Orientation includes describing to the client the nature and goals of the program; the rules of client’s conduct and the violations that can lead to disciplinary measures or discharge from the program; in the case of out-patient programs, the hours during which services are available; treatment costs that need to be paid by the client, and client’s rights.
Global Criteria
- Provide an overview to the program, describing the program goals and objectives for client care.
- Provide the client with a description of the program rules, and client’s obligations and rights.
- Provide information about the program hours of operation.
Miller, Geri. “Learning the Language of Addiction Counseling.” 2nd ed.
LCDC Exam Review 
Samantha, I had the opportunity to share some ideas with you over the past couple of weeks, and you also recommended a on behavior modification too. I would like to get your opinion on a topic. Is addiction a primary disease? Or a maladaptive behavior? I am having quit the discussion with some class member on this topic. From all of my research, I clearly see addiction as a primary disease. The addiction is what we are equating with the alcohol or drug. The disease is developed,out of no other cause other then the vulnerability to the drug, and many changes take place in the brain , such as the reward center, and how the nuerotransmitters are reacting. Along with that idea, wouldn’t you say that the genes are also being shaped?
Thanks for your input.
Tim
Hi Tim,
That’s a good question. In my opinion, it is both and needs to be treated as such, I will explain why I believe that. You are right, changes take place in the brains of substance abusers. There are moments in human development when we are more vulnerable to “permanent” changes in the brain; one of those moments is during adolescence, which happens to be also the moment in life when a strong, natural desire for experimentation takes place. But these changes happen also in people that have been abusing drugs for many years. The way I see it is, addiction is the word we use to describe maladaptive behavior patterns, also known as the cycle of addiction; substance dependence describes the disease; according to the DSM IV-TR, criteria for substance dependence includes the presence of withdrawal symptoms, which means that, in order to function “normally”, the substance must be used or taken, even when the person does not want to use it anymore, now they have to do it to avoid feeling sick…that, to me, is the disease. The actual pattern that involves triggers (feelings of guilt, shame, fear), relapse, then shame, guilt (triggers again), anger, then relapse…that’s the maladaptive pattern of behavior called addiction. To answer your question, I believe that, as genes can be shaped from adaptive behaviors (Darwin), so can they from maladaptive ones. What do you think?
I am not an expert. I’m in the process to having a better understanding. This is how I see it now. Thanks for your question! It’s great for a discussion, I think I will move it to the Forum. Hopefully more people would want to participate!
Thanks!
Thanks for the response. I was pondering this issue for a paper, and it has been a discussion among members in class. Wouldn’t you say that it is the brains hyper responsive need or craving. Its not the alcohol, but the chemical changes in the brain consume the person in their desire (craving ) for more, in order to feel normal. Even in the event that you held a gun or stun gun( not so extreme) to that person, they can choose not to take the drink, but what’s going on in their mind is something different. Even as their life is depending on a decision, they are still craving and wondering how to still taste it. I would also like to see what others think? Thanks for your input Samantha.
Hi Tim. Thank you for posting this comments. You actually mentioned something that has to do with one of my passions: self-regulation and impulse control. I like to read about this because it offers really good explanation for what happens with things like addiction, PTSD, and ADHD. It is believed that two motivational systems (in the brain) underlie behavior; the BIS (behavioral inhibition system) inhibits behavior, and the BAS (behavioral activation system) activates behavior. People with an extremely high BIS are the ones suffering from phobia and schizophrenia. People with a high BAS are the ones with ADHD or addiction, just to mentioned some examples. You can read more about it; it’s pretty interesting. What you mentioned is somewhat related to these motivational systems; your example is good in that, even when their life is depending on that decision, they still think about using and finding ways to outsmart everybody, and that– according to the motivational systems– is because high-BAS individuals are driven/motivated by reward, and the reward system in addicted brains has been conditioned to seek exactly that, rewarding experiences.
If you are into behavior modification and conditioning, you will enjoy reading about self-regulation, impulse control, and BIS/BAS as it relates to addiction. Thanks Tim!
Sounds like you have been doing some reading. Your answers are very educational and insightful. I have found behavior modification very interesting, I’m sure my career will take me into that area in someway or another. Its great getting feedback from you Samantha.
Thanks for your feedback. You are choosing a very interesting area to go into. Good luck on your paper!
I am finishing my degree in Addiction Counseling, you stated that there is a standard for the clients conduct, and what behaviors are and are not acceptable. I agree that there are standards and expectations that the addict should follow. When this isn’t met by the client, how quickly are they terminated? Also, behavior modification is the key to change and making small incremental goals.
Hello Tim,
Congratulations on your degree! What did you receive, an associate’s or a bachelor’s?
How quickly a client is discharged depends on the agency. When I did my practicum, the agencies I worked at gave clients two chances before they got discharged for bad conduct and dirty UAs. But I know different agencies have different policies.
I agree with you on behavior modification being key to promoting small changes. That’s why Cognitive-Behavioral Therapy has been and is one of the most effective approaches for the treatment of substance abuse disorders, including dual diagnosis clients.
Have you done your practicum/internship? If so, what were your experiences?
Thanks for the comment!
I will have a BA degree. Also I will be working on my practicum. Where do you recommend further training in Cognitive-Behavior Therapy? Any recommendations, advice, or advice on what not to do?
Congratulations! How exciting. I can recommend you one of my favorite books on behavior modification. The title is Behavior Modification: What It is and How To Do It, by Garry Martin and Joseph Pear http://books.google.com/books/about/Behavior_Modification.html?id=jan_QQAACAAJ
As far as training, I don’t know what to recommend but you might want to check the Behavior Analyst Certification Board http://www.bacb.com/ They might have some information about that.
Let me know if this is helpful 😉