Addiction Treatment with Deaf and Hard of Hearing People: An Application of the CENAPS Model

ABSTRACT

Alcohol and drug addiction is a significant problem among deaf and hard of hearing people. Looking through a Deaf culture lens, treatment for alcohol and drug addiction is key for providing care for deaf and hard of hearing clients. Using the CENAPS model, an applied cognitive-behavioral therapy program is recommended for addiction treatment. The CENAPS model provides clinicians with tools for stabilizing deaf and hard of hearing clients, supporting their transition to early recovery. Educating the client about the stages of relapse and the stages of recovery, clinicians using this model can better treat and prepare deaf and hard of hearing clients for long-term recovery.     

Toward a grounded theory of lesbians' recovery from addiction

This article presents the results of a qualitative study on lesbians' recovery from addiction. The study involved semi-structured interviews with 20 lesbians in recovery from addiction and was analyzed using grounded theory method. The central theme that emerged was self-acceptance, both as a lesbian and as a recovering alcoholic/addict, with considerable interaction between the two. Categories that contributed to this theme were learning to recover, relationships with other people, and relationship with something bigger than self. The discussion addresses how this information can be used to assist lesbians trying to recover from addiction.     

Applying an Ecological Framework to Understanding Drug Addiction and Recovery

ABSTRACT

A new conceptual model of drug addiction and recovery, the Acculturation Model, is presented, with “addiction” and “recovery” understood as distinct sociocultural phenomena with their unique prescribed behaviors, rituals, symbols, and language that serve to construct and consolidate a cultural identity. The model suggests that individuals in recovery from drug addiction will need to make a cultural transformation in order to maintain sobriety. Examples of specific rituals that may help facilitate movement from addiction to recovery are detailed.     

Collegiate Recovery Communities Programs: What Do We Know and What Do We Need to Know?

As the broad construct of recovery increasingly guides addiction services and policy, federal agencies have called for the expansion of peer-driven recovery support services. The high prevalence of substance use and abuse in colleges and universities in the United States constitutes a significant obstacle to pursuing an education for the unknown number of youths who have attained remission from substance use dependence. Collegiate recovery programs (CRPs) are an innovative and growing model of peer-driven recovery support delivered on college campuses. Although no systematic research has examined CRPs, available site-level records suggest encouraging outcomes: low relapse rates and above-average academic achievement. The number of CRPs nationwide is growing, but there is a noticeable lack of data on the model, its students, and their outcomes. We review the literature supporting the need for the expansion of CRPs, present information on the diversity of CRP services, and outline key areas where research is needed.     

The influence of unconscious fantasy process in addictions and relapse

This discussion reaffirms the connection between addiction and underlying unconscious fantasy process. It suggests that unconscious fantasies play a determining role in persisting patterns of substance abuse and addiction. Within this context, addiction is understood both as a derivative of thepersistence of these unresolved fantasies and an inadequate compromise formation. It suggests that relapse is a manifestation of the episodic reassertion and influence of these powerful fantasies. Consequently, successful treatment requires the working through of the underlying fantasy process and the establishment of healthier compromise formations.     

Narratives of Low-Income Mothers in Addiction Recovery Centers: Motherhood and the Treatment Experience

ABSTRACT

This study examines the narratives shared by low-income women in addiction recovery centers about the meaning they attach to being a parent in recovery and how they view current program models that include children in daily treatment. Their stories reflect the centrality of the mothering role to women in recovery and offer insights that can guide treatment and program planning with families.     

How soon is too soon? Addiction recovery and family reunification

This article describes the addiction recovery process and its impact on parenting behaviors-information needed by child welfare workers involved in decisionmaking regarding family reunification. Two models of recovery-from alcoholism and from cocaine addiction-are reviewed, along with issues encountered in recovery, particularly for women. Case examples and discussion demonstrate how child welfare workers can apply these models in determining the appropriateness of reunification.     

Integrating Art Therapy Methodology in Brief Inpatient Substance Abuse Treatment for Adults

ABSTRACT

Decades of drug addiction research and clinical work have underscored the need for multifaceted and comprehensive treatment responses in order to sufficiently address the varied needs of individuals struggling with addiction. One valuable treatment component that can be incorporated into traditional treatment protocols to expand the comprehensive nature of treatment response is art therapy. A conceptual framework is presented, detailing the integrative opportunities and benefits of including an art therapy component to short-term hospital-based inpatient substance abuse treatment programs. A creative arts component can be particularly beneficial for brief inpatient programs, where the client population is diverse, in crisis, and at high-risk for relapse; and where clinicians need to obtain comprehensive client information from multiple sources in a short amount of time. Art therapy methodology can provide a mechanism for collecting such collateral information for assessment purposes, can be employed to facilitate therapeutic change, and is used to track and document client progress and clinical change over time. Practice guidelines and specific treatment techniques are presented through short case examples.     

Incorporating Spirituality and the Strengths Perspective into Social Work Practice with Addicted Individuals

Abstract

In the last two decades, the social work profession began to confront the professional avoidance of alcoholics and other drug addicts, and discussions of spirituality. While acknowledging the importance of 12-Step Programs of Alcoholics/Narcotics Anonymous, we also acknowledge that spirituality is a major aspect of addiction and recovery from an addiction. The authors present the Strengths Perspective and apply key concepts to Steps 1-3 of the 12-Steps to increase our understanding of addiction and recovery from alcoholism and other drug addiction. The article concludes that social workers must continue to increase their understanding of the recovery and spiritual issues of alcoholics and other drug addicts.     

Exploring the factors influencing relapse and recovery among drug and alcohol addicted women

1. Both women who were in treatment for relapse to and in sustained recovery from drugs and alcohol had multiple co-occurring addictions such as relationship, spending, food, and shopping that complicated the recovery process. 2. Depression is a major trigger for relapse in women with alcohol and drug problems. Recognition and treatment of depression is critical to achieve successful outcomes of treatment for these women, and teaching them to monitor their mood changes and seek help will improve the chances of preventing relapse. 3. Subjects in neither the relapse nor recovery sample recognized the significant influence of current violent partnerships or the ending of a violent relationship on their relapse or recovery.     

“I AM STILL SUFFERING:” THE DILEMMA OF MULTIPLE RECOVERIES IN THE LIVES OF METHADONE MAINTENANCE PATIENTS

This study examines narratives on the meaning of addiction recovery through interviews with 45 methadone maintenance treatment (MMT) patients. Results show that heroin addicts are dealing with multiple recoveries and many are simultaneous to each other: recoveries concerning (1) addiction, (2) associational disruptions, (3) self-identity and actualization, (4) drug induced diseases (HIV/AIDS, HCV, etc.), and (5) catalyzing event(s). The research findings, anathema of clinical MMT views on recovery, suggest that drug addicted individuals might benefit from interventions that address their multiple recovery issues as opposed to ones that emphasize recovery strictly in sobriety terms.     

A Systematic Review of Psychosocial Interventions in Treatment of Opioid Addiction

Opioid addiction has become a U.S. epidemic. It is important to determine whether psychosocial interventions help prevent relapse. A total of 14 studies were included in this systematic review. Most studies compared psychosocial interventions in conjunction with pharmacological maintenance. Only 2 studies found that psychosocial interventions led to statistically significant benefits for outcomes related to opioid abuse when compared to maintenance and less or no psychosocial intervention. Psychosocial interventions were not found to be additive to pharmacological treatments during induction or maintenance stages. Further research is needed to determine effectiveness of psychosocial interventions during dose reduction and long-term relapse prevention.     

Perceptions of Substance Abuse on College Campuses: Proximity to the Problem,Stigma, and Health Promotion

For college students recovering from substance addiction, the path to sobriety is fraught with challenges. Many campuses offer recovery support resources, but students indicate stigma associated with recovery prevents them from using these services. This problem could be ameliorated through communication campaigns addressing misperceptions of substance abuse and recovery. The purpose of this study was to understand how students’ perceptions of addiction and recovery vary based on their experience and background. A quantitative survey was employed to examine stigma beliefs among 2 subpopulations of college students at a large Southwestern university. Findings indicate students with exposure to issues surrounding substance abuse and recovery held fewer stigmatized beliefs, emphasizing the importance of identifying and researching a target audience before developing a health promotion campaign.     

Neuroscience in Social Work Practice and Education

Abstract

In the past two decades, advances in neuroscience research have revolutionized the scientific community's understanding of branehavior connections. Social work is now taking note of this trend. Specialists in substance abuse, addiction, and co-occurring diagnoses are beginning to relinquish long-held beliefs in mind-body dualism in favor of a truly integrated biopsychosocial understanding. This article identifies challenges related to social work and argues that neurobiological knowledge is essential for a biopsychosocial understanding of substance abuse and addiction, other mental disorders, co-occurring conditions, and human behavior. It gives examples of drawing on neurobiological knowledge for practice applications. These include educating users, families, and providers about neurobiological aspects of substance abuse (psychoeducation); using neuroscience research on mental illness and addiction to develop integrated approaches for dually diagnosed persons; and considering a range of medication options to alleviate cravings and reduce relapse.     

Briefly Noted

Clayton Stafford died after using Vivitrol, and his family is suing Alkermes, the manufacturer, saying that the medication doesn't adequately treat addiction, compared to buprenorphine and methadone, and that the manufacturer knew this. In the lawsuit, California‐based law firm Lieff Cabraser alleges that Stafford, his parents and his treatment providers were misled into thinking Vivitrol was an appropriate treatment for his opioid use disorder. “Clayton Stafford's tragic death could have been avoided,” notes Lieff Cabraser partner Fabrice N. Vincent, who filed the lawsuit on behalf of the Stafford family. “The well‐reported defects in Vivitrol made Clayton's overdose a near‐foregone conclusion, and had the Staffords received accurate information about Vivitrol's risks and effective deficiencies from Alkermes, they would never have consented to its use by Clayton.” Naltrexone doesn't work to treat addiction and cravings, but just to block the effects of opioids, according to the lawsuit (and many others agree with this). “Because the patient's addiction is not adequately treated, the patient requires indefinite Vivitrol use to merely block the euphoric effects and keep the patient from seeking opiates,” Vincent said. “Patients therefore remain highly likely to relapse despite indefinite use of Vivitrol.” The lawsuit also makes note of Alkermes' direct‐to‐consumer marketing campaign, which extended into influencing the criminal justice system to use Vivitrol. Stafford had been mandated to use Vivitrol. Last year, the Food and Drug Administration issued a warning letter to Alkermes stating that its advertising did not state that stopping Vivitrol can lead to relapse and overdose, as is clearly stated by the label and package insert (see “FDA warns Alkermes about OD risk on Vivitrol ads,” ADAW, Dec. 16, 2019, https://onlinelibrary.wiley.com/doi/10.1002/adaw.32566 ).     

Beyond “Dry Drunkenness”: Facilitating Second Stage Recovery Using Wilber's “Spectrum of Consciousness” Developmental Model

ABSTRACT

The usefulness of Wilber's “Spectrum of Consciousness” developmental model in the treatment of substance abuse is demonstrated by a case study that illustrates how underlying emotional pain and intimacy issues can be worked through in the counselling process with a client during the second stage of recovery from addiction. Wilber's model allows for narcissistic, critical self, social, identity, intimacy, existential, and psycho-spiritual issues to be integrated into the counselling process for long-term recovery. This model provides social workers and addictions counselors with a useful map in embracing client recovery.     

Attitudes about addiction: a national study of addiction educators

The following study, funded by the National Institute of Drug Abuse (NIDA), utilized the Addiction Belief Inventory (ABI; Luke, Ribisl, Walton, & Davidson, 2002) to examine addiction attitudes in a national sample of U.S. college/university faculty teaching addiction-specific courses (n=215). Results suggest that addiction educators view substance abuse as a coping mechanism rather than a moral failure, and are ambivalent about calling substance abuse or addiction a disease. Most do not support individual efficacy toward recovery, the ability to control use, or social use after treatment. Modifiers of addiction educator attitudes include level of college education; teaching experience; licensure/certification, and whether the educator is an addiction researcher. Study implications, limitations, and directions for future research are discussed.     

After 30 years,SAMHSA walks away from Recovery Month

“Recovery” is widely considered the main brand of the Substance Abuse and Mental Health Services Administration (SAMHSA), and every September for 30 years, recovery from addiction has been celebrated, with gradually increasing input from the recovery field. But communication, hasn't been SAMHSA's strong point, at least with the recovery community.     

Psychodynamic therapy for SUD: Counselor's view

First of all, psychodynamic psychotherapy as treatment for substance use disorder (SUD) works. Ian McLoone, lead therapist with the Alltyr Clinic in Minneapolis, knows that firsthand — he's in recovery from heroin addiction and is in it himself. And despite the fact that addiction therapists aren't taught psychodynamic theory or psychoanalytic psychotherapy in graduate school, where cognitive behavioral therapy (CBT), motivational interviewing (MI) and, to a lesser degree, 12‐Step facilitation are stressed, he became interested in it mainly because of his employer, Mark Willenbring, M.D., a psychiatrist and former medical director of the National Institute on Alcohol Abuse and Alcoholism. We talked to McLoone for this story as a follow‐up to our article on the self‐medication hypothesis of addiction, for which we interviewed its developer, Ed Khantzian, M.D. (see “Psychodynamic psychotherapy: When it helps people in recovery,” ADAW, June 22, https://onlinelibrary.wiley.com/doi/10.1002/adaw.32756 ).     

How does the stigma of problem gambling influence help-seeking,treatment and recovery? a view from the counselling sector

Problem gambling attracts considerable public stigma and can cause significant self-stigma. However, little research has investigated the role of stigma during treatment-assisted recovery from problem gambling. This study aimed to examine gambling counsellors’ perspectives on whether and how the stigma associated with problem gambling influences problem acknowledgement, help-seeking, treatment and recovery. In-depth interviews with nine gambling counsellors from Victoria, Australia, were analysed to extract shared meanings of experiences using interpretative phenomenological analysis. Counsellors indicated that the burden of problem gambling is typically increased by the addition of stigma and its impacts. This stigma is created and maintained by a lack of public understanding about problem gambling and its causes, and internalization of self-stigmatizing beliefs, leading to delayed help-seeking, anxiety about attending treatment, concerns about counsellor attitudes, and fear of relapse. Counsellors maintained that, before effective gambling treatment could occur, they needed to help clients overcome their self-stigmatizing beliefs to establish confidence and trust in the counsellor, restore self-esteem, enhance stigma coping skills and foster a belief that recovery is possible. Harnessing support from significant others and preparing clients for relapse were also important inclusions to lower stigma. Addressing stigma early in treatment can help to improve treatment adherence and recovery.