Institute Inbrief - 01/02/2018

WELCOME

Welcome to Edition 284 of Institute Inbrief! Addiction is a plague that affects individuals and society in an adverse manner. It is a very costly illness that has worldwide prevalence. In this edition we look at the definitions, characteristics and aetiology of addiction.

Also in this edition:

Counselling Parents: The Early Stages
Working with Clients with Intellectual Disability
Compulsive Gambling: Myths and Facts
Social Media Updates & Much More!

Enjoy your reading!

Editor.

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Diploma of Counselling

Imagine Being Passionate About Your Work

And Assisting People Every Day Lead Better Lives

It’s rare these days to hear people talk about their work with true passion. You hear so many stories of people working to pay the bills; putting up with imperfect situations; and compromising on their true desires. That’s why it’s always so refreshing to hear regular stories from graduates living their dream to be a Counsellor. They’re always so full of energy, enthusiasm and passion. There’s no doubt that counselling is one of the most personally rewarding and enriching professions.

Just imagine someone comes to you for assistance. They’re emotionally paralysed by events in their life. They can’t even see a future for themselves. They can only focus on their pain and grief. The despair is so acute it pervades their entire life. Their relationship is breaking down and heading towards a divorce. They can’t focus on work and are getting in trouble with their boss. They feel they should be able to handle their problems alone, but know they can’t. It makes them feel helpless, worthless. Their self-esteem has never been lower. They’re caught in a cycle of destruction and pain.

Now imagine you have the knowledge and skills to help this person overcome their challenges. You assist to relieve their intense emotional pain. You give them hope for the future. You assist to rebuild their self-esteem and lead a satisfying, empowered life. As a Counsellor you can experience these personal victories every day. And it’s truly enriching. There is nothing more fulfilling than helping another person overcome seemingly impossible obstacles.

You can learn more here: www.aipc.net.au/course_dippro.php

AIPC’s Community Services Courses

Helping You Help Your Community!

We’ve helped people from all sorts of backgrounds become counsellors, and now we can assist you in fulfilling your goal of working within the Community Services sector! AIPC is delivering the following two new courses:

Diploma of Community Services (Case Management) – learn more

Diploma of Youth Work – learn more

There has never been a better time for you to become involved and invested in the Community Services industries. It is predicted, between the years of 2015 to 2019, that employment within the Health Care and Social Assistance industries will increase by 18.7% (www.lmip.gov.au, 2015).

By gaining a qualification in Community Services (Case Management) or Youth Work, you will be contributing to an industry that serves a very important purpose: to assist those with personal or relationship challenges. There is nothing more fulfilling than helping others overcome seemingly impossible obstacles. And there’s no better time to do that than now!

To learn more about these programs, visit https://www.aipc.net.au/enrolment.php

AIPC courses:

Diploma of Counselling

Diploma of Financial Counselling

Diploma of Community Services (Case Management)

Diploma of Youth Work

Bachelor of Counselling

Master of Counselling

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Enrol Now: Graduate Diploma of Relationship Counselling

Specialise in the field of relationship counselling and family therapy.

As a Relationship Counsellor, you will have the ability to assist those who require specialist skills in areas such as relationships, couples and family therapy.

AIPC’s Graduate Diploma of Relationship Counselling focuses on counselling interventions of a complex and specialist nature, by providing students with both theoretical and practical applications of the required skill-sets.

Click here to learn more.

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The Mechanisms of Addiction

Addiction is a plague that affects individuals and society in an adverse manner. It is a very costly illness that has worldwide prevalence. There are many forms of addiction. The most commonly recognised addictions include alcoholism, cigarette smoking, and marijuana and other illicit drug use (such as amphetamines and opiates). Research has shown that non-substance-related forms of addiction have become problematic as well. These include gambling, workaholism, exercise, pornography viewing, and other sexual behaviours, and are commonly referred to as behavioural addictions, or compulsions.

Definition of addiction

Addiction refers to persistent, repetitive, and often irresistible self-destructive activity that, in the beginning, is perceived as rewarding. It involves behaviour that, once learnt, becomes difficult to get rid of despite its negative consequences on the individual and his or her life. The term addiction is often used to refer to physiological dependence on the substance (DiClemente, 2003; Martin, Weinberg & Bealer, 2007). All addictions are said to be disorders that result in uncontrolled, repetitive behaviours and in most cases addicts may not recognise the harmful effects of their behaviours until the behaviour has progressed far enough to seriously disrupt their lives (Martin, Weinberg & Bealer, 2007). Addiction is viewed as a chronically relapsing disorder characterised by compulsion to take the substance, loss of control, and emergence of negative emotional stages of dysphoria (Koob & Simon, 2009).

Drug use along with other potentially addictive activities, such as gambling or sex, causes the brain to release dopamine, a chemical involved in experiencing pleasure (Phillips & Crabble, 2005). This surge in dopamine can be so powerful that it compels users to keep taking the drug. With prolonged use, however, drugs can alter the brain so that experiencing pleasure without the drug is nearly impossible. At this point, drug use does not raise dopamine levels or produce a “high”. Instead, the user keeps taking the drug to manage painful withdrawal symptoms such as fever, cramps, violent nausea, and depression (Robbins & Everitt, 1999). Based on research of how drugs affect the brain, scientists have theorised that people who are deficient in dopamine may be more likely than others to become addicted (Robbins & Everitt, 1999). The two contrasting perspectives on addiction, biological versus behavioural influences, have engendered ongoing debate over the appropriate way to treat drug addictions and alcoholism.

Characteristics of Addiction

Despite how addictions may manifest, they have three characteristics commonly referred to as the three C's: compulsive use, loss of control, and continued use

i) Compulsive use

Compulsive use has three elements: reinforcement, craving, and habit. Reinforcement refers to a process in which the using behaviour is strengthened by previous experience. People begin to use in order to seek relief from pain or stress, to increase pleasure, and/or to become more sociable. (Coombs & Howatt, 2005). Being rewarded with pleasure or relief from stress and pain encourages further substance use (Koob & Simon, 2009). As use of the substance continues, tolerance develops.

Tolerance refers to the need for an increased amount of the substance/ behaviour to achieve a desired effect similar to that which was achieved previously. Tolerance develops when normal brain functions adapt to compensate for the disruption caused by the substance in both the behaviour and the bodily functions. Chronic exposure to the substance produces neuronal adaptation that results not only in tolerance, but more: in the requirement of the substance for normal function (Harris & Buck, 1990; Coombs & Howatt, 2005; Koob & Simon, 2009). As tolerance increases, absence of the substance leads to craving.

Craving is the physiological need for the substance triggered by relevant brain activity. The body and the brain send intense signals during the absence of the substance, triggering withdrawal symptoms.

Withdrawal symptoms refer to a maladaptive behaviour change with physiological and cognitive effects that occur as a result of abrupt termination or substantial reduction of the substance in the body (Becker, 2008; Coombs & Howatt, 2005).

Habit refers to an automatic and compulsive pattern of the behaviour that demonstrates poor self-control and tends to continue despite negative feedback. This results from the deeply ingrained patterns in the memory of the nervous system (Coombs & Howatt, 2005). The brain’s normal circuits include the brain reward system that induces pleasurable feelings when stimulated. To regain these rewarding feelings, the circuit encourages a repeat of the behaviours that stimulate pleasurable feelings, which in turn encourages continued use of the desired substance (Coombs & Howatt, 2005).

ii) Loss of control

Loss of control in its broader sense encompasses both the relative inability of an addict to terminate consumption once initiated and the inability to refrain from substance use following a period of abstinence (Lyvers, 2000). This has been attributed to impairments in the area of the brain that is responsible for executive functions, including behavioural autonomy and self-control. Impairments to the frontal lobe following long-term chronic substance use may result in compulsive behaviour (Lyvers, 2000). Typically, addicts cannot predict or determine how much of the drug they intend to use and for how long they will use it. Loss of control is manifested by the following:

Using more of the substance than intended
Using the substance longer than the intended time
Not being able to keep track of how much of the substance they have used

iii) Continued use

Addicted individuals usually experience a compulsive desire to use the substance despite their efforts to cut down or stop. Addicts are typically unaware of the negative consequences associated with the using, but even if they gain awareness, they may opt to focus on the perceived positive reinforcements that they associate with substance use: for example, stress relief (Coombs & Howatt, 2005).

Aetiology of addiction

Psychological Factors

Almost all substance use affects the "reward mechanism" in the brain. The main chemical messenger involved in the brain's reward mechanism is dopamine. Each time a people use a substance they tend to feel ‘good’, which makes them want to use the substance again. Over time, changes in the brain occur (e.g., less dopamine is produced), which lessens the pleasurable effects of the substance and therefore larger amounts are needed to get the same effect.

The early stages of addiction are actually associated with both positive and negative reinforcement. Reinforcement refers to the process by which the substance use behaviour is strengthened due to previous consequences experienced by the user as a result of the substance use behaviour. Positive reinforcement refers to a situation where there is a rewarding experience obtained from the using behaviour (for example, feeling calm and relaxed after smoking cannabis or feeling sociable after drinking alcohol). The rewarding experience increases the probability of the using behaviour occurring again, in order for the user to have the rewarding experience again.

For example: individuals who feel relaxed after drinking alcohol are more likely to use alcohol to obtain that same relaxed feeling again.

Negative reinforcement refers to a situation in which there is a negative experience avoided as a result of the using behaviour (for example, a person may be able to avoid the feelings of anxiety by smoking cannabis or avoid social anxiety by drinking alcohol). The successful avoidance of the negative experience through the using behaviour increases the likelihood of the behaviour occurring again in order to avoid the same negative experience again (Koob & Simon, 2009; Gilpin & Koob, 2008).

It is common for individuals to get caught up in the addictive use and abuse of substances in order to eliminate negative emotions such as stress, depression, anxiety, and irritability. Users come to realise that they don’t experience these emotions, at least not so intensively, when they use their desired substance. Avoiding emotional pain operates as a motivator for continued use; it also helps to manage withdrawal symptoms that they may have experienced at various times following cessation of the substance (McMullin, 2000; Gilpin & Koob, 2008). In this sense addicted individuals not only use substances to avoid negative emotions and chemically induce more positive side effects. The motivation for continued use is also fuelled by the physiological and psychological need to manage withdrawal symptoms that develop with their dependency (Gilpin & Koob, 2008; McMullin, 2000).

Biological Factors

There is compelling research to suggest that the development of addiction, particularly with alcohol and drugs, is influenced by genetic factors. For example, numerous twin studies have shown that if one of the twins has a substance use disorder, the probability is increased that the other twin will also develop a substance use disorder, even if raised in a different environment (Phillips & Crabbe, 2005). Specifically, twin and adoption studies have convincingly demonstrated that genes contribute to the development of alcohol and other illicit drug dependence, with heritability estimates ranging from 50 to 60 percent for both men and women.

Data from the Virginia Twin Registry found that a common genetic factor seemed to contribute to the total variance in alcohol dependence, illicit drug abuse and dependence, conduct disorder, and adult antisocial behaviour (Dick & Agrawal, 2008). In their study, Nielsen, Ji, Yuferov, Ho, Chen, Leveran, Ott, and Kreek (2008) claimed to have identified a specific genotype and other genes that are associated with heroin addiction. Although there is increasing evidence of a relationship between genetic makeup and addiction, further research is needed to ascertain the specific genes involved in substance dependency.

Social Factors

Society, peers, and family systems have all been found to influence addiction. For example, conformity to some social norms has been said to contribute to the onset of addiction (DiClemente, 2006). Moreover, some authors contend that social policies attempting to control the use of drugs by making them illegal have instead perpetuated addiction by increasing the preoccupation with drugs in some individuals (Martin, Weinberg & Bealer, 2007; DiClemente, 2006). Changing social trends, in which the use of alcohol and illicit drugs is more readily acceptable and in some cases associated with a certain status also constitute a contributing factor (cocaine use, for example, is associated with the rich and famous). Finally, the glamorising of substance use, particularly by celebrities, has been strongly linked to the development of addiction among young adults.

Family influences have also been implicated in the development of addictive behaviours (DiClemente, 2006). Advocates of family systems ideas hold problematic parental modelling of adult roles as a key contributing factor. Excessive substance abuse on the part of the parent is seen to influence undesirable behaviour in children that can result in them experimenting with and continuing to use substances, making them more susceptible to addiction (DiClemete, 2006). Social relationship influence (that is, peer pressure) also contributes to an individual’s vulnerability to developing substance addiction. Attitudes of favoured friends can prompt substance use, which can ultimately lead to addiction (Beck, Arria, Caldeira, Vincent, O’Grady & Wish, 2008; Martin, Weinberg & Bealer, 2007). Clearly, we cannot ignore the significant contribution of social and environmental factors to both the acquisition and maintenance of addictions.

This article was adapted from Mental Health Academy’s General Addiction: From Diagnostic Criteria to Treatment professional development course.

References:

Becker, H.C. (2008). Alcohol Dependence, Withdrawal and Relapse. Alcohol Research and Health, 31. 348-361.

Beck, K.H., Arria, M.A., Caldeira, K.M., Vincent, K.B., O’Grady, K.K., & Wish, E.D. (2008). Social contexts of drinking and alcohol problems among college students. America Journal of Health Behaviour, 32, 420-430.

Coombs, R.H., & Howatt, W.A. (2005). The addiction cousellor’s desk reference. Hoboken, NJ: John Wiley & Sons, Inc.

Dick, D.M. & Agrawal, A. (2008). The genetics of alcohol and other drug dependence. Alcohol Research and Health, 31, 111-118.

DiClemente, C.C.. (2006). Addiction and change. How addictions develop and addicted people recover. New York, NY: The Guilford Press.

Gilpin, N.W., & Koob, G.F. (2008). Neurobiology of alcohol dependence. Focus on motivational mechanisms. Alcohol Research & Health, 32, 1850195.

Harris, R.A. & Buck, K.J. (1990). The process of alcohol tolerance and dependence. Alcohol Health and Research World,14. 105-110.

Koob. G.F., & Simon, E.J. (2008). The neurobiology of addiction. Where we have been and where we are going. Journal of Drug Issues, 39. 115-132.

Lyvers, M. (2000). Loss of control in alcoholism and drug addiction. A neuroscientific interpretation. Bond University.

Martin, PR., Weinberg, B.A., & Bealer, B.K. (2007). Healing addiction. An integrated pharmacopsychosocial approach to treatment. Hoboken, NJ: John Wiley & Sons, Inc.

McMullin, R. (2000). The new handbook of cognitive therapy techniques. New York, NY: Norton Inc.

Nielsen, D.A., Ji, F., Yuferov, V., Ho, A., Chen, A., Levran, O., Ott, J., & Kreek, M.J.(2008). Genotype pattern that contribute to increased risk for or protection from developing heroin addiction. Molecular Psychiatry, 13, 417-428.

Phillips, T. J. & Crabbe, J. C. (2005). Determining addiction. Genes and substance use. Drugs and Alcohol Today, 5. 26-31.

Robbins, T.W., & Everitt, B.J. (1999). Drug addiction: Bad habits add up. Nature, 398, 567-570.

AIPC courses:

Diploma of Counselling

Diploma of Financial Counselling

Diploma of Community Services (Case Management)

Diploma of Youth Work

Bachelor of Counselling

Master of Counselling

Join our community:

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Counselling Parents: The Early Stages

The counselling of parents, like most counselling and many other endeavours, is likely to be heavily influenced by what happens in the early stages. If parents come to you and feel welcomed, respected, and understood, they are more likely to open up with the vital information that will enable you to help their children change challenging or harmful behaviours.

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Working with Clients with Intellectual Disability

Are you as a mental health professional aware of the needs of clients with intellectual disabilities? Do you know what generally constitutes “impairment”, “disability”, or “activity limitation”? Would you be aware of special considerations or needs that such a client might have in a counselling context?

Click here to continue reading this article.