1. Johnson’s Model of Substance Dependency
Disease - Alcoholism and chemical dependency are a disease. ( A disease has its own symptoms and is describable)
Primary Disease-It is not a secondary symptom of some thing else
Progressive Disease-It progressively gets worse. People become physically, psychologically, and spiritually ill.
Chronic Disease-There is no cure, There is no way to safely use substances again.
Fatal Disease-The disease can only be arrested. If it is not arrested, the person will die from it.

2. Phase 1: The Learning Phase
Pain Normal Euphoria
________________[_________]________________

3. Phase 2: The Mood Swing Pain Normal Euphoria
________________[_________]________________

4. Phase 3: Harmful Dependency
Pain Normal Euphoria
________________[_________]________________

5. Phase 4: Chronic Stage Pain Normal Euphoria
________________[_________]________________

6. Alcoholism As A Disease
Jellineck (late 1940’s) established that alcohol dependence progressed through a natural sequence.
Disease concept includes the notions that alcoholics are out of control and abstinence is the only answer.

7. Alcoholism: A Genetic Link?
Nature VS. Nurture
Twin Studies:
3,000 children ion Sweden
showed children with one biologic alcoholic parent was at a greater risk of developing an alcohol problem
Even when raised by adoptive parents

8. Cognitive/Behavioral Approach to Substance Problems (1)
Problematic substance use arises based on a number of motivations
Individuals lacking coping/life skills may use substances to self-medicate
Abusive patterns of use can be changed
Concept of controlled drinking

9. Cognitive/Behavioral Approach to Substance Problems (2)
Problematic use is a result of Nurture, not Nature
Problematic use does not always result in death
Physical dependence does not occur (Vietnam vets)
Problematic use is a learned behavior that can be unlearned
Use is a way of coping yourself and your world

10. Disease Concept: Treatment
Abstinence
Alcoholics Anonymous
Narcotics Anonymous
Turn life over to a higher power
Once alcoholic, always an alcoholic
Treatment Services

11. Cognitive/Behavioral: Treatment
Controlled drinking
Counseling focusing on:
Rational Thinking
Cognitive Restructuring
Development of life skills
Development of self-awareness and self efficacy