Hypothetical Counseling Plan Substance Use Disorder Counseling

Maria is married and has an addiction to alcohol that is damaging their family's chances at reuniting with their daughters, as well as many marital problems in general. It seems as if she does not work, nor does she adhere to many of the household tasks. Her relationship with her husband seems on the brink of failure and without making some changes in her life she will likely continue to fall deeper into problematic situations. Changing her attitudes, belief, and values could be a difficult proposition and will mostly likely time a significant amount of time in counseling to make progress. It seems reasonable to suspect that Maria's basic human needs are not being met and her addiction is damaging her quality of life. It is recommended that counseling should initially focus on understand Maria's situation as well as treating the substance abuse issues that are intertwined with her current lifestyle. This paper outlines a proposed counseling plan to help Maria and further recommends that her husband, Paul, play an active role in the counseling session as well.

Treatment Improvement Protocols

Treatment Improvement Protocols (TIPs) are best practice guidelines for the treatment of substance abuse disorders, provided as a service of the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (CSAT) (SAHHSA/CAT, 1999). Within these guidelines, there are a number of different therapy interventions that are recommended to deal with substance abuse. One of the more comprehensive treatment plans is the cognitive behavior therapy CBT approach due to the fact that it intergrates some of the key points from subsequent theories. The CBT theory is defined as:

"Cognitive-behavioral theory represents the integration of principles derived from both behavioral and cognitive theories, and it provides the basis for a more inclusive and comprehensive approach to treating substance abuse disorders. However, a broader range of cognitions is included in cognitive-behavioral theory than had been involved in earlier versions of cognitive theory. These include attributions, appraisals, self-efficacy expectancies, and substance-related effect expectancies (SAHHSA/CAT, 1999)."

The CBT methodology focuses on "distorted or irrational thoughts" that can often develop into habitual thinking. These thoughts are...

Given the fact that Maria seems to have thoughts about her home life that may be inaccurate or exaggerated, using the CBT approach to empower her to deal with her stressors would likely be an ideal counseling route. A commonly used approach to structuring an intervention is known as the ABC framework.
ABC Framework

1. Activating Event

2. Beliefs

3. Consequences

Irrational thoughts can be beliefs about one that are not necessarily grounded in reality. For example, if you felt depressed and believe you were the source of other people's problems then you might filter out all the different things that would contradict this belief. You would think that even when people told you things to the contrary that they were only saying them for some other reason and this was not the case.

Cognitive behavior therapy (CBT) is a psychological approach that addresses problematic behaviors that occur from the recurrence of bad thoughts which can cause stress, anxiety, and many other problems. One research study used Motivational Interviewing (MI) applied using Co-Active life coaching (CALC) tools (MI-via-CALC) is a theoretically grounded, cognitive behavioral approach to lifestyle coaching to address obesity in a sample of college students (Pearson, Irwin, Morrow, & Hall, 2012). Obesity is related to addictions in the sense that some people are literally addicted to food and thus many parallels can be drawn. The study found that when people have a negative body image then this could cause a negative self-esteem image which can then continue to create a cycle that leads to irrational thoughts and behaviors.

Irrational thoughts and justifications are also commonly used to rationalize addictions such as alcoholism as well. Some might think they are in control of their addictions and that they are only using as a response to some external factor in their life, such as an unhappy marriage for example. Exposure to different sources of stress, such as the stressors found in a hostile family environment, have been correlated with the impairment of mental health in virtually all populations. Despite the subjectivity, the level of self-esteem in an individual can carry many personal consequences for an individual's life. For example, self-esteem has been shown to correlate with greater confidence,…