Group Addiction TX Theory Selection Term Paper

Pages: 15 (5755 words)  ·  Bibliography Sources: 10  ·  Level: Master's  ·  Topic: Psychology

SAMPLE EXCERPT:

[. . .] For strict behaviorists addiction or compulsion are simply a terms for an operantly conditioned behavior. Other compulsive behaviors follow the same line of reasoning. The inability to refrain from using a drug or engaging in a compulsion merely indicates that a sufficient history of reinforcement has been acquired to drive a high rate of the behavior. Therefore, physical dependence, as in the DSM-IV-TR diagnostic criteria, is neither sufficient nor necessary to result in a diagnosis of an addiction (American Psychiatric Association [APA], 2000). Physical dependence is just a result of the overuse of certain drugs according to this view (McAuliffe & Gordon, 1980).

Behaviorists offer many different techniques that can applied to group counseling. Typically contingency management (CM) techniques are applicable behavioral for group counseling involved with addiction or compulsive behaviors (Higgins & Petry, 1999). CM initially begins with a functional analysis to determine antecedents and consequences of the behavior. By understanding the antecedent conditions and reinforcers for the behavior other more adaptive behaviors can be substituted for the addiction or the compulsion. In the early CM approaches Dustin and George (1973) specified three phases of CM that can be applied to group counseling. The first phase is problem specification which incorporates a functional analysis and defines terms as they have relevance for the client. The second phase is making a commitment to change. In addictions and compulsive behaviors the client is often in treatment at the bequest of others; the client needs to commit to change and believe that change is needed. Incentives to generate and maintain the clients' motivation are crucial to identify. The third phase is specifying goals where the group and the client specify the client's goals and the means to achieve them. The contingencies are delivered based on the client's maintenance of abstinence and on their attendance. Some groups use vouchers or reinstatement of privileges, whereas other contingences can be more internalized. In some cases punishment may be used to maintain treatment adherence, but the preferred way is to use positive reinforcement.

The Cognitive Model

According to the strict behaviorists all learning was a result of reinforcement (or punishment); however, as might be clear from the above description of CM behavioral therapies benefit from the addition of the recognition of the importance of thoughts and attitudes. Cognitive models of behavior have been extremely influential in counseling. The cognitive paradigm got its start when in 1946 Edward Tolman, in order to discredit a pure behavioral explanation of behavior, performed an experiment where completely sated rats were allowed to explore a T-maze. At one end of the maze was water, at the other end food. Later when half the rats were deprived of food and the other half were deprived of water they returned to the spot in the maze that would allow then to satisfy their needs. According to behaviorist theory since the rats were never reinforced for learning they should not have been able to find food or water later; however, Tolman had argued that the rats had made "cognitive maps" of the maze and this is why they knew where the food (or water) was (Tolman, 1948). Tolman's views would later be adopted by other psychologists such as Uric Neisser to develop the cognitive perspective of psychology (Neisser, 1967). The cognitive paradigm holds that people's mental states, thoughts, perceptions, and beliefs shape and mold their behaviors. Modern cognitive psychological principles have likened humans to complex information processing systems that input, analyze, and manipulate information in order to make decisions. Thus, cognitive psychologists acknowledge the presence of inner mental states like the psychodynamic and humanist models and still adhere to the rigid empirical and methodological approach of the behaviorist school. Cognitive psychology principles have been applied to all areas of psychological applications and in other fields such as economics and decision making theory.

Bandura's (1977) social learning theory (SLT) is an obvious cognitive application that fits in with group models of counseling. SLT indicates that learning (hence behavior) can occur via the modeling of another's actions. This is an obvious advantage to the group counseling process whereas individuals learn, relate, and share from each other's experiences. Motivational interviewing (Miller & Rollnick, 2002) is an empirically supported cognitive behavioral treatment for addiction, substance abuse, and compulsive behaviors. Motivational interviewing works by positively reinforcing treatment relevant cognitive behaviors such as "change talk" by means of an interpersonal process in the therapy session (e.g., the use of support, empathy and contingent feedback to the members of the group).

The Humanistic Model

The use of empathy, being able to take the client's perspective, is often regarded as a key component in fostering change. This component was popularized by the "third force" in psychology, the humanistic movement. This movement was fueled primarily by Carl Rogers, although certain other theorists like Abram Maslow were also instrumental in promoting the humanist perspective (Mcleod, 2007). This perspective came about as a reaction to the mechanistic and deterministic stances of the psychodynamic and behavioral models, hence the third force tag. Humanists strongly believe in choice, free will, and self-determination (or self-actualization as characterized by Maslow) as the important determinants of behavior and personality. Their ideas are reaction to the psychodynamic notion that instincts direct behavior and the behaviorist notion that the environment shapes personality. Therefore the humanistic model sought to put the control of people's lives back in their own hands and concentrated on issues such as the need to meet basic human needs such as food and shelter, but also the human need to strive for other more abstract goals such as a sense of belongingness, creativity, and becoming more in tune with the greater meanings of life. Motivation was then not also due to instincts or environmental pulls, but was also fueled by the need to become something more than a cog in a machine and a need to find deeper meanings to life and existence, something not well explained by the previous two paradigms. The humanistic paradigm was also extremely accomplished in the area of psychotherapy thanks to Carl Rogers being the first therapist to apply experimental methodologies to psychotherapy outcomes (Barry, 2002). Given their views the humanists are often considered to have the most positive outlook on behavior and personality compared to the previous paradigms.

Using the Rogerian ideals of therapist empathy, genuineness, and unconditional positive regard will enhance any group counseling format (Okiishi, Lambert, Nielsen, & Ogles, 2003). However, there are some other principles that Rogers explored that are also important in group counseling for compulsive behaviors or addictions. Rogers believed that every person had a drive towards self-actualization, but this drive was hindered by the "shoulds" which are attitudes people accept as being valid, but are actually based on false perceptions of what the person believes will validate them as a person (Rogers, 1965). We incorporate these values from others. In addiction and compulsive behaviors these "shoulds" can be important to identify and challenge.

Theoretical Analysis of the Paradigms

Which of the above paradigms is correct? There is no easy answer to that question; however, the most parsimonious answer is that all of the influences described by these paradigms play an important part in human behavior (Fava & Sonino, 2008).

The accomplished psychoanalyst Wurmser (1974) believed that addicts were not suitable clients for analysis. Moreover, the psychodynamic notion of addictive or compulsive behavior as a form of "self-medication" while long accepted in lay circles, has not stood up to empirical efforts to test its validity. Most of the research forecasting group membership by pathology is ad hoc, and not predictive. For example, even as far back as 1985 Cox found that those subjects who later developed addictions demonstrated the traits of independence, nonconformity, and impulsivity but no significantly difference levels of psychopathology than those who did not become abusers or addicts. In fact the opposite appears to be true: the comorbidity of depression, anxiety, etc. appears to result after significant abuse/addictive problems have occurred with the lone exception being personality disorders, but none of these predicted substance abuse problems better than the other (Grant et al., 2004). The self-medication hypothesis then may explain the maintenance and increasing intensity of compulsions or addictions, but not their etiology. Nonetheless the model can still be a useful consideration in treatment. The psychoanalytic notion of conscious and unconscious components of behavior has recently been popularized by models of social cognition that have divided cognition into automatic and controlled cognitive processes is relevant to understanding compulsive behaviors and addiction and can be applied in a cognitive behavioral model.

CM has solid empirical support to its effectiveness in the treatment of compulsive behaviors and addictions and meta-analyses of treatment studies indicate robust effect sizes (e.g., Dutra et al., 2008). However, the use of behavioral techniques is enhanced significantly by including cognitive therapy techniques. The principles of motivational interviewing have been empirically supported as valid methods to treat addictions and compulsive behaviors and are compatible in CM… [END OF PREVIEW]

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