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Addiction and Recovery: Foundational Principles 1
Light University Online
Addiction and Recovery: Foundational Principles
ARCO 501
Module 2
Addiction and Recovery: Foundational Principles 2
Light University Online
Module Two
Table of Contents
Models of Addiction David Jenkins, Psy.D. .................................................................................................................................................... 3
Addiction: Sin vs. Disease? A Holistic Model to Understand and Cure Addiction Karl Benzio, M.D. . ...................................................................................................................................................... 12
MODELS OF ADDICTION AND RECOVERY
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Description Addiction is a very complex area of study – psychologists and doctors have been trying to conceptualize, treat, and make sense of this destructive cycle for years. In this lesson, Dr. David Jenkins identifies ways in which people have tried to understand addiction. Students will be able to develop systematic ways of looking at addiction in order to point the way towards more effective treatment.
Learning Objectives:
1. Explain a number of models that can be used to understand addiction. 2. Identify key points, strengths, and limitations of the models.
3. Comprehend biblical integrative issues regarding the models.
MODELS OF ADDICTION
VIDEO
David Jenkins, Psy.D.
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I. Models of Addiction
A. Moral/Volitional Model Addiction is solely a model of personal choice and individual responsibility
Sin-Only type of model
Includes social sanctions
Hallmark sign of addiction includes loss of control over use of
substance/behavior
Underlies current truths towards increasing coercion and punishment as counter-measures to drunk driving
Strengths:
1. Places responsibility on the individual
2. Emphasizes personal choice/responsibility for recovery
3. Clarifies moral/spiritual issues of conduct
Limitations:
1. Does not take into account biological/environmental issues or other
factors involved in addiction
2. Tends to give unnecessary shame and guilt
B. Personality Model
There is an underlying disturbance in the person’s personality which contributes to or causes addiction.
Underlying traits simply get worse with behavior
Strengths:
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1. Highlights the importance of healthy personality development
2. Emphasizes that addiction may be a problem that is related to an underlying disturbance, cause, or psychological problem that needs to be addressed
3. Suggests the need for healing of the soul
Limitations:
1. There is mixed and unconvincing evidence that there is a such thing as an addictive personality as a stand-alone, identifiable personality type
2. Holds the potential to distract helpers from dealing directly with the addiction
3. Tends to overvalue individual personality at the expense of other critical aspects of being human, including the spiritual nature of people
C. Dispositional/Disease Model
Addiction is a disease and for that reason, addicts bear no responsibility for the problem.
Addicts are viewed as incapable of making rational decisions if they are actively engaging/expressing the use of the addictive substances/behaviors
Because of the inability to make rational decisions, coercion into treatment may
have to be utilized.
Something is irrevocably disturbed in the biology of the individual
Core assumptions of this model include that addiction is a unitary disease, qualitatively distinct, and discontinuous from being normal
Causes of alcoholism or addiction are solely biological, rooted in heredity and
physiology
Behavioral, family, and personality disturbances are merely symptoms of the disease addiction, and they represent the underlying physical abnormality in the body that is especially reactive to the substance/behavior
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Definitive Symptom: the inability to control the user consumption/engagement of the behavior
Addiction cannot be cured, but can be arrested through abstinence
Strengths:
1. Promotes acceptance of the disease 2. Helps to relieve the paralyzing guilt and shame that accompany addiction 3. Allows medical approaches
4. Opens up researchers to examine the causes, onset, symptoms,
progression, and treatment of addiction
5. Points to the fact that bodies are not in a glorified state and are susceptible to disease and addiction
Limitations:
1. Allows for denial of personal responsibility
2. Shared experience of other people who have the disease is an important part of recovery, but the limitation in that treatment is that it tends to emphasize personal stories and experiences rather than using other sources of information, evidence, and scientific research
D. Genetic/Physiological Models
Biological and genetic factors create vulnerability and predisposition for the development of addiction
Considers the issues of vulnerability and predisposition
Recognizes that there is not one particular “addicted gene”, but it is polygenetic – therefore, the solution will be complex
Strengths:
1. Lays the foundation for further research 2. Points to the need for intergenerational studies
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Limitations:
1. Intergenerational studies are ineffective at discerning effects of genetics
vs. environment
2. Research can become so narrowly focused that it fails to take into account other factors that may be contributing to the development of addiction
E. Conditioning & Reinforcement Behavioral Models
Addictive substance or behaviors are learned and reinforced through reward and negative reinforcement
Helps one understand both physiological and psychological addictions
Provides an understanding for the initiation and maintenance of addiction
Strengths:
1. Behaviors are readily observed and measured, and this may help in the
development of interventions 2. Treatment goals that are behavioral in focus can help people identify how
to change behavior and learn cues that set off the addictive response, allowing treatment plans to be better developed.
3. Emphasizes the role of learning
Limitations:
1. Individual tends to be treated in isolation from family and other relationships
F. Social/Environmental Models Larger social forces and factors (peer pressure, social policies, availability, etc.)
contribute to the development of addiction
Focuses on protective factors
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Largely defines addiction according to the deviance of social norms/conditions
Focuses on boundaries and appropriate behavior Strengths:
1. Helps identify relationships that can act as underlying factors in the
development and maintenance of addictive behavior 2. Once identified, the addictive behavior becomes more available to change
3. Emphasizes social forces in relationships and helps define healthy and
unhealthy relationships
4. Helps identify factors in a relational context, stressing the importance of the family environment
Limitations
1. It is difficult to accurately measure societal influences
2. There is some conflicting research about intergenerational transmission of addiction as a disease
G. Coping and Social Learning Model
Addiction develops as a result of having poor or inadequate coping mechanisms for dealing with the stressors of life
Emphasizes cognitive expectancies and vicarious learning
Focuses on the influence of peers
Strengths:
1. Takes into account the importance of both learning and social relationships, including one’s relationship with God
2. Deals realistically with cognitive and social aspects of addiction, as well as
behavioral aspects
3. Provides the expectation and hope for change
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Limitations:
1. People who cope well in life often become addicted anyway
2. Genetic predispositions tend to be minimized or ignored
3. There is the potential to minimize God-given capacities for resistance and resilience that human beings have
H. Integrated Bio-Psycho-Social-Spiritual Model
Addiction is best understood as a confluence or convergence of a number of factors. There is not simply one reason or pathway to addiction.
Strengths:
1. Recognizes that there may be multiple pathways to recovery
2. Example: Public Health Model
3. All contributing factors that can be related to the development of substance abuse are considered, which points to the fact that treatment can be multi-faceted
Limitations:
1. May be so broad and all-encompassing that people may lose focus
2. If addiction is potentially caused or influenced by everything, it is difficult to narrow down key contributory aspects to the development and maintenance of addiction
II. Biblical and Integrative Issues
A. Addiction results from the degrading effects of sin.
B. There is room for disagreement among Christians over use of substances that can become addictive.
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C. There should only be consensus that excessive and addictive use of any substances is strongly discouraged or condemned.
D. Addiction may be viewed as a worship disorder that amounts to a form of
idolatry.
E. Ephesians 5:1-21 – This passage stresses wisdom, thankfulness, and mutual submission
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Study Questions
1. Discuss the notion that addiction is a very complex area of study, and why there are so many models of addiction.
2. Give a brief overview of each model of addiction mentioned in the lesson. Which one has the most appeal?
3. Compare and contrast the Dispositional-Disease Model and the Genetic-Physiological Models.
4. Discuss the Integrated Bio-Psycho-Spiritual-Social Model. How is this model helpful to counselors?
5. Discuss this statement: “Addiction distorts the image of God in human beings and adversely impacts sanctification in a believer.” How does this affect one’s role as a counselor?
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Description Sin is intimately tied to decision making. Decisions have complex causes and reactions. In this lesson, Dr. Karl Benzio introduces the physiological, psychological, and spiritual factors related to decision making and addictive behavior.
Learning Objectives: This lesson is intended to provide the student with an informative overview of this material. The material will not be part of the testing for this module, but will be integral in a discussion forum. Notes:
ADDICTION: SIN VS. DISEASE? A HOLISTIC MODEL TO UNDERSTAND AND CURE
ADDICTION
AUDIO
Karl Benzio, M.D.
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