Theoretical Practice Employing Cognitive, Research Paper Example

Theoretical Practice Employing Cognitive, Motivational Interviewing, and Solution Focused Theories to Addiction Group Therapy

Introduction

Cognitive behavioral, motivational interviewing, or solution-focused theoretical models are recognized as effective intervention in addiction group therapy practice. Intervention strategies applied to each of these models practiced in the addiction group therapy setting. Identify three different approaches the three in the following. Included in the following discourse is a sample dialogue of the clients’ statements and the counselor’s statements implementing the three strategies. The purpose of the intervention as well as anticipated outcome of its use as has been described by Rotgers an Sharp (2005) of intervention is that “treatment should be to initiate an maintain abstinence from not only the substance that created the … (addiction) that led to a diagnosis but often from all other substances as well (p.351)”.

Theoretical Practice

In practice it is essential in group intervention therapy for addiction to establish a mutual agreement with a set of guidelines about promoting both thoughtful and respectful dialogue as has been outlined by the National Institute of Drug Abuse (NIDA) (2018). Once this is understood the group can proceed with sharing their thoughts, experiences, insights, and expectations about group therapy outcomes. As a facilitator of the group therapy intervention process in developing and asking questions it is always about what Messina (2016) advises as applying open-ended type of questions.

The Therapy Models

Cognitive

The intention of employing the cognitive therapy intervention is to increase the clients’ level of understanding and awareness of the nature of their addictive behavior as explained by McCabe and Anthony (2005). The therapist asks frequent and specific questions further using a chalkboard, whiteboard, or easel for engaging the group members.

Therapist Writes Question on Chalkboard: How do you feel when your addiction wins over you not wanting to indulge? (Invites open invitation for responses)

First Client Response: “I am anxious, restless, confused, and angry”.

Second Client Response: “I just want to feel good and when I use, I feel good”.

Therapist Question Verbally: “So, once your high is over how do you feel about yourself?”

Another Client Response: “I feel even worse than I did before using”.

Therapist: “Why do you think you feel even worse?” Is it physically, emotionally, mentally, or all of those? Why do you feel worse?”

Several Client Responses at Same Time Are Summed Up: “Feel worse for having given in to the addiction”.

Therapist: Who can give an example of their personal experience?

Single Response: For that moment in time when doing what I do there is a feeling that of empowerment … not a positive feeling … a false one for that moment because I can forget what is really bothering me. I know my problem and why I am an addict. Most of the time I have not cared enough about the addiction to do anything and that is why I am here. Being a part of this group has given me a real empowerment the addiction never has and that is to have a voice in my life.

Again, the intention of the cognitive model is to assure the clients’ in the group setting have a clear understanding about why their addiction is a band aid for personal issues they have about self. The cognitive model opens the door for self-discovery through interpersonal engagement among the clients because they have the same experiences that help them to relate on a specific level one with the other (Center for Substance Abuse, 2005; D’amico, Osilla, & Hunter, 2010; Messina, 2016, National Institute for Drug Abuse, 2018).

Motivational Interviewing (MI)

The National Institute of Drug Abuse (NIDA) (2018) continually provides literature on their research outcomes. Using MI in a group intervention process has proven an effective therapy as a guiding approach for the clients having the opportunity for reflection about their readiness for making the needed changes for successfully overcoming and controlling their addiction. Thus, the MI model as explained by Messina (2016) is about evoking self-motivation for changing addiction behavior within the group participants. Initially questions would focus on why the group members believe their addiction is a problem. The concurrent step after they admit the addiction is a problem is about change. That is how this session dialogue opens.

Question: What do you think change would look like in your life without the addiction?

First Response: My quality of life would get better without chasing after my addiction.

Second Response: I could get back to relating to concepts like hope for a better tomorrow for myself and the people I love.

Question: Why is abstinence a critical component of the success of this therapy you have chosen to participate?

First Response: Well, the only way to stop addiction is to ‘stop’. (laughter from the group)

Second Response: Duh, if you ain’t using then you ain’t abusing. (more laughter from the group)

Third Response: Not using drugs and alcohol is the only way for recovery and the focus of change. (murmurs of agreement from the group).

Solution Focused (SF)

The Solution Focused (SF) Model as has been described by Messina (2016) is an extension of the MI model As an issue within the SF process MI as previously exhibited was to apply the open-ended questions and to get the participants talking about the needed changes to overcome and maintain abstinence from their addiction. In the change process aligned to the SF model the questions become personal for the participants because it specifically addresses the depth of their use of the drugs and/or alcohol. It is critical at this juncture to employ. Setting realistic goals for practicing abstinence in a timeframe is the first step. With abstinence working on the issues that have led to the addiction is a converging process that requires problem solving, identifying social support, encouraging small steps in the initial process (Messina, 2016)

Question: Realistically what goal could you apply for abstaining from your addiction in terms of timeframe?

First Response: Maybe for a day.

Second Response: Getting serious for at least a week.

Question: What obstacles do you see getting in the way of abstinence and what can you do about it?

Response: Stay away from those people who are enablers

Discussion/Conclusion

As has been explained throughout the above focusing on each of the three models for the group intervention treatment for addiction the intention using them has been achieving an outcome with each of the participants overcoming and maintaining abstinence from their addition. D’amico et al. (2016) has provided an example of the ideal outcome of these intervention models. The cognitive model again, establishes the participants’ understanding of the negative effects of addiction on their quality of life. The MS and SF models as has been previously noted work in conjunction generating meaningful therapeutic dialogue through the process of open-ended questions.

To this, D’amico et al. (2016) has explained the value of open-ended facilitator questions in the group therapy process and evocation of the participants’ responses aligned to how, “the counselor encourages clients to brainstorm reasons and ideas for how to change (p. 6)”. Consequently, as additionally offered by D’amico et al. (2016), the desired outcome of the group therapy process for achieving and maintaining change from addictive behavior is about how, “Collaboration occurs when there is little power differential, there is agreement on goals, and the facilitator encourages clients to share the talking. Autonomy/support occurs when the facilitator emphasizes and supports youth’s personal choice for changing. Empathy occurs when the facilitator expresses understanding of the youth and attempts to understand … (the individual) point of view (p. 7)”. The viability of using these three theoretical models in a group setting has been documented in research as has been provided by McCabe and Anthony (2005), Messina (2016), and D’amico et al. (2016).  In conclusion, the three therapy models presented in the above in this brief academic paper have substantiated a rationale for achieving the desired outcome for changing addictive behavior among participants in an intervention group therapy process. The implications of the above literature have suggested the application of theoretical models for counseling practice in group addiction intervention settings is a pragmatic means for achieving success.

References

Center for Substance Abuse Treatment. Substance Abuse Treatment: Group Therapy. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); (2005). (Treatment Improvement Protocol (TIP) Series, No. 41.) 1 Groups and Substance Abuse Treatment. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK64223/

D’Amico, E. J., Osilla, K. C., & Hunter, S. B. (2010). Developing a Group Motivational Interviewing Intervention for Adolescents At-Risk for Developing an Alcohol or Drug use Disorder. Alcoholism treatment quarterly, 28(4), 417–436. doi:10.1080/07347324.2010.511076

McCabe, R. E., & Antony, M. M. (2005). 1: Panic Disorder and Agoraphobia. Ledley, D.R., & Heimberg, R. G. (eds). Improving Outcomes and Preventing Relapse in Cognitive-Behavioral Therapy, (New York: Guilford Press, Retrieved from http://www.questia.com/read/118037414/improving-outcomes-and-preventing-relapse-in-cognitive-behavioral

Messina, J. (2016). Solution-Focused Therapy for Alcohol and Substance Use Disorders. Retrieved from http://coping.us/images/Solution_Focused_Therapy_for_Alcohol_and_Substance_Use_Disorder_2-19-16.pdf

National Institute on Drug Abuse (NIDA). (2018). Principles of Drug Addiction Treatment: A Research-Base Guide (Third Edition). Retrieved from https://www.drugabuse.gov/node/pdf/675/principles-of-drug-addiction-treatment-a-research-based-guide-third-edition

Rotgers, F., & Sharp, L. (2005). 10: Alcohol Use Disorders,” Antony, M.M., Ledley, D.R., & Heimberg, R. G. (eds). Improving Outcomes and Preventing Relapse in Cognitive-Behavioral Therapy, (New York: Guilford Press, Retrieved from http://www.questia.com/read/118037414/improving-outcomes-and-preventing-relapse-in-cognitive-behavioral

Substance Abuse and Mental Health Administration. (2012). Substance Abuse Treatment: Group Therapy Inservice Training. HHS Publication No. (SMA) SMA-11-4664. Rockville, MD. Retrieved from https://store.samhsa.gov/system/files/sma11-4664_0_0.pdf