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In my life, I have watched people close to me continue to struggle with addiction and others who were able to achieve sobriety and begin recovery. Through these experiences, I have seen how specific methods are not a "one size fits all" and that although a method can be proven to work on a majority of the population, that isn't to say it will work on someone you know, or in my case now - with a client. As I continue to educate myself on addiction, this realization has become much more evident to me as a counselor and is an idea that needs to continuously guide my work with clients to allow for adaptability and flexibility for our clients.

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Narcotics Anonymous (NA)

suitable for George's recovery

provides support from individuals who are also recovering from addiction

offers peer support to help minimize feelings of isolation or shame

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For the client:

peer-support

connectedness

opportunity for helpful feedback

increases accountability through regular attendance at group

increased confidence

additional support

For providers:

allow for a holistic approach (integrates community)

assist in improving client outcomes

provides additional resources and knowledge

can assist with tailoring treatment methods

helps to monitor client's progress

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Blow (2001) Official Trailer - Johnny Depp, Penelope Cruz Movie HD

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Born in 1942

Raised in Massachusetts in a working-class family

Father worked long hours to make ends meet

Frequent arguments between parents over finances

Admired his father growing up

Frequently resented mother for leaving family

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Moved to California in his early adulthood and quickly became involved in the international drug trade

After the death of his first serious girlfriend, his addiction worsened

Became top importer of cocaine

worked with Pablo Escobar

Heavily abused cocaine during this time alongside other substances such as alcohol, marijuana, and nicotine

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severely damaged his relationship with his father

extreme disappointment from both parents

romantic relationships were unstable/fueled by substance abuse

his drive for money and his addiction negatively impacted his relationships (emotional detachment)

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after his imprisonment, his daughter became estranged from him

has deep regrets for prioritizing drug trade/addiction over his family (specifically Kristina)

has an awareness of how his actions led to the deterioration of his relationship with Kristina

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currently serving his prison sentence

experiencing immense pain and guilt

wants to rebuild his relationships

wants to reach sobriety

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References:

Alderson, K. (2020). Addictions counseling today: Substances and addictive behaviors. SAGE Publications, Inc.

Miller, P. M. (2013). Principles of addiction: Comprehensive addictive behaviors and disorders (A. W. Blume, D. J. Kavanagh , K. M. Kampman , M. E. Bates , M. E. Larimer , N. M. Petry , P. De Witte , & S. A. Ball, Eds.; Vol. 1). Elsevier/AP.

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2:04-2:41

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YOUTH Culture of the 1960s [APUSH Review Unit 8 Topic 12] Period 8: 1945-1980

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Prison treatment programs that include:

substance abuse treatment programs

support groups

family therapy

other counseling services

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A study analyzing recovery-supportive elements of NA found that "connectedness appeared to be the crucial recovery-supportive element in NA. emphasizing the relational character of SUD recovery" (Dekkers et al., 2020).

highlights the value of connection among group members and between members and therapists in supporting recovery

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For the client:

Every client is unique - recovery looks different for everyone

not to say this structure would work for George

Scheduling conflicts

may not have the availability to attend sessions regularly due to his imprisonment

Negative experiences

may feel judged by other group members or facilitators

can hinder his motivation to get support

For providers:

Mixed messages

if the feedback differs between the NA sessions and individual sessions it can cause confusion for the client, impact the client's development, and negatively impact the client-therapist relationship

Reliance on NA

if providers rely on the group for the progression of the recovery process it can negatively affect the client-therapist relationship

therapist isn't addressing concerns related to the addiction

therapist lacks collaboration

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Overall, this project was helpful for me in understanding the overall process of conceptualizing a client with addiction. With a deeper knowledge now, of the theoretical framework behind addictions counseling, it was insightful to analyze a client and see their story through a movie. Although I'm not able to work with this client, it is interesting to take a deeper dive into the psychological, biological, and social aspects of someone's life to better understand their addiction.

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create a safe environment for the client to build rapport and trust

ensure that your are nonjudgmental in your approach and continue to show support

take into account the client's intersectionality and how that may impact their story and process toward recovery

collaborate with clients on treatments and strategies

help to build trust and enhance the therapeutic relationship

remembering that every client is different - ensuring flexibility with treatment methods to support client's progress

staying informed on resources and engaging in professional development to best support clients

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Substance Abuse and Mental Health Services Administration (SAMHSA)

https://www.samhsa.gov

resources, information, and training

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National Institute on Drug Abuse (NIDA)

https://nida.nih.gov

research on drug abuse

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NIDA.NIH.GOV | National Institute on Drug Abuse (NIDA)

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NIDA's mission is to advance science on the causes and consequences of drug use and addiction and to apply that knowledge to improve individual and public health. NIDA is one of the National Institutes of Health.

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National Association for Alcoholism and Drug Abuse Counselors (NAADAC)

https://www.naadac.org

certifications, trainings, and other resources

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Journal of Substance Abuse Treatment (JSAT)

peer-reviewed research on substance abuse treatment/therapy approaches

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Aware of the need for change

realization that many current problems are related to addiction/drug trade

indecisive about when to start change

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Transtheoretical Model of Change:

provide him with resources and information

discussing the positives and negatives of seeking support

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Alderson, K. (2020). Addictions counseling today: Substances and addictive behaviors. SAGE Publications, Inc.

Dekkers, A., Vos, S., & Vanderplasschen, W. (2020). “Personal recovery depends on NA unity”: an exploratory study on recovery-supportive elements in Narcotics Anonymous Flanders. Substance Abuse Treatment Prevention and Policy, 15(1). https://doi.org/10.1186/s13011-020-00296-0

Demme, T. (Director). (2001). Blow [Film]. SF Studios.

Helping you to help others. Home. (n.d.). https://www.naadac.org/

Home Page: Journal of substance use & addiction treatment. (n.d.). https://www.jsatjournal.com/

Miller, P. M. (2013). Principles of addiction: Comprehensive addictive behaviors and disorders (A. W. Blume, D. J. Kavanagh , K. M. Kampman , M. E. Bates , M. E. Larimer , N. M. Petry , P. De Witte , & S. A. Ball, Eds.; Vol. 1). Elsevier/AP.

Substance abuse and mental health services administration. SAMHSA. (n.d.). https://www.samhsa.gov/

U.S. Department of Health and Human Services. (n.d.). Nida.nih.gov. National Institutes of Health. https://nida.nih.gov/

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Presenting Problem:

Seeking counseling to address his substance abuse and criminal past which severely impacted his relationship with his family

led to his imprisonment

separation from daughter

Long-lasting pattern of addiction throughout most of his adulthood (cocaine, marijuana, frequent drinking, nicotine addiction)

Reports feelings of hopelessness

Hopes for Counseling:

rebuild his relationship with his daughter and father

reach sobriety and ensure his sobriety after his release from prison

have a better understanding of his addiction

gain insight into how his substance abuse has affected his life choices and relationships with loved ones