In part one of the text, I will
discuss my own issues related to addiction that could potentially negatively or
positively affect my ability as a counselor and how I will improve on them. In
part two, I will exam Cognitive Behavioral Therapy (CBT) in depth and how I will
apply it into a treatment program specific to opioid addiction. I then discuss
why it fits for me, the positive aspects of it, and what I believe needs
improved. Part three will focus on my overall reaction to the course, this
assignment, and what I perceive will be my future role in the addictions
counseling field. I will also discuss how I will incorporate this information,
more broadly, as a counselor.
Addiction is a problem that has
affected a very large population. Not only has it consumed the lives of those
that are using, but it has affected their friends, families, and loved ones. As
future counselors, we are asked to recognize our own biases or issues, and one
in particular that could affect me both, positively and negatively would be
having family members that are addicts. My sister and cousin are both addicts;
one is addicted to heroin/fentanyl, and the other alcohol.
Having family members that struggle
with addiction could cause a number of issues; I could experience counter-transference
and push my feelings onto the client, not be as removed from the situation as I
should be, or start to give advice instead of acting as a mirror. Some of these
could happen because of what I went through as a result of seeing what has
happened to my sister as a result of heroin/fentanyl use; seeing her in the
hospital being kept alive by machines. Seeing what she put my parents and her
children through. All of the damage that was caused as a result of drug use
could potentially cause any of that to happen. However, I have been working
through my own struggles with how all of this has affected me and I am more
understanding of what they are experiencing.
This could positively affect me
because now I have a personal understanding of what addiction can do. I have
learned that addiction really does not discriminate and anyone could struggle.
I believe that it has made me more aware of what addiction is like and I will
be less likely to judge addicts than most. This could also be a way to develop
rapport with clients. Knowing that I have witnessed first-hand what an addict might
experience can make it easier for a client to trust me as a counselor, making
These are my strengths and
weaknesses. Even though I am currently working through what I have experienced
as the sister and cousin of an addict, something a client might say or do could
potentially trigger me to think of my own life rather than theirs. These
experiences could be viewed as a strength because I have an insight to what the
client may be facing.
I will constantly be improving in
these areas. Not only do I currently work through these struggles, but will
seek supervision while counseling to address any concerns that I might have. The
best way to improve is to practice and continuously learn from the world around
us and all it has to offer.
There are many different counseling
theories that could be used in addiction treatment. I believe that Cognitive
Behavioral Therapy would be an effective therapy to use because it is easier
for most to understand and can be used for patients with a dual diagnosis (Barrowclough
et al, 2001). CBT is one of the most
studied, distinct, and extensively used approaches for treating substance abuse
(Carroll, 1999; Thase, 1997). CBT focuses on changing the perspective of the
person and alter their behaviors. CBT, in its own way, remaps the brain. It
teaches a person how to change their thoughts and behaviors to avoid negative
consequences. Using this theory would allow the client to identify the
following: A- activating event, B- belief, C- consequence; emotional and
behavioral. It would also teach them how to: D- dispute intervention, E-
effect, and F-feeling of the new emotion or behavior. Once the client
identifies A, B, and C they can find a method to avoid the consequences through
D, E, and F.
A helpful tool for clients to use is
the cognitive conceptualization diagram. With this diagram, users can
physically see their beliefs and dysfunctional strategies, how their beliefs
influence their perceptions, and explain why they respond in such unproductive
ways. As a counselor, we will challenge
the client to question their own automatic thoughts and how they may lead to
their substance abuse and to see why they are not substantial. Doing so allows
them to see how unrealistic their thoughts are and to feel better about their
selves. Once they start to think more realistically, they will be less stressed
by the “should, must, and ought” in their lives. After accepting that these
beliefs are not practical, they will be less likely to have an emotional need
to use their substance of choice. Changing how they think will then begin to
change how they behave and finding new, healthier methods of coping (Beck,
Liese, & Najavits, 2005).
For addictions, I find that this
theory would not only be affective for clients but also for me as a counselor.
Those that struggle with substance use disorder often have lives that have no
sense of organization or stability and this theory allows for structure. It
allows addicts to see how irrational their thoughts and behaviors are rather
than just hearing it. Having a physical copy or journal of irrational beliefs
can provide a sense of control in a typically out of control life. I have no
true critiques of this theory, but I do believe it would be hard to implement
in mandated clients. If the client does not want to be there, it is going to be
harder to get them to follow through with doing homework and keeping a journal
to review their automatic thoughts.
This course has been very
eye-opening. I have explained that I have family that struggle with addiction,
but this provided a new insight to what addiction really is. I was able to gain
a more scientific understanding of addiction; what the body and the brain go
through, how many people are affected, what the different drugs are, and
various treatment methods. The videos were especially worthwhile. Hearing from
current and recovering addicts was sad, interesting, and helpful. They gave us
an opportunity to see the everyday struggles an addict can go through, the
effects on the families, and what we as future counselors will be up against.
I also enjoyed reading the opinions
of my peers. Writing and interacting with each other allows for the opportunity
to gain another perspective, one we might not have thought of without our
discussion posts. Here, we were questioned and challenged to examine the
material further, making it more interactive and interesting to learn about.
This assignment is a creative way
to exam our own biases and how we plan to work through them. We are also
challenged to think more about the theories, style, and techniques we could see
ourselves implementing in future practice, and what we believe needs improved
and what we can do to make it more beneficial for our clients.
C., Haddock, G., Tarrier, N., Lewish, S. W., Moring, J., O’Brien, R., et al.
(2001). Randomized controlled trial
of motivational interviewing, cognitive behavioral
therapy, and family intervention for
patients with comorbid schizophrenia and substance
use disorders. Am J Psychiatry, 158, 1706-1713.
J. S., Liese, B. S., Najavits, L. M. (2005). Cognitive Therapy. Frances, R. J.,
Mack, A. H.,
Miller, S. I. (Ed. 3.), Clinical textbook of addictive disorders
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The Guilford Press.
K. M. (1999). Behavioral and cognitive behavioral treatments. In B. S. McCrady
& E. E.
Epstein (Eds.), Addictions: A comprehensive guidebook (pp. 250-267). New York:
Oxford University Press.
M. E. (1997). Cognitive-behavioral therapy for substance abuse disorders. In L.
Dickstein, M. B. Riba, & J.
Oldham (Eds.), American Psychiatric Press
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Washington, DC: American Psychiatric Press.