Week 6: Psychotherapy for Addictive Disorders

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Week 6: Psychotherapy for Addictive Disorders

Levy Family Case Study
Introduction
Mr. and Mrs. Levy’s family is experiencing difficulty due to the drinking habit of the husband. The wife believes the drinking habit is a problem that can cause issues in the family. Mr. Levy does not accept the drinking habit is a problem and that it is a solution to his problems. The alcohol issue calls for further evaluation of the problem to determine the solution. Evidence-based practice shows that deep breathing improves mental, emotional, psychological, and physical health. Exposure therapy is crucial in ensuring that Mr. Levy can confront the issues he fears. The purpose of the paper is to examine the Levy family case study and suggest solutions and treatment approaches.
Episode One
Mr. Levy’s perception of the problem is that he does not realize his drinking behavior is a problem. He sees the drinking habit as a solution to his problems. For instance, when the wife asks him to go back to the bedroom, he is confrontational. He does not realize he has a problem. He is confrontational that the wife does not understand he has post-war issues.
Mrs. Levy’s perception of the problem is that his husband’s drinking problem is a problem for the entire family. She perceives that marriage will experience a challenge due to the drinking problem. She worries that the husband will taint his image as a father before the children.
The implication of the problem on the family is separation or divorce. The family is at risk of experiencing a hostile environment risky for children and parents. Children are at risk of developing substance and alcohol abuse problems as they get older.
Episode Two
Mr. Levy has good intentions while making the suggestions, but it is not effective to begin treatment without evaluating a client. The ideas would work if the client were only dealing with stress issues. The alcohol issue calls for further evaluation of the problem to determine the solution. Veterans Affairs requires clients to partake in counseling sessions using cognitive behavior therapy (Flanagan et al., 2018). It is the responsibility of a social worker to utilize the approaches to realize quality outcomes.
The supervisor was effective in asking various questions about therapy. The questions were effective in evaluating if the suggested treatments were based on evidence-based practice. All the questions were beneficial to the client to ensure they realize quality outcomes.
Episode Three
Mr. Levy’s therapist was effective in allowing the client to express themselves freely. The breathing mechanism to relieve stress was a professional approach to the issue (Shiban et al., 2017). The mechanism of breathing was important in showing Mr. Levy the importance of breathing properly. The therapist did a quality job of ensuring a professional approach in the session.
Evidence-based practice shows that deep breathing improves mental, emotional, psychological, and physical health. It involves deep breathing, contraction of the diaphragmatic muscles, and maximizes oxygen in the blood. Deep breathing is an important approach in psychotherapy (Shiban et al., 2017). The approach is beneficial to the clients due to reducing anxiety levels, improvement in cognition, emotion, and stress responses.
Bhattarai et al. (2020) state that when people experience frightening situations, they tend to avoid similar future events. Exposure therapy is crucial in ensuring that Mr. Levy can confront the issues he fears. Exposure therapy is a gold standard of treatment for post-traumatic stress disorder (Shiban et al., 2017). Evidence-based practice shows that veterans with post-traumatic stress disorder benefit from exposure therapy.
Episode Four
I would respond in a loving, considerate, and welcoming manner. The approach would guarantee client safety and confidentiality. It would be important to assure the client that they will not experience any harm if they continue sharing their experience with the platoon officer. It would be essential to praise or encourage the client to share or continue sharing the event since it is a step towards healing and inner peace.
Episode Five
The best approach is to listen to the concerns and understand the main issues affecting the therapist. Listening actively to the concerns is essential since the therapist had to listen to a traumatic story. I would advise the therapist to take the feelings she felt for the client and apply the issues to the therapeutic strategy. The approach would help the therapist to avoid personal attachments to the client. It would help the therapist to embrace countertransference in the future (Brown et al., 2018). As a supervisor, I would be ready to offer support to the therapist in subsequent sessions.
Conclusion
Levy’s family is experiencing constraints due to the alcoholic behavior of the husband. The wife appreciates that drinking can cause family problems, but the husband does not realize the danger of his behavior. Therapists embrace deep breathing to improve mental, emotional, psychological, and physical health. Mr. Levy requires exposure therapy to confront his fears. Supervisors should respond in a considerate manner to therapists to support them and improve client outcomes.
References
Shiban, Y., Diemer, J., Müller, J., Brütting-Schick, J., Pauli, P., & Mühlberger, A. (2017). Diaphragmatic breathing during virtual reality exposure therapy for aviophobia: functional coping strategy or avoidance behavior? A pilot study. BMC Psychiatry, 17(1), 29.
Bhattarai, J., Oehlert, M. E., & Weber, D. K. (2020). Psychometric properties of the Mississippi Scale for Combat-Related Posttraumatic Stress Disorder based on veterans’ period of service. Psychological Services, 17(1), 75.
Flanagan, J. C., Sippel, L. M., Wahlquist, A., Moran-Santa Maria, M. M., & Back, S. E. (2018). Augmenting prolonged exposure therapy for PTSD with intranasal oxytocin: a randomized, placebo-controlled pilot trial. Journal of Psychiatric Research, 98, 64-69.
Brown, W. J., Dewey, D., Bunnell, B. E., Boyd, S. J., Wilkerson, A. K., Mitchell, M. A., & Bruce, S. E. (2018). A critical review of negative affect and the application of CBT for PTSD. Trauma, Violence, & Abuse, 19(2), 176-194.

Week 6: Psychotherapy for Addictive Disorders

“A long-standing debate has roiled over whether addicts have a choice over their behaviors. The disease creates distortions in thinking, feelings, and perceptions, which drive people to behave in ways that are not understandable to others around them. Simply put, addiction is not a choice. Addictive behaviors are a manifestation of the disease, not a cause.”

–Dr. Raju Hajela, former president of the Canadian Society of Addiction Medicine

A common misconception is that addiction is a choice, and addicts are often labeled as individuals who lack morals, willpower, or responsibility. However, addiction is a clinical disorder that must be treated with the support of a health care professional. Although many people who are exposed to potentially addictive substances and behaviors continue life unaltered by their experiences, some people are fueled by these experiences and spiral out of control. In your role as the psychiatric mental health nurse practitioner, you must be prepared to not only work with these individuals who struggle with addiction, but also help them and their families overcome the social stigmas associated with addictive behavior.

This week, as you explore psychotherapy for addiction, you assess clients presenting with addictive disorders. You also examine therapies for treating these clients and consider potential outcomes.

Photo Credit: Laureate Education

Learning Resources
Required Readings

Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.

Chapter 7, “Motivational Interviewing” (pp. 299–312)
Chapter 16, “Psychotherapeutic Approaches for Addictions and Related Disorders” (pp. 565–596)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Albrecht, U., Kirschner, N. E., & Grusser, S. M. (2007). Diagnostic instruments for behavioral addiction: An overview. German Medical Science Psycho-Social-Medicine, 4, 1–11. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2736529/

Fisher, M. A. (2016a). The ethical ABCs of conditional confidentiality. In Confidentiality limits in psychotherapy: Ethics checklists for mental health professionals (pp. 13–25). Washington, DC: American Psychological Association. doi:10.1037/14860-002

Required Media

Laureate Education (Producer). (2013c). Levy family: Episodes 1 [Video file]. Baltimore, MD: Author.

Note: The approximate length of this media piece is 2 minutes.

Laureate Education (Producer). (2013c). Levy family: Episodes 2 [Video file]. Baltimore, MD: Author.

Note: The approximate length of this media piece is 2 minutes.

Laureate Education (Producer). (2013c). Levy family: Episodes 3 [Video file]. Baltimore, MD: Author.

Note: The approximate length of this media piece is 6 minutes.

Laureate Education (Producer). (2013c). Levy family: Episodes 4 [Video file]. Baltimore, MD: Author.

Note: The approximate length of this media piece is 5 minutes.

Laureate Education (Producer). (2013c). Levy family: Episodes 5 [Video file]. Baltimore, MD: Author.

Note: The approximate length of this media piece is 2 minutes.

Laureate Education (Producer). (2012c). In their own words [Video file]. Baltimore, MD: Author.

Note: The approximate length of this media piece is 23 minutes.

Optional Resources

Dronen, S. O. (2012). New research about Facebook addiction. Retrieved from http://www.uib.no/en/news/36380/new-research-about-facebook-addiction

Substance Abuse and Mental Health Services Administration. (2005). Substance abuse treatment for adults in the criminal justice system. Treatment Improvement Protocol (TIP) Series 44. Rockville, MD: Author. Retrieved from https://store.samhsa.gov/system/files/sma13-4056.pdf

Substance Abuse and Mental Health Services Administration. (2013). Substance abuse treatment for persons with co-occurring disorders: A treatment improvement protocol. Treatment Improvement Protocol (TIP) Series 42. Rockville, MD: Author. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK64197/

Assignment: Assessing Clients With Addictive Disorders

Addictive disorders can be particularly challenging for clients. Not only do these disorders typically interfere with a client’s ability to function in daily life, but they also often manifest as negative and sometimes criminal behaviors. Sometime clients with addictive disorders also suffer from other mental health issues, creating even greater struggles for them to overcome. In your role, you have the opportunity to help clients address their addictions and improve outcomes for both the clients and their families. For this Assignment, as you examine the Levy Family video in this week’s Learning Resources, consider how you might assess and treat clients presenting with addiction.
Learning Objectives
Students will:

Assess clients presenting with addictive disorders
Analyze therapeutic approaches for treating clients with addictive disorders
Evaluate outcomes for clients with addictive disorders

To prepare:

Review this week’s Learning Resources and consider the insights they provide.
Review the Levy Family video Episodes 1 through 5.

The Assignment

In a 2- to 3-page paper, address the following:

After watching Episode 1, describe:
What is Mr. Levy’s perception of the problem?
What is Mrs. Levy’s perception of the problem?
What can be some of the implications of the problem on the family as a whole?
After watching Episode 2, describe:
What did you think of Mr. Levy’s social worker’s ideas?
What were your thoughts of her supervisor’s questions about her suggested therapies and his advice to Mr. Levy’s supervisor?
After watching Episode 3, discuss the following:
What were your thoughts about the way Mr. Levy’s therapist responded to what Mr. Levy had to say?
What were your impressions of how the therapist worked with Mr. Levy? What did you think about the therapy session as a whole?
Informed by your knowledge of pathophysiology, explain the physiology of deep breathing (a common technique that we use in helping clients to manage anxiety). Explain how changing breathing mechanics can alter blood chemistry.
Describe the therapeutic approach his therapist selected. Would you use exposure therapy with Mr. Levy? Why or why not? What evidence exists to support the use of exposure therapy (or the therapeutic approach you would consider if you disagree with exposure therapy)?
In Episode 4, Mr. Levy tells a very difficult story about Kurt, his platoon officer.
Discuss how you would have responded to this revelation.
Describe how this information would inform your therapeutic approach. What would you say/do next?
In Episode 5, Mr. Levy’s therapist is having issues with his story.
Imagine that you were providing supervision to this therapist, how would you respond to her concerns?
Support your approach with evidence-based literature.

Note: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this formatting.

By Day 7

Submit your Assignment.