The rapid increment in substance abuse over the past three decades negatively affects the social, economic, and health conditions of over 22 million drug users in America (Jhanjee, 2014). The challenges of curbing substance use disorder (SUD) due to the early involvement in drug use among most youths have led to the increase in suicides, addiction, and chronic ailment. Scholars concur that failure for early intervention results in the dependency or addiction hence the continued studying on determining the best ways to diagnose and treat the psychological ailment. The essence that SUD causes irresponsible and dangerous lifestyles means that failure to intervene breakup families, increases risks of contracting HIV and other STDs, lowers concentration thus resulting in diminished productivity among the users.
Definition and Symptoms of SUD
The American Psychiatric Association (APA) understand that although SUDs can cause physical injuries and ailments such as cancers or ulcers, SUDs are mental disorders that need psychiatric intervention through therapies and medications. Therefore, SUD is a mental disorder under the fifth edition of the diagnostic and statistical manual of mental disorders (DSM-5). The DSM-5 combines the DSM-IV categories of substance abuse and substance dependence into a single ailment. The combined categories enable the measurement of the ailment based on the continuum from mild to severe. The DSM-5 contains a list of eleven symptoms with the mild diagnosis involving two or three of the symptoms in the list (American Psychiatric Association, 2013). The increment of the symptoms in a patient enables the psychiatrist to determine the level of SUD of the patient based on the substance or drug the individual uses.
Delegate your assignment to our experts and they will do the rest.
The symptoms list used to diagnosis the presence of SUD uses the questions to understand the needs or dependence on the substance, the effects, timeline, and the frequency among other elements that enable the psychiatric determine the level of disorder. SUD involve the use of tobacco, alcohol, opioids, marijuana, cocaine, inhalants, hypnotic anesthetics, hallucinogens, among other drugs (American Psychiatric Association, 2013). The DSM-5 contains a section of each drug due to the differences in the rate of dependence among other aspects of treatments required.
Some of the general symptoms and warning signs of SUDs include speech incoherence, distractions, changes in the behaviors such as untidiness, short-term memory, blackouts, bad breath or body odor, mood swings, defiance, irritability, denial, criminality to fund the SUD and impulsivity. Parents, friends, and relatives can note the above warning signs and help intervene a developing SUD abuse of their loved ones. The broad category of the topic makes it difficult to enhance the quality of paper; therefore, the essay narrows the topic to address SUD among the youths. It is important to note that SUD is an ailment affected all generations but the effects are different and with the youths having the most problems in decision making and easier to influence into drug abuse, they are the most suitable targets for this study.
Protective and Risk Factors
Rick factors characterize the conditions or elements that increase the likelihood of the youth to use or consider substances use. Unlike the existing confusion that risk factors are warning signs, risk factors are broader and behavioral in the essence that they attract youths to drugs whereas warning signs are symptoms arising from the use of a drug(Stone, Becker, Huber & Catalano, 2012). Therefore, risk factors pre-exist the substance use whereas warning signs are the aftermath of substance consumption. Protective factors, on the other hand, are the opposite of risk factors as they are the characteristics that limit the likelihood of the youth indulging in substance use or abuse. Protective factors as the name states protects an individual from drugs(Stone, Becker, Huber & Catalano, 2012). Psychiatrists evaluate the risk and protective factors under six domains namely, individual, family, peer, school, institutions, and community (Stone, Becker, Huber & Catalano, 2012). These six domains help to project or predict individuals who are more likely or unlikely to indulge in substance use. The discussion below evaluates the risk and protective factors under each domain. The six domains are based on psychological, social, legal, and biological risk factors.
Individual
Psychology acknowledges that every person has different personalities. Some of these personalities or behaviors may include aggressiveness or self-control. Children with early aggressive behaviors are likely to develop with little or no abilities to control their aggressiveness. The aggressiveness may be from parenting or other issues discussed later but it is evident that their failure to control their emotions or the aggressiveness alienates them from socialization (Stone, Becker, Huber & Catalano, 2012). The development of antisocial traits results in low self-esteem hence the higher chances to abuse drugs to boost their ego. However, the ability of an individual to control their emotions and frustrations enhances the self-esteem, which enables the childhood transition to adolescence whereby the peer influence bears greater influence in their decision-making and behaviors. Therefore, the risks posed by aggression increases the likelihood of drug abuse whereas if the child can learn self-control, the risks are mitigated and the individual is less likely to indulge in substance use.
Family
The early years of children’s lives determine the adult lives of the individuals. The increment in divorce and economic constraints have resulted in the decrease of parental interrelations and supervision. The parental absenteeism in the whereabouts of their children due to different factors limits the ability of the parents to enhance positive behaviors. Children tend to copy their parents or adults since they are their role models, therefore, parents that are irresponsible or abuse drugs influence their children negatively into drug consumption. Studies in sociology and philosophy portray that parents who monitor their children’s progress prevent their likelihood of substance abuse (Stone, Becker, Huber & Catalano, 2012). Parent-child interaction enhances the monitoring process hence the claim that parent who engages their children influence positive results.
Peer Groups
Adolescence involves the hormonal transition and increased significance of recognition and self-belonging. The need for recognition influenced by the individual characteristics and parental issues determine the peer influence and drug abuse. It is evident that social learning valuables such as substance abuse demonstrate that peer influence is the main cause of substance use in most adolescents. Therefore, if the peers of an individual engage in substance abuse, the teen is more likely to adopt similar behaviors to gain approval from the peers (Stone, Becker, Huber & Catalano, 2012). However, if the peer group engages in academic competence then the individual is more likely to refrain from substance abuse. Therefore, an individual in peer groups that engage in substance abuse risks to suffer from SUD whereas an individual that is a peer group focusing on academic competence is protected from drug abuse.
The other three domains are based on social aspects that are schools, institution, and community. Sociologists and psychologists tend to argue that this external environment influences behaviors of the individual. Therefore, drug availability, foster care or homelessness, and poverty respectively are risk factors increasing youth’s substance use (Stone, Becker, Huber & Catalano, 2012). However, anti-drug policies, professional monitoring, and strong neighborhood attachment protect the youths from substance use.
Evidence-Based Psychotherapy Treatments
According to Stoner (2016), evidence-based treatment is practices tested in heterogeneous or targeted population through randomized or statistically controlled assessments and the evidence demonstrated sustained improvements in the outcome. The practices or programs contain implemented procedures that enable successful replication in a different population with similar characteristics. The study described evidence-based treatments related to youths marijuana use.
Adolescent Community Reinforcement Approach (ACRA)
The behavioral treatment targets adolescents and young adults between the age of 12 and 24 years. It targets the family, education and social reinforcement to support SUD recovery. The sessions begin with the individual, then the caregivers before engaging the individual and caregivers together. Stoner (2016) cites a study by Dennis and colleagues in 2004 where 300 adolescents with marijuana-related disorders which, is a subsection of the SUD. The study depicted that ACRA was slightly effective than other treatments in marijuana use disorder. ACRA recovery success rate was 34% compared to 23% of MET/CBT. ACRA targets the problem-solving skills, positive recreation, and communication skills with the intention of enhancing life satisfaction and eliminating SUD.
Brief Intervention (BI)
Unlike ACRA that involves continuous engagement, BI involves one or two motivational interviewing (MI) techniques. MI is a strategy that involves goal-oriented communication with an increased attention for a change. It uses language and communication to enhance personal understanding and reasoning on the need to change by providing a conducive environment for the youth to open up to the clinician. The method eliminates arguments and confrontations that inhibit motivation in the SUD patient. Stoner (2016) cites a study with 200 youths demonstrated that BI decreased marijuana use frequency by 66% due to the weekly and monthly follow-ups.
Cognitive Behavioral Therapy (CBT)
This psychotherapy combines thoughts, behaviors, and emotions to determine the problem-solving, coping skills and changing problematic behaviors based on thought processes. The broad aspects of the approach try to enhance abstinence from substances thus identifies the risk situations and their impacts. The approach employs play and exercises to help enact new skills and instill confidence and problem-solving techniques. According to Hendriks, Van der Schee and Blanken (2011), CBT reduced SUD and delinquent behaviors among the 109 youths studied.
Multidimensional Family Therapy (MDFT)
This treatment approach uses a multidimensional perspective of youths and teens SUD. It argues that individual, peers, family, and the community influence SUD in youths (Jhanjee, 2014). Hence, the need to ensure that the treatment involves multiple pathways. The pathways include the youth’s functioning as individuals, parent functioning, youth-parent interaction, communication between families and the social system. In a study involving 224 youths that abused marijuana, the study demonstrated great success as it limited cannabis use to zero or one occasion after one year follow up (Hendriks, van der Schee & Blanken, 2011). The study depicted that MDFT enhanced more benefits to the participants than CBT.
Application of MDFT
The above descriptions demonstrate that psychotherapies improve the lives of drug use among youths. However, the description focused on marijuana use, which is just a single substance under SUD. It is essential to note that the differences in people and drugs involved, therefore, the choice to apply MDFT in this scenario are based on the multidimensional pathways it employs to eliminate the risk factors and enhance protective factors (Stoner, 2016). Earlier in the essay, it was evident that protective factors hinder drug use in youths; therefore, a method that influences and integrates most of the protective factors for its success is the most appropriate in treating SUD patient.
The essay applies MDFT in treating a SUD youth. The individual (Paul) has low self-esteem, is aggressive, his father is serving a prison sentence of 10 years for drug trafficking, and the mother works in two low-income jobs to ensure that Paul can acquire quality education. Paul’s family lives in the ghetto but he was one of the best football players before he joined a local gang.
Paul’s description demonstrates that he faced many risk factors and it was when no if he would indulge in substance abuse. The essence that he has no father figure and the mum is always working exposed him to join the gang. Therefore, MDFT can formulate the multiple pathways to help Paul. Firstly, the clinician should address the issue of his failure to continue with his football play. The other issue is challenging, as the mother has to continue working to finance the family’s needs. However, the lack of a father figure can motivate Paul to choose an alternative path from that of the incarcerated father. Football is an American sport that can transform Paul’s life; therefore, involving the football coach to communicate and help Paul focus on the sport for his health and future monetary values would motivate Paul.
The community and school through the national sports and other policies such as enforcing anti-drug policies in the area and engaging local NFL clubs to recruit or offer support to the high school teams will help Paul and other patients. Paul is desperate to fit in, therefore, churning his talent in football, offering incentives limits the time wasted with the gang, and the coach plays the role of the father figure. Engaging people such as LeBron James, a player who persevered under poverty, to become one of the best basketball players of all times is a strategy that the clinician can use to help Paul face the current constraints as mere issues that he must overcome to reach greater heights.
MDFT offers the clinician with a wide perspective of viewing SUD problem and employs different pathways to eliminate drug dependence or use among the patients (Stoner, 2016). Therefore, it enables the involvement of individuals, peers, family, and community making it a collaboration to enhance protective factors and eliminate the risk factors.
Controversies on SUD
The wide range of substances, different success rates of a given type of treatment to patients abusing a similar drug result in the arguments on the appropriateness of the DSM-5 to include the drugs under the same category. The essence that risk factors enhance the likelihood of substance use has led to profiling or targeting youths from affected by risk factors. The essence that not all individuals who face risk factors engage in substance use, therefore, targeting them for screening can result in stereotyping or focusing investments on the wrong people. The stereotyping forgets to screen children from stable and high social families whereas most of the recent studies demonstrate that SUD in youths is spreading almost evenly in all socio-economic levels.
Biblical Framework Useful for a Christian Counselor
Christian counselors tend to face issues of employing strategies that are different from the scientific worldview. The different aspects of beliefs tend to limit their ability to help SUD patients due to the failure to influence their patients. Biblical counselors should understand that their roles involve compassionating, and evangelize the word of God to the lost and enhance the reconciliation of the people with Christ. The counselor should have sufficient scriptures that enable the patient to understand that the God loves them and their bodies are God’s temples. The scriptures enable the counselors to understand that wisdom and knowledge are God-given thus enabling the counselor to value and engage in psychotherapy rather than only relying on the bible (Lambert, & Recorded Books, Inc. 2016). Integrating the bible and psychotherapies techniques will enable the Biblical counselor to integrate MDFT and the Christian teachings.
References
American Psychiatric Association. (2013). Substance-Related and Addictive Disorders. Diagnostic And Statistical Manual Of Mental Disorders .
Hendriks, V., van der Schee, E., & Blanken, P. (2011). Treatment of adolescents with a cannabis use disorder: Main findings of a randomized controlled trial comparing multidimensional family therapy and cognitive behavioral therapy in The Netherlands. Drug And Alcohol Dependence , 119 (1-2), 64-71.
Jhanjee, S. (2014). Evidence based psychosocial interventions in substance use. Indian Journal Of Psychological Medicine , 36 (2), 112.
Lambert, H., & Recorded Books, Inc. (2016). A Theology of Biblical Counseling: The Doctrinal Foundations of Counseling Ministry . Grand Rapids, Mich: Zondervan.
Rowe, C. L. (2010). Multidimensional Family Therapy: Addressing Co-Occurring Substance Abuse and Other Problems among Adolescents with Comprehensive Family-Based Treatment. Child and Adolescent Psychiatric Clinics of North America , 19 (3), 563–576.
Stone, A., Becker, L., Huber, A., & Catalano, R. (2012). Review of risk and protective factors of substance use and problem use in emerging adulthood. Addictive Behaviors , 37 (7), 747-775.
Stoner, S. (2016). Treating Youth Substance Use: Evidence-Based Practices & Their Clinical Significance. Alcohol & Drug Abuse Institute, University of Washington .
