5 - Addictions Green


Show #5
Date: April 3rd, 2009
Chase Producer: James

Tape Date: April 2nd, 2009

Field Work
Camera: Matt
Editor: Kahleed

Guest: Leslie Davies-Lilly

Position/Title: Addictions Counselor

Focus: The focus of this segment is discover the treatment process of an drug addiction. We’ll ask Leslie what her approach is to treating clients with drug addictions and find out through her counseling experience how one can fight their addiction.

Production Notes
Taped Elements – a XXX min biography of Leslie-Davies Lilly
Time of arrival – 12:45 pm

Research (courtesy Wikipedia)

The term "addiction" is used in many contexts to describe an obsession, compulsion, or excessive physical dependence or psychological dependence, such as: drug addiction, video game addiction, crime, alcoholism, compulsive overeating, problem gambling, computer addiction, pornography addiction, etc.
In medical terminology, an addiction is a state in which the body relies on a substance for normal functioning and develops physical dependence, as in drug addiction. When the drug or substance on which someone is dependent is suddenly removed, it will cause withdrawal, a characteristic set of signs and symptoms. Addiction is generally associated with increased drug tolerance. In physiological terms, addiction is not necessarily associated with substance abuse since this form of addiction can result from using medication as prescribed by a doctor.
However, common usage of the term addiction has spread to include psychological dependence. In this context, the term is used in drug addiction and substance abuse problems, but also refers to behaviors that are not generally recognized by the medical community as problems of addiction, such as compulsive overeating.
The term addiction is also sometimes applied to compulsions that are not substance-related, such as problem gambling and computer addiction. In these kinds of common usages, the term addiction is used to describe a recurring compulsion by an individual to engage in some specific activity, despite harmful consequences to the individual's health, mental state or social life.

Methods of care
Early editions of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM) described addiction as a physical dependency to a substance that resulted in withdrawal symptoms in its absence. Recent editions, including DSM-IV, have moved toward a diagnostic instrument that classifies such conditions as dependency, rather than addiction. The American Society of Addiction Medicine recommends treatment for people with chemical dependency based on patient placement criteria (currently listed in PPC-2), which attempt to match levels of care according to clinical assessments in six areas, including:
Acute intoxication and/or withdrawal potential
Biomedical conditions or complications
Emotional/behavioral conditions or complications
Treatment acceptance/resistance
Relapse potential
Recovery environment
Some medical systems, including those of at least 15 states of the United States, refer to an Addiction Severity Index to assess the severity of problems related to substance use. The index assesses problems in six areas: medical, employment/support, alcohol and other drug use, legal, family/social, and psychiatric.
While addiction or dependency is related to seemingly uncontrollable urges, and arguably could have roots in genetic predispositions, treatment of dependency is conducted by a wide range of medical and allied professionals, including Addiction Medicine specialists, psychiatrists, psychologists, and appropriately trained nurses, social workers, and counselors. Early treatment of acute withdrawal often includes medical detoxification, which can include doses of anxiolytics or narcotics to reduce symptoms of withdrawal. An experimental drug, ibogaine,[13] is also proposed to treat withdrawal and craving. Alternatives to medical detoxification include acupuncture detoxification. In chronic opiate addiction, a surrogate drug such as methadone is sometimes offered as a form of opiate replacement therapy. But treatment approaches universal focus on the individual's ultimate choice to pursue an alternate course of action.
Therapists often classify patients with chemical dependencies as either interested or not interested in changing. Treatments usually involve planning for specific ways to avoid the addictive stimulus, and therapeutic interventions intended to help a client learn healthier ways to find satisfaction. Clinical leaders in recent years have attempted to tailor intervention approaches to specific influences that affect addictive behavior, using therapeutic interviews in an effort to discover factors that led a person to embrace unhealthy, addictive sources of pleasure or relief from pain.
Treatment Modality Matrix
Behavioral Pattern Intervention Goals
Low self-esteem, anxiety, verbal hostility Relationship therapy, client centered approach Increase self esteem, reduce hostility and anxiety
Defective personal constructs, ignorance of interpersonal means Cognitive restructuring including directive and group therapies Insight
Focal anxiety such as fear of crowds Desensitization Change response to same cue
Undesirable behaviors, lacking appropriate behaviors Aversive conditioning, operant conditioning, counter conditioning Eliminate or replace behavior
Lack of information Provide information Have client act on information
Difficult social circumstances Organizational intervention, environmental manipulation, family counseling Remove cause of social difficulty
Poor social performance, rigid interpersonal behavior Sensitivity training, communication training, group therapy Increase interpersonal repertoire, desensitization to group functioning
Grossly bizarre behavior Medical referral Protect from society, prepare for further treatment
Adapted from: Essentials of Clinical Dependency Counseling, Aspen Publishers
From the applied behavior analysis literature and the behavioral psychology literature several evidenced based intervention programs have emerged (1) behavioral maritial therapy (2) community reinforcement approach (3) cue exposure therapy and (4) contingency management strategies.[14][15] In addition, the same author suggest that Social skills training adjunctive to inpatient treatment of alcohol dependence is probably efficacious.

Suggested Host intro

Throughout most of our lives we are faced with roadblocks, challenges and obstacles and sometimes we feel they are impossible to overcome and we choose to escape, digging ourselves a deeper hole through use of drugs and alcohol until we become addicted. Today we’re fortunate to have Addictions Counselor Leslie Davies-Lilly speak to us about treating an addiction but first here’s a look at her biography.

Suggested Host extro

Well thank you Leslie for coming on and giving us your expert advice on treating drug addictions and I’m sure that your (input won’t go unnoticed? ) [tell me what you think] After the break we’ll look at….

Suggested Questions

What is your approach to treating people with a drug addiction?

When would you use an intervention and what kinds of interventions are appropriate?

How effective is drug addiction treatment?

What are the stages of recovery?

How long does drug addiction treatment last?

Can you share a success story of one of your clients battling a serious addiction?

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