Addiction Counselor Exam Review: Models of Treatment for Substance Use and Mental Health

This podcast episode provides a comprehensive overview of various psychological models for treating addiction and co-occurring mental health issues, emphasizing that these conditions often stem from deficits in learning, thinking, and emotion regulation. It contrasts psychological approaches with biological models, acknowledging the role of pharmacotherapy while focusing on behavioral and cognitive interventions. The discussion covers a range of evidence-based practices, highlighting their core premises, therapeutic techniques, and target populations, from individual skill-building to systemic family interventions.

The episode delves into specific models such as Behavioral Self-Control Training, which focuses on strengthening internal mechanisms, developing coping skills, and using functional analysis to identify triggers and prevent relapse. Dialectical Behavior Therapy (DBT) is presented as a robust approach for complex clients, emphasizing mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness, while also addressing therapist awareness of client dynamics. The Matrix Model is introduced as a manualized, intensive program for stimulant and cannabis use, and Motivational Enhancement Therapy (MET) as a brief, client-centered approach to resolve ambivalence using the FRAMES method.

Further models include Family Behavior Therapy (FBT), which integrates behavioral contracting and contingency management for both patients and significant others to improve family dynamics and address co-occurring issues. Seeking Safety is highlighted as a present-focused curriculum specifically designed for clients with co-occurring trauma, PTSD, and addiction. The Sociocultural Model emphasizes the impact of socialization, culture, and relationships on recovery, advocating for building new social competencies within cultural contexts. Relapse Prevention is discussed as a strategy to identify cues and develop alternative coping responses.

Finally, the episode covers Medication Assisted Therapy (MAT) for specific substances like opiates (Methadone, Suboxone, Vivitrol), alcohol (Vivitrol, Antabuse), and general mental health support (SSRIs, SNRIs, atypical antipsychotics, tricyclic antidepressants) to manage withdrawals, cravings, and co-occurring mental health conditions, thereby reducing relapse risk. The overarching message underscores the importance of integrated, client-centered approaches that address the multifaceted nature of addiction and mental health, promoting self-efficacy and harm reduction while acknowledging the challenges and complexities of the recovery journey.

the premise of this model is that addiction and mental health issues result from deficits in learning... deficits in thinking... or deficits and emotion regulation

behavioral self-control teaches coping skills goal-setting it helps people develop behavioral contracts

functional analysis... asks what is the function of this behavior and how did we get to this point

DBT helps therapists become aware of when a client is sort of lulling them into a false sense of laziness

overriding themes in DBT mindfulness... distress tolerance and urge surfing... emotion regulation... interpersonal effectiveness and problem-solving

motivational enhancement therapy... helps resolve ambivalence about treatment and abstinence and empower people to make the next right choice for them

family behavior therapy combines behavioral contracting with contingency management

seeking safety is a great curriculum for clients who have issues with trauma PTSD and addiction its present focused

recovery involves building new social and family relationships... develop social competency and interpersonal effectiveness... working within their cultural infrastructure

harm reduction recognizes that drug use and mental health issues are a reality the goal of harm reduction is to prevent harm caused by them