1. CHAPTER 8 Prof. Maritza Leon-Veiguela, M.S. Mleon-veiguela@kaplan.edu

2.  Trend is leaning towards combining models and forming “Eclectic Model”  Minnesota Model (most well known)  Behavioral Techniques  Matrix Model  12 Step Facilitation Therapy  Cognitive-Behavioral Model  Motivational Enhancement Therapy  Pharmacological procedures

3.  Developed by Hazeldon Foundation in the 1940’s  Abstinence oriented  Multi-professional  Based on AA principles  Disease concept of AOD dependency  Promises recovery but no cure for those who adhere  Includes group therapy, counseling and lecture

4. 1. Clients change attitudes, beliefs and behavior 2. AOD dependence is a disease 3. Long term recovery, not cure, includes lifestyle improvement and complete abstinence from mood altering chemicals 4. Uses AA and NA principles as its philosophical and spiritual base

5. 1. Assessment & diagnosis 2. Detox 3. Inpatient therapeutic communities 4. Outpatient and aftercare 5. Group therapy is confrontational 6. Staff is multi-disciplinary 7. Recovering addicts used as counselors 8. Reading & writing assignments 9. Attend AA/NA meetings during and after 10. Work assignments or recreational activity

6. 1. Uses classical and operant conditioning to treat AOD addiction 2. Aversive conditioning includes unpleasant stimuli such as:  Nausea (most common)  Electric shock  Apnea  Unpleasant images 3. Covert Desensitization 4. Contingency Contracts 5. Community Reinforcement Approach

7. 1. Matrix Model – includes group, family therapy, emphasizes relationship betweem counselor and client. Promotes self esteem and self worth 2. 12 Step Facilitation Therapy – based on AA principles, similar to Minnesota Model 3. Cognitive Behavioral – bases on Social Learning Theory 4. Motivational Enhancement Therapy – based on motivational psychology 5. Pharmacological – controversial, should not be used as only treatment, contraindicated in many situations

8. 1. Family, Individual, and Group Counseling 2. Support Groups (AA, NA) 3. Lifestyle Changes 4. Education 5. Aftercare

9. 1. Therapeutic Community 2. Inpatient and Residential 3. Partial Hospitalization 4. Day Treatment 5. Intensive Outpatient/Outpatient

10. 1. No single treatment is appropriate for all individuals 2. Treatment needs to be readily available 3. Effective treatment attends to multiple needs of the individual, not just his or her drug use 4. Individual’s treatment and service plan must be continually assesses and modified as necessary to meet changing needs 5. Remaining in treatment for adequate period of time critical for effectiveness

11. 6. Counseling is critical component 7. Medication important element for many 8. Addicted client with co-existing mental illness should have integrated treatment 9. Medical detox first step but no good alone 10. Treatment does not have to be voluntary 11. Possible use during treatment must be monitored 12. Programs should assess presence of infectious diseases 13. Recovery is a long term process and oftentimes requires multiple episodes of treatment

12.  Ethnically Diverse Population  Elderly  Adolescents  People with disabilities  Women  Gay and Lesbian Population  Criminal Justice Population  Clients with Co-occurring Disorders

13.  Recovering Individuals as Counselors  Confrontation  Medication  Controlled Use  Natural Recovery

14. Reference Fisher, Gary L. & Harrison, Thomas C. (2009) Substance Abuse: Information for School Counselors, Social Workers, Therapists, and Counselors. 4 th edition. Allyn & Bacon: Boston, MA.