1. Chapter 16: Group Work: Addictions Introduction to Group Work, 5th Edition Edited by David Capuzzi, Douglas R. Gross, and Mark D. Stauffer

2. Introduction to Group Work, 5th Edition Edited by: David Capuzzi, Douglas R. Gross, and Mark. D. Stauffer Substance Dependence Demonstrating an increase or decrease in tolerance Showing symptoms of withdrawal or using to relieve or avoid symptoms Using more of substance or increasing frequency of use Having a strong desire to stop using and/or repeated unsuccessful attempts to stop Spending more time than intended obtaining, using, or recovering from use Avoiding or failing to meet social, family, occupational, or recreational activities because of use Continued use in spite of the likelihood of negative consequences (DSM-IV-TR)

3. Introduction to Group Work, 5th Edition Edited by: David Capuzzi, Douglas R. Gross, and Mark. D. Stauffer Substance Abuse Significant degree of impairment or distress within the past 12 months Recurrent failure to meet family, occupational, or school responsibilities due to use Recurrent use under hazardous conditions Persistent use in spite of negative consequences to health, family, social interactions, work or school performance Must not have met criteria for substance dependence (DSM-IV-TR)

4. Introduction to Group Work, 5th Edition Edited by: David Capuzzi, Douglas R. Gross, and Mark. D. Stauffer Models for Understanding Addictions and Compulsive Behaviors The moral weakness model The medical model The sociocultural models The biopsychosocial model

5. Introduction to Group Work, 5th Edition Edited by: David Capuzzi, Douglas R. Gross, and Mark. D. Stauffer Moral Weakness Model The oldest model Addict has a character disorder and lacks the moral fortitude to do the right thing. Addict is sinful and morally weak. Addict likely feels ashamed and keeps the problem a secret from others. Addict can be cured if he or she controls urges

6. Introduction to Group Work, 5th Edition Edited by: David Capuzzi, Douglas R. Gross, and Mark. D. Stauffer Medical Model Addiction = a disease that includes four stages Pre-alcoholic stage (to relieve social stress and pressures) Prodromal stage (includes blackouts, preoccupation with obtaining the substance, shame, guilt, concealment) Crucial stage (physical dependence, malnutrition, loss of control, lowered self- esteem, abandonment of other activities) Chronic stage (tremors, use of other drugs)

7. Introduction to Group Work, 5th Edition Edited by: David Capuzzi, Douglas R. Gross, and Mark. D. Stauffer Medical Model The conceptualization of alcoholism as a disease opened the door for systematic investigation of the problem and made treatment available to many people by allowing medical insurance to reimburse for treatment. The genetic model for understanding addictions is a subcategory of the medical model and proposes that people become addicted to substances because they are genetically predisposed to addictions.

8. Introduction to Group Work, 5th Edition Edited by: David Capuzzi, Douglas R. Gross, and Mark. D. Stauffer Sociocultural Models Encompass the concepts of family systems, peer pressure, cultural norms, and modeling theories Explain the addictive process from the perspective of forces in the environment that either encourage or inhibit the development of addictive behaviors

9. Introduction to Group Work, 5th Edition Edited by: David Capuzzi, Douglas R. Gross, and Mark. D. Stauffer Biopsychosocial Model Integrates aspects of the medical, sociocultural, and psychological models Attributes addiction to a combination of factors including genetic predisposition, exposure, individual reaction to the substance or behavior, social factors, learning, and environmental influences

10. Introduction to Group Work, 5th Edition Edited by: David Capuzzi, Douglas R. Gross, and Mark. D. Stauffer Substances of Abuse Stimulants Examples: caffeine, nicotine, Ritalin Depressants Examples: alcohol, benzodiazepines (e.g., Valium, Xanax), barbiturates (e.g., phenobarbital, Nembutal), opiates (e.g., morphine, Demerol) Cannabinols Examples: marijuana, hashish Hallucinogens Examples: LSD, PCP, Ecstasy, Psilocybin Inhalants Examples: household cleaning materials, nitrous oxide, ether

11. Introduction to Group Work, 5th Edition Edited by: David Capuzzi, Douglas R. Gross, and Mark. D. Stauffer Kinds of Addictions Substances Gambling Sex Food

12. Introduction to Group Work, 5th Edition Edited by: David Capuzzi, Douglas R. Gross, and Mark. D. Stauffer Treatment Modalities Inpatient: Treatment usually combines the expertise of physicians, recovering addicts, counselors, psychologists, nurses, and social workers as treatment, detoxification, rehabilitation, & aftercare take place. Groups are often part of the entire process. Partial hospitalization and intensive outpatient: Clients attend sessions in the hospital but sleep at home. Groups are often part of the entire process. Support Groups: AA, Narcotics Anonymous, Cocaine Anonymous, Overeaters Anonymous, and Gamblers Anonymous are examples. Groups are often part of the entire process.

13. Introduction to Group Work, 5th Edition Edited by: David Capuzzi, Douglas R. Gross, and Mark. D. Stauffer Advantages of Groups Harness peer pressure to achieve treatment goals Reduce the sense of isolation Some members act as role models Provides therapeutic factors Less expensive than individual treatment

14. Introduction to Group Work, 5th Edition Edited by: David Capuzzi, Douglas R. Gross, and Mark. D. Stauffer Issues to Consider Structuring and ground rules Closed vs. open Homogeneity vs. heterogeneity Leadership Relapse prevention