Introduction to Addictive Behaviors, First Edition

by Thombs, Dennis L.

• ISBN13: 9780898623369
• ISBN10: 0898623367
• Edition: 1st
• Format: Hardcover
• Copyright: 1994-01-10
• Publisher: The Guilford Press

Summary

This unique book is written specifically for the entry-level counselor preparing for work in the addictions treatment field or the master's-level mental health professional who has little or no training in the treatment of alcohol and drug dependence. An ideal training text, Introduction to Addictive Behaviors reviews and critiques the major contemporary perspectives on alcoholism and other addictions. Emphasizing behavioral science theory rather than the biology or pharmacology of alcohol and drug dependence, the volume explores those theories most important to the front-line substance abuse counselor and mental health clinician: the disease model, psychoanalytic formulations, and theories based on conditioning, social learning, family systems, and sociology. In the treatment field today, there is an enormous gap between clinical practice on the one side and theory and research on the other. Introduction to Addictive Behaviors integrates theory and research with clinical practice to help entry-level practitioners more effectively treat clients with drug and alcohol problems. Clearly illustrating the importance of theory in clinical practice, each chapter features examples that demonstrate how concepts are applied to the helping process. Moreover, each section includes review questions to help clarify and reinforce major points, making the book ideal for classroom use. Introduction to Addictive Behaviors is essential reading for courses in psychology, counseling, social work, nursing, and health science that deal with alcohol and drug dependence. It is invaluable for master's-level counselors, social workers, health educators, nurses, occupational therapists, and other mental healthprofessionals preparing for entry-level work who have limited graduate training in alcoholism and other drug dependencies.

Author Biography

Dennis L. Thombs, PhD, is Associate Professor in the Department of Adult, Counseling, Health, and Vocational Education at Kent State University

Table of Contents

The Multiple Conceptions of Addictive Behavior and Clinical Practice Today	p. 1
Conceptions of Addiction in U.S. History	p. 1
Addiction as Immoral Conduct	p. 4
Addiction as a Disease	p. 6
Addiction as Maladaptive Behavior	p. 8
The Need for Theory	p. 9
What Exactly Is a Theory?	p. 10
Formal Attributes of a Good Theory	p. 11
Substantive Attributes of Theories on Addictive Behavior	p. 12
Theory, Research, and Contemporary Clinical Practice	p. 14
Barriers to Change in the Treatment Community	p. 16
Practical Issues Ignored by Researchers	p. 18
Recent Efforts to Bridge the Gap: Technology Transfer	p. 19
Competently Administered Prevention and Treatment Programs Are Effective	p. 21
Purpose of the Book	p. 23
Review Questions	p. 24
References	p. 25
The Disease Models	p. 29
Different Disease Conceptions	p. 30
Tolerance and Withdrawal	p. 31
Addiction as a Primary Disease	p. 32
Genetic Origins of Addiction: The Susceptibility Model	p. 34
Effects of Drugs on Brain Structure and Function: The Exposure Model	p. 54
Loss of Control	p. 61
Addiction as a Progressive Disease	p. 64
Addiction as a Chronic Disease	p. 68
Denial	p. 69
Strengths of the Disease Models	p. 70
Weaknesses of the Disease Models	p. 71
Review Questions	p. 72
References	p. 73
Psychoanalytic Formulations	p. 81
Freud	p. 81
Psychoanalysis: A Type of Psychotherapy	p. 81
Personality Structure	p. 84
Anxiety, Defense Mechanisms, and the Unconscious	p. 86
Psychosexual Development	p. 89
Insights into Compulsive Substance Use	p. 92
Contemporary Treatment of Addiction	p. 99
The Importance of Psychoanalytic Concepts in Substance Abuse Counseling	p. 102
General Criticisms of Psychoanalysis	p. 103
Criticism of the Psychoanalytic View of Addiction	p. 104
Review Questions	p. 105
References	p. 106
Conditioning Models and Approaches to Contingency Management	p. 109
Conditioned Behavior	p. 110
Initiation of Alcohol and Drug Use	p. 114
Addiction	p. 115
Relationship between Addiction and Physical Dependence	p. 115
Cessation and Relapse	p. 116
Blood Alcohol Discrimination	p. 117
Behavioral Tolerance	p. 119
Principles of Contingency Management	p. 124
Applications of Contingency Contracting	p. 125
Effectiveness of Contingency Management Approaches	p. 140
Review Questions	p. 140
References	p. 141
Cognitive Models	p. 144
Basic Social Cognitive Concepts	p. 144
Modeling and Substance Use	p. 148
Self-Efficacy and Treatment Outcomes	p. 150
Role of Outcome Expectancy in Alcohol and Drug Use	p. 153
Alcohol and Stress: Cognition as a Mediating Process	p. 163
Stress Response Dampening	p. 166
Tiffany's Model of Drug Urges and Cravings	p. 167
Relapse	p. 169
Project MATCH: A Test of Cognitive Therapy	p. 177
Summary	p. 177
Review Questions	p. 178
References	p. 180
The Family System	p. 184
Clinically Generated Concepts	p. 184
Bowen's Family Systems Theory	p. 196
Codependency	p. 203
Children in Alcoholic Families: Clinical Accounts	p. 206
Role Behavior	p. 208
The Process of Family Therapy	p. 213
Findings from the Research Literature	p. 216
Summary	p. 229
Review Questions	p. 230
References	p. 231
Social and Cultural Foundations	p. 236
Resistance to Considering the Social Origins of Alcoholism	p. 236
Time and Place as Social Determinants of Illicit Drug Use	p. 237
The Influence of Culture on Diagnostic Determinations	p. 239
Sociological Functions of Substance Abuse	p. 241
Social Facilitation	p. 242
"Time Out" from Social Obligations	p. 244
Promoting Group Solidarity/Establishing Social Boundaries	p. 246
Drug Subcultures: Repudiation of Middle-Class Values	p. 251
Implications for Counseling	p. 261
Limitations	p. 264
Review Questions	p. 265
References	p. 266
Conditions That Facilitate and Inhibit Change in Addictive Behavior	p. 270
Addictive Behavior Models and Client Motivation	p. 271
Stages of Change in Addictive Behavior	p. 273
Coercion	p. 278
Confrontative Treatment	p. 281
Motivation Enhancement	p. 282
Harm Reduction Approaches	p. 283
The Impact of Managed Care	p. 284
Review Questions	p. 286
References	p. 286
Author Index	p. 290
Subject Index	p. 297
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