Transcript File

Javier Ley
Mississippi College
POSITIVE PSYCHOLOGY AND TREATMENT FOR
SUBSTANCE USE DISORDERS
IN A RESIDENTIAL FACILITY
ADDICTION
• Addiction is understood as a primary brain disease
that affects reward circuitry, motivation, and
memory and that becomes manifested in multiple
dimensions, including biological, psychological,
social, and spiritual (ASAM, 2011).
• Within the broad range of addictions, Substance
Use Disorders (SUD) represent a heavy burden on
our society with over 22 million people in the United
States meeting diagnostic criteria in 2012 (SAMHSA,
2013).
IMPORTANT FACTORS
• Co-occurring disorders: out of the US population
with any mental illness (AMI), 19.2% also met
diagnostic criteria for a SUD, while only 6.4% of those
without AMI met diagnostic criteria for a SUD
(SAMHSA, 2013).
• Criminal Justice System: about half of all prisoners
meet diagnostic criteria for a SUD (Chandler,
Fletcher, & Volkow, 2009)
IMPORTANT FACTORS
• Suicide: the risk of suicide for individuals with a SUD
is more than six times the average risk for suicide
(CSAT, 2008).
• Deaths: around 3.5 million people around the world
lose their lives in alcohol and drug related deaths
per year (UNODC, 2013; WHO, 2014).
DEVELOPMENT OF THE DISORDER
• Risk factors that can lead to the development of
the disorder: gender, psychiatric disorders, age of
onset, family, and stress in early life.
• Experiencing early life stress in the form of
maltreatment or other stressful events can be
associated with early problem drinking and
substance dependence in the early adult years
(Enoch, 2010).
NEGATIVE AFFECT
• Research has shown that people in recovery from
drug addiction score higher on measurements of
shame, depression, and maladaptive guilt (Meehan
et al., 1996).
• Being engulfed in these negative affective
consequences can lead to difficulty in identifying
and acknowledging positive aspects of their
personalities and of their lives.
SELF-HELP OR MUTUAL-HELP
• Self-help or Mutual-help movement has historically been
a common pathway to recovery from SUD. Among
these self-help options, Alcoholics Anonymous (AA) is the
most commonly known.
• 58% of those entering SUD treatment had attended AA
meetings (Magura, 2007).
• Higher rates of abstinence for those who attended both
formal treatment and 12 step programs versus those who
attended only one or the other (Fiorentine & Hillhouse,
2000).
• AA involvement following treatment resulted in better
outcomes 16 years after (Moos & Moos, 2006).
POSITIVE PSYCHOLOGY
• Positive Psychology (PP) is a field that represents a
supplementary perspective to traditional
psychology’s concentration on psychopathology
and human deficit. Its focus is on the positive
aspects of human experience above and beyond
the removal of suffering, psychopathology, or
deficit.
• It seeks to provide a more complete vision of
human beings and their experience (Seligman,
Steen, Park, & Peterson, 2005).
PP AND ADDICTION
• SCARCE LITERAURE INTEGRATING PP AND ADDICTION
• Two PP interventions with potential for benefit among those with SUD:
the three good things exercise and the best future self (you at your
best) exercise. Also of importance is that those with low affect,
physical illness, or who are highly self-critical could benefit more than
healthier individuals from gratitude interventions (Krentzman, 2013).
• Akhtar and Boniwell’s (2010) article “Applying positive psychology to
alcohol-misusing adolescents: A group intervention” was the only
article found on specific interventions applied to people with SUD of
any age, in any setting. It was a pilot study.
• The authors assumed that PP could be an alternative route to seeking happiness,
resilience, and positive emotions for young people, instead of drinking and/or
drugging.
• Findings from quantitative and qualitative measurement instruments suggested a
significant increase in well-being and decrease in alcohol use.
PROPOSAL
Develop a model integrating the theoretical premises
and interventions of Positive Psychology (PP) with
Treatment as Usual (TAU) which utilizes components
of the Twelve Steps of Alcoholics Anonymous /
Narcotics Anonymous.
STATEMENT OF THE PROBLEM
The problem of this study is developing a
model integrating Positive Psychology with
Treatment as Usual for Substance Use
Disorders in a Residential Facility in Nicaragua.
PURPOSE OF THE STUDY
The purpose of this study is:
1. To determine the components of Positive Psychology
that could be beneficial for those in treatment for SUD
2. To determine the components of the Twelve Steps of
Alcoholics Anonymous / Narcotics Anonymous used in
Treatment as Usual
3. To examine the process of integration between the
selected components of Positive Psychology and those
of Treatment as Usual, specifically those that include
the Twelve Steps of Alcoholics Anonymous / Narcotics
Anonymous?
SIGNIFICANCE OF THE STUDY
• This study could be useful in providing an integrated
framework that attempts to balance the individual’s selfconcept and narrative through a more complete perspective
and with an inclination towards the positive aspects of human
nature.
• Treatment as Usual utilizing the Twelve Steps of Alcoholics
Anonymous / Narcotics Anonymous could present the
individual with the negative aspects and consequences of
their alcohol and/or drug use. This could prove a heavy
emotional burden for some.
• The proposed integrated framework is intended to help
individuals identify and recognize in themselves positive
aspects of their personalities and their lives that could have
easily been obscured by addiction, therefore providing a
more balanced view of themselves and their histories.
RESEARCH QUESTIONS
1. What are the selected components of Positive
Psychology that could be beneficial for those in
treatment for Substance Use Disorders?
2. What are the core components of the Twelve
Steps of Alcoholics Anonymous / Narcotics
Anonymous used in Treatment as Usual?
3. How can selected components of Positive
Psychology be integrated with the core
components of Treatment as Usual, specifically
those that include the Twelve Steps of Alcoholics
Anonymous / Narcotics Anonymous?
METHOD
Developmental Research and Utilization Model (DRU; Southern, 2007))
• DRU is a phase model designed to direct the dissemination of knowledge,
along with the development, implementation, and adoption of new
innovations or programs.
• The DRU consists of two stages—research and utilization—divided into five
phases.
• The research stage consists of three phases: analysis, development, and
evaluation. The utilization stage has two phases: diffusion and adoption.
DRU
DRU
DEFINITION OF TERMS
• Addiction: a primary brain disease that affects reward circuitry,
motivation, and memory and that becomes manifested in multiple
dimensions, including biological, psychological, social, and spiritual
(ASAM, 2011). For the purpose of this study, the term Addiction will be
used specifically to designate a Substance Use Disorder.
• Positive Psychology: the field that represents a supplementary
perspective to traditional psychology’s concentration on
psychopathology and human deficit. This supplementary perspective
directs its focus to the positive aspects of human experience above and
beyond the removal of suffering, psychopathology, or deficit. (Seligman,
Steen, Park, & Peterson, 2005).
• Treatment as Usual: is defined in this study as all interventions used in the
treatment for those with Substance Use Disorders and which utilize some
form of the Twelve Steps of Alcoholics Anonymous / Narcotics
Anonymous. This could include Twelve Step Facilitation Therapy, readings
from Alcoholics Anonymous / Narcotics Anonymous texts, homework
utilizing content from Alcoholics Anonymous / Narcotics Anonymous,
individual and/or group counseling utilizing content from Alcoholics
Anonymous / Narcotics Anonymous.
ORGANIZATION OF REMAINDER OF
STUDY
• This proposal represents Chapter 1.
• Chapter 2: extensive review of the literature related to
Substance Use Disorders, its treatment, and Positive
Psychology.
• Chapter 3: detailed research methodology.
• Chapter 4: results of the research.
• Chapter 5: discussion of the results, implications of
findings, and recommendations for future application.
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