Alcoholics Anonymous, Essay Example

John Doe is a 57 year old male who is a current user of cocaine. Furthermore, he has abused alcohol for approximately 15 years. His financial situation makes it difficult to fund his addictions and he has resorted to committing petty crimes in order to ensure that he will be able to receive his next fix. Doe has been to jail several times for being caught committing these crimes and he is currently out on bail. Understanding an addict’s readiness to change allows a successful treatment program to begin (Battaglia, 2009). Doe is in the precontemplation stage of change. He does not realize that his actions are problematic and contributing to more severe problems in his life. His family members know that he needs to change, but Doe does not recognize that his behavioral patterns are considered abnormal; he has always used cocaine and consumed alcohol throughout his life, but it has only begun to interfere with his personal relationships and lead him to crime recently. It would be beneficial for Does to rethink his behaviors. He has aged significantly compared to his siblings, seemingly due to drug use. It is therefore having a negative impact on his physical health and he may benefit from mental health counseling. It is essential for either trained counselors or close friends to help him come to the realization that he has a problem and he should begin to make changes to resolve it.

The Precursors Assessment Form for Predicting and Enhancing Psychotherapeutic Change indicates that change is unlikely in this individual. Counseling efforts should focus on educating the client on change and focus should be on the precursors with the lowest ratings. In this particular situation, several precursors received ratings of none, and effort should be taken to increase them to at least one. Table 1 shows that John Doe’s sense of necessity for change, awareness in identifying the problem, ability to confront the problem, and effort towards change are marked as not existing in this individual. If each of these points are successfully changed to at least one, Doe will be considered more likely to change his habits and behaviors.

According to the DSM-IV, John Doe is a substance abuser rather than substance dependent because his drug and alcohol use interferes with his ability to live a relatively normal life outside of his addiction. The criteria for substance abuse that pertain to Doe’s situation include, “failure to fulfill major role obligations at work, school, home such as repeated absences or poor work performance related to substance use; substance-related absences, suspensions”; “frequent use of substances in situation in which it is physically hazardous”, “frequent legal problems for substance abuse”, and “continued use despite having persistent or recurrent social or interpersonal problems”. As a consequence of his substance abuse, John Doe fails to attend work when expected, and since being let go from his job is prevented from searching for another. Furthermore, while he avoids alcohol consumption when driving, he is often high on cocaine. As stated above, Doe has been to jail several times to serve crimes related to raising funds to support his addition. Lastly, this addiction has interfered with his social life, causing many fights with his wife that has led to discussions about divorce.

While John Doe is primarily a substance abuser due to the fact that he meets all four DSM-IV substance abuse criteria, he also demonstrates substance dependence. He reports that he exhibits “tolerance or markedly increased amounts of the substance to achieve intoxication or desired effect or markedly diminished effect with continued use of the same amount of substance”, “withdrawal symptoms or the use of certain substances to avoid withdrawal symptoms”, and “reduction or abandonment of social, occupational or recreational activities because of substance use”. It is possible that Doe fall into the other criteria for substance dependence, but it is difficult for him to compare his behaviors before and during his period of abuse. Furthermore, there is no persistent desire to cut the substance use because Doe does not recognize these actions as problematic.

The general treatment approach that will be used for this individual is the 12 Step Program because the primary goal of treatment in this stage is to allow him to recognize that he has a problem. Once this is accomplished, additional therapies could be added to supplement treatment. Traditionally, the 12 Step Program enables the addict to seek help from a higher power. This would be effective for John Doe because he was raised as a devout Catholic. Furthermore, he has lost his mother a few years ago, and it would be beneficial for him to think about how she would react to his current state as a judgment of whether he is doing well or if his behaviors are erroneous.

The 12 Step Program is useful in this situation because it can be used to allow John Doe to recognize that he has a problem with both alcohol and cocaine. The first step of this program is to assist the addict in recognizing that their lives are unmanageable and this is due to the harmful effects of the substance(s) they are abusing (Alcoholics Anonymous, 1993). Next, they must come to the realization that a higher power can restore them to sanity. Since John Doe already believes in a higher power, this step will be simplified. This will then allow him to turn his life over to the will of God and allow him to be healed in this manner. Eventually after admitting his problem to God, Doe will himself finally grasp that there is a problem that must be solved. He will focus on his changes through prayer and meditation, make amends to the people that he has harmed, and be more willing to speak to friends and family about his struggle. Once John Doe recognizes this problem and begins to ask his family support, he will have successfully reached the preparation stage of change which will allow him to make the necessary alterations in his life.

It is essential to consider that each step of the 12 Step Program is difficult to achieve in isolation. Therefore, the five specific treatment techniques I would use with this person include group therapy, family therapy, future-oriented therapy, art therapy, and behavior modification therapy. As table 1 shows, the Precursors Assessment Form demonstrates that John Doe’s sense of necessity for change, awareness in identifying the problem, ability to confront the problem, and effort towards change do not exist. Therefore, these therapies will cater to the solution of these issues. Group therapy will be used to show Doe that there are individuals similar to him who recognize that they have a problem. Furthermore, it will provide him with information concerning how they are personally dealing with their addictions, which will allow Doe to determine whether he believes these methods would be able to help him as well. Group therapy can be extended to visiting a local church of his choice, where he speaks to other addicts in a specifically religious context. Next, family therapy will be conducted. The Precursors Assessment Form recognized that Doe has social support for change, including a wide network of family and friends that he can confide in. Therefore, these individuals will be called in to help Doe by allowing them to talk to him in a guided manner. This will emphasize that he will continue to have support from his friends and family throughout the process and that they want him to succeed. Furthermore, this group will continue to act as support for him even after he makes necessary changes. They may be able to act as a barrier that prevents him from reverting to his old behaviors and habits after he is cured. Future directed therapy has been shown to reduce symptoms of depression and anxiety. A likely reason that John Doe began his substance abuse was due to problems he experienced in his life that resulted in these symptoms. Therefore, it is essential to remove the root cause of substance abuse. This is consistent with the 12 Step Program because it will allow him to learn an advanced set of skills that will allow him to take charge of his future and create more of the life he wants to live. This will also help him cope with the social difficulties that resulted due to his behavior related to the substance abuse. Art therapy will be utilized primarily to determine what Doe is thinking throughout his recovery while allowing him a unique manner of communication if conversation with therapists and other addicts is not adequate. Since his awareness of the problem was marked low on the Precursors Assessment Form, it is essential to find ways that will allow Doe to comfortable communicate with the therapy staff. To ease him into the process of constant communication with others for healing, art therapy will provide a good transition into this activity. Furthermore, art therapy often feels like it is not therapy at all, which will add additional comfort to the situation. Lastly, behavior modification therapy will be used to address some of Doe’s behaviors related to substance abuse and withdrawal. He will be taught how to fight his urges and be told useful ways to help repair his damaged relationships. He will be awarded when he demonstrates that he is able to behave appropriately (Martin et al., 2007).This therapy recommendation will not cure John Doe of his addiction, but will allow him to recognize that he has a problem. Doing so will provide a context that allows him to make continued improvement in the future. The precontemplation stage of change is difficult to treat in addicts due to their inability to seek help, but it is crucial to determine who these individuals are so they can begin to be helped to recover.

References

Alcoholics Anonymous. (1993). Alcoholics Anonymous: the story of how many thousands of   men and women have recovered from alcoholism. New York City : Alcoholics Anonymous World Services.

Battaglia E. (2009). Stages of Change and Substance Abuse Treatment. Drug & Alcohol Addition Recovery Magazine. Retrieved from http://www.drugalcoholaddictionrecovery.com/stages-of-change-and-substance-abuse-treatment/

Perkinson, R. R. (2007). Chemical dependency counseling: A practical guide. Thousand Oaks, CA: Sage.

Martin, G.; Pear, J. (2007). Behavior modification: What it is and how to do it (Eighth Edition). Upper Saddle River, NJ: Pearson Prentice Hall,