Transcript Johnson’s Model of Substance Dependency

Johnson’s Model of Substance
Dependency
Disease - Alcoholism and chemical dependency are a
disease. ( A disease has its own symptoms and is
describable)
Primary Disease-It is not a secondary symptom of some
thing else
Progressive Disease-It progressively gets worse. People
become physically, psychologically, and spiritually ill.
Chronic Disease-There is no cure, There is no way to
safely use substances again.
Fatal Disease-The disease can only be arrested. If it is
not arrested, the person will die from it.
Phase 1: The Learning Phase
Pain
Normal
Euphoria
________________[_________]________________
Phase 2: The Mood Swing
Pain
Normal
Euphoria
________________[_________]________________
Phase 3: Harmful Dependency
Pain
Normal
Euphoria
________________[_________]________________
Phase 4: Chronic Stage
Pain
Normal
Euphoria
________________[_________]________________
Alcoholism As A Disease
• Jellineck (late 1940’s) established that
alcohol dependence progressed through a
natural sequence.
• Disease concept includes the notions that
alcoholics are out of control and
abstinence is the only answer.
Alcoholism: A Genetic Link?
• Nature VS. Nurture
• Twin Studies:
– 3,000 children ion Sweden
– showed children with one biologic alcoholic
parent was at a greater risk of developing an
alcohol problem
– Even when raised by adoptive parents
Cognitive/Behavioral Approach
to Substance Problems (1)
• Problematic substance use arises based on a
number of motivations
• Individuals lacking coping/life skills may use
substances to self-medicate
• Abusive patterns of use can be changed
• Concept of controlled drinking
Cognitive/Behavioral Approach
to Substance Problems (2)
• Problematic use is a result of Nurture, not Nature
• Problematic use does not always result in death
• Physical dependence does not occur (Vietnam
vets)
• Problematic use is a learned behavior that can be
unlearned
• Use is a way of coping yourself and your world
Disease Concept: Treatment
•
•
•
•
•
•
Abstinence
Alcoholics Anonymous
Narcotics Anonymous
Turn life over to a higher power
Once alcoholic, always an alcoholic
Treatment Services
Cognitive/Behavioral:
Treatment
• Controlled drinking
• Counseling focusing on:
–
–
–
–
Rational Thinking
Cognitive Restructuring
Development of life skills
Development of self-awareness and self
efficacy