and why. Use Marge from the media piece as an example.
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