Week 4: Evaluating Substance-Related and Addictive Disorders
What would you say if someone made the following statements to you?
“So what if I bought a few more toys for the kids? I can afford it.”
“It helps me relax if I walk around the block three times before going to school.”
“I don’t see anything wrong with a few glasses of wine after work. I deserve them.” Week 4: Evaluating Substance-Related and Addictive Disorders.
Your answer would likely depend on many factors, such as what your relationship is to these individuals, how much is “a little” or “a few,” your evaluation of what constitutes normal behavior, and how this behavior is affecting this person’s or your own life. If you knew the particulars of these situations, would you be able to determine whether these individuals were behaving normally, as they imply, or are they exhibiting signs of an addiction or a compulsion? Is there value in knowing the difference?
This week, you examine and differentiate between addictions and compulsions. In addition, you begin to learn how to assess for addictions through an intake process.
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Learning Objectives
Students will:
- Differentiate between addictions and compulsions
- Apply an addiction intake process to assess addiction
Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
Miller, G. (2015). Learning the language of addiction counseling (4th ed.). Hoboken, NJ: Wiley.
- Chapter 3, ”Assessment and Diagnosis of Addiction”
Focus on the section titled “Interviews,” particularly on sample questions provided and the advice on clients’ potential defense mechanisms. Week 4: Evaluating Substance-Related and Addictive Disorders. - Chapter 4, “Co-Occurring Disorders and Behavioral Addictions”
For your Discussion, focus on the section “Types of Co-Occurring Diagnoses.” As well, focus on issues with diagnosing, screening, and multiple disorders.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.)
- “Obsessive-Compulsive and Related Disorders” (pp. 235–256)
- “Substance-Related and Addictive Disorders” (pp. 481–589)
- Focus on the categories of the DSM-5 for these disorders. You can access the DSM-5 via the Walden Library
Garcia, F. D., & Thibaut, F. (2010). Sexual addictions. American Journal of Drug and Alcohol Abuse, 36(5), 254–260.
Focus on the similarity between excessive sexual behavior and other addictive behaviors.
Garcia, F. D., & Thibaut, F. (2010). Sexual addictions. American Journal of Drug and Alcohol Abuse, 36(5), 254–260.
Go Ask Alice! (2009). What’s the difference between an addiction and a compulsion? Retrieved from http://goaskalice.columbia.edu/whats-difference-between-addiction-and-compulsion
Focus on the similarities and differences between compulsions and addictions.
Shaw, M., & Black, D. W. (2008). Internet addiction: Definition, assessment, epidemiology and clinical management. CNS Drugs, 22(5), 353–365.
Focus on the characteristics of Internet addiction.
Wareham, J. D., & Potenza, M. N. (2010). Pathological gambling and substance use disorders. The American Journal of Drug and Alcohol Abuse, 36(5), 242–247.
Focus on the similarities between pathological gambling and substance abuse disorders.
Document: Sample Intake Form (Word document)
Note: You will use this document to complete this week’s Assignment.
Optional Resources
Hartney, E. (2011). The difference between an addiction and a compulsion. Retrieved from http://addictions.about.com/od/howaddictionhappens/a/addcompulsion.htm.Week 4: Evaluating Substance-Related and Addictive Disorders.
Capuzzi, D., & Stauffer, M. D. (2020). Foundations of addictions counseling (4th ed.). Upper Saddle River, NJ: Pearson.
- Chapter 3, “Process Addictions”
Focus on text that discusses possible differences between addiction and compulsion. See the sidebar on Internet usage.
DiFranza, J. R., Ursprung, W. W. S., & Contreras, G. A. (2011). Assessment of tobacco addiction in adolescents. International Journal of Mental Health, 40(1), 65–84.
Focus on the characteristics of nicotine dependence and how nicotine addiction develops.
Levine, S. B. (2010). What is sexual addiction? Journal of Sex & Marital Therapy, 36(3), 261–275.
Focus on the description and definition of sexual addiction.
Discussion: Compulsions and Addictions
Have you ever heard someone refer to himself or herself as a “social drinker” or “social smoker”? Many people enjoy caffeine or alcohol, spend a little too much on a shopping trip, and even gamble in moderation. For the most part, individuals are capable of engaging in these and other activities in a controllable way. Almost any behavior has the potential to transform into a compulsion or addiction, however.
Determining when a behavior is a compulsive or an addiction can be a challenging process. Although there are guidelines such as diagnostic criteria and statistics for both, there are few scientific rules regarding what constitutes a compulsion versus an addiction. Is one worse than the other? Is one more common than the other? Experts in the field of addictions typically determine what is considered healthy and normal and what is considered problematic. Addictions professionals recognize the signs of both compulsion and addiction in individuals and the difference between these two conditions.
To prepare for this Discussion:
- Review Go Ask Alice! (2009). What’s the difference between an addiction and a compulsion? Retrieved from http://goaskalice.columbia.edu/whats-difference-between-addiction-and-compulsion
Go Ask Alice! (2009). What’s the difference between an addiction and a compulsion? Retrieved from http://goaskalice.columbia.edu/whats-difference-between-addiction-and-compulsion. Week 4: Evaluating Substance-Related and Addictive Disorders.
- Review the articles “What’s the Difference Between an Addiction and a Compulsion?,” “Internet Addiction: Definition, Assessment, Epidemiology and Clinical Management,” and “Pathological Gambling and Substance Use Disorders.”
- Review the list of behaviors provided below. When posting, try to choose a behavior that has not been discussed by one of your colleagues at the time that you post, or if all have been selected, be sure to include a new insight that has not been covered.
- Marijuana use
- Gambling
- Spending
- Hoarding
- Nail biting
- Technology/e-mail checking/Internet
- Hair picking
By Day 4
Post a brief explanation of the difference between compulsion and addiction using one of the behaviors above. Then, explain why it is important to know the difference. Be specific and use the week’s Learning Resources in your response.
Assignment: Designing an Intake Process
Assessing a client for addiction can be a challenge, especially if the client has not chosen to voluntarily seek treatment. What are the key outcomes needed from an intake process in order to effectively assess clients? This Assignment will familiarize you with the rationale and process behind assessment.
To prepare for this Assignment:
- Review Learning the Language of Addictions Counseling:
- Chapter 3, ”Assessment and Diagnosis of Addiction”
- Chapter 4, “Assessment, Diagnosis, and Treatment of Co-occurring Disorders”
- Review the sample intake form provided as a guide.
- Select one addiction for which you will write a paper.
By Day 7
Submit a 4- to 6-page paper that includes the following:
- Background information on the addiction you have chosen to write about. Use at least 2–3 sources of information that describe how to assess your chosen addiction.
- Elements of an intake process that would elicit relevant information on an individual demonstrating signs of this addiction, including the following:
- Two addiction evaluation measures that might be appropriate for that individual, and explain why you chose them. Week 4: Evaluating Substance-Related and Addictive Disorders.
- Five questions you would ask to assess for addiction
- Five questions you would not ask, and explain why these questions would be inappropriate
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
- Please save your Assignment using the naming convention “WK4Assgn+last name+first initial.(extension)” as the name.
- Click the Week 4 Assignment Rubric to review the Grading Criteria for the Assignment.
- Click the Week 4 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
- Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK4Assgn+last name+first initial.(extension)” and click Open.
- If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
- Click on the Submit button to complete your submission.
Grading Criteria
To access your rubric:
Week 4 Assignment Rubric
Check Your Assignment Draft for Authenticity
To check your Assignment draft for authenticity:
Submit your Week 4 Assignment draft and review the originality report. Week 4: Evaluating Substance-Related and Addictive Disorders.
Submit Your Assignment by Day 7
To submit your Assignment:
Week 4 Assignment
Week in Review
This week you differentiated between addictions and compulsions and applied an addiction intake process to assess addiction.
Next week you will analyze the influence of a counselor’s personal experience on provision of addictions treatment and examine the impact of defense mechanisms on behavior and the treatment process.
Sample Intake Form: Not for actual use.
PRESENTING COMPLAINT: __________________________________________________________________________
Psychological:
DEPRESSION: Appetite Change Depressed Affect Anhedonia Sleep Disturb. Low Energy Conc./Memory
Social Withdrawal Suicidal Thoughts Hopelessness Helplessness Crying Onset ___________________________
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Recurring: Y/N
ANXIETY: Ruminating Nervousness Worry Panic Attack Avoids Situations PTSD Onset: ____________________
SLEEP QUALITY: Good Difficulty Falling Asleep Wakes up early Nightmares Onset: ______________________
OTHER: Anger Irritability Mania ___________________________________________________________________
Guilt Perfectionism//Eating Abuse/Trauma Addiction: Gambling Pornography Shopping
Family history of psychological problems: Y/N
If yes, please describe: ___________________________________________________________________________________
Current Stress: ______ Stressors: ____________________________ Coping: _____________________________________
Self-Esteem: __________________________________________________________________________________________
Appearance: Well-groomed Unkempt Unusual Other: _____________________________________________
Cooperation: Cooperative Indifferent Dependent Defiant Manipulative Guarded Hostile
Affect: Normal Flat Blunted Constricted Labile __________________________________________________
Speech: Normal Slow Too detailed Pressured Incoherent Slurred Perseverating
Mood: Normal Depressed Anxious Euphoric/Manic _____________________________________________
Thought Content: Coherent Illogical Delusions Hallucinations___________________________________________
Orientation: Person _____ Place______ Time______
Judgment: Intact Impulsive Immature Impaired __________________________________________________
Motor: Relaxed/calm Restless Agitated Tense Tremors Tics ______________________________________
Attention/Concentration: Normal Mildly Distractible Majorly Distractible
Employment: Title: ______________________ Tenure: ________ In field: ______ Work supportive: Y/N ___________
_____________________________________________________________________________________________________
Education: Highest Grade: _______________________ Special Ed: Y/N Held back: Y/N LD: Y/N _______________
Medical: _________________________________________________ Allergies: Food____________ Meds_____________
Meds: ________________________________________________________________________________________________
Hit in Head/Knocked Unconscious: Y/N __________________________________________________________________
Current Exercise: Y/N Type: ____________ Frequency: ____________ Duration: ____________ Onset: ___________
Previous Counseling:
Type: ______________ Date: ______________ # Sessions: ___________ Response: _____________________________
Type: ______________ Date: ______________ # Sessions: ___________ Response: _____________________________
Suicide Attempt: Y/N __________________________________________ Homicide Attempt: Y/N __________________
Spiritual Life: _________________________________________________________________________________________
Substance Abuse:
Nicotine: Y/N Frequency: _______________________________________________________________________________
Alcohol: Y/N _____________________________________________ Past: ______________________________________
Drugs: Y/N _________________________________ Past: ____________________________________________________
Legal: _______________________________________________________________________________________________
Notes: _______________________________________________________________________________________________
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Week 4: Evaluating Substance-Related and Addictive Disorders
