Week 5: Treatment

Tadd’s wife, Sharon, gave Tadd an ultimatum: “Get help for your cocaine problem, or our marriage is over.” Tadd insisted that he just liked to party with his friends. “I can still hold down a job. In fact, I just got a promotion. So why do you care how I spend my money?”

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Sharon began to research local addictions professionals. She found two organizations that sounded promising. Organization A featured counselors who had been former substance abusers themselves. “We know what you are going through,” their slogan read. Organization B featured counselors with advanced degrees in psychoanalytic theories. “We get at the heart of the defense mechanisms keeping you in the situation you are in now.”

How might an addictions professional advise Sharon? Should the fact that Tadd is demonstrating defense mechanisms impact her decision either way?

In the field of addictions, unlike in other counseling fields, it is not unusual for former substance abusers to provide counseling services to addicts. However, this common practice is controversial among addictions theorists and professionals. This week, you analyze the influence of a counselor’s personal experience on provision of addictions treatment. You also examine the impact of defense mechanisms on behavior and treatment processes.

Learning Objectives

Students will:

  • Analyze nature of treatment unique to addictions
  • Analyze impact of defense mechanisms on behavior
  • Analyze impact of defense mechanisms on treatment processes
  • Analyze manifestations of defense mechanisms in stages of change

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Miller, G. (2015). Learning the language of addiction counseling (4th ed.). Hoboken, NJ: Wiley.

  • Review Chapter 1, “Introduction” (p. 9)
    Focus on the difference between the medical and biopsychosocial models.

  • Review Chapter 2, “Theories of Counseling Related to Addiction Treatment” (pp. 19-22)
    Focus on the goals and techniques of general counseling theories.

  • Chapter 5, “The Treatment Process for Addictions”
    Focus on crisis intervention and therapies as part of the treatment process for addictions.

  • Chapter 6, “Treatment-related Issues” (pp. 138-159)
    Focus on the difficult topics that arise in counseling settings.

  • Chapter 8, “Self-Help Groups”
    Focus on the client’s best match for available outside support.

  • Chapter 12, “Incorporating Spirituality Into Addiction Counseling” (p.408-411)
    Focus on counselor self-care and countertransference issues.

  • Chapter 13, “Personal And Professional Development Of The Counselor” (pp. 429-427, 432-435, 436-439)
    Focus on the roles and vulnerabilities of the counselor and personal experience with addiction.

Gupta, R., Nower, L., Derevensky, J. L., Blaszczynski, A., Faregh, N., & Temcheff, C. (2013). Problem gambling in adolescents: An examination of the pathways model. Journal of Gambling Studies, 29(3), 575–88.

Problem Gambling in Adolescents: An Examination of the Pathways Model by Gupta, R.; Nower, L.; Derevensky, J.; Blaszczynski, A.; Faregh, N.; Temcheff, C., in Journal of Gambling Studies, Vol. 29/Issue 1. Copyright 2013 by Human Sciences Press – Journals. Reprinted by permission of Human Sciences Press – Journals via the Copyright Clearance Center.


Focus on the three Pathways (pp. 577-578).

Muñoz, Y., Chebat, J., & Borges, A. (2013). Graphic gambling warnings: How they affect emotions, cognitive responses and attitude change. Journal of Gambling Studies, 29(3), 507–24.

Graphic Gambling Warnings: How they Affect Emotions, Cognitive Responses and Attitude Change by Muñoz, Y.; Chebat, J.; Borges, A., in Journal of Gambling Studies, Vol. 29/Issue 1. Copyright 2013 by Human Sciences Press – Journals. Reprinted by permission of Human Sciences Press – Journals via the Copyright Clearance Center.<


Focus on the Use of Graphic Images (p. 510)

Suissa, A. (2011). Vulnerability and gambling addiction: Psychosocial benchmarks and avenues for intervention. International Journal of Mental Health and Addiction, 9(1), 12–23.

Focus on “A Hidden Area of Vulnerability”: Internet Gambling. Read the entire article, as it is important and provides good information on gambling addiction (p. 18).

Optional Resources

Miller, G. (2010). Learning the language of addiction counseling. New York, NY: Wiley.

  • Chapter 10, “Culturally Sensitive Addiction Counseling”


Discussion: Unique Features of Addictions Treatment

A therapist specializing in childhood sexual abuse would not likely divulge his or her experience with a similar trauma. Instead, the therapist would most likely have a doctorate in psychology, counseling, or social work, and would take an objective role in therapy. However, this is not the case in addictions treatment. In fact, it was not until the mid-1970s that licensure of addictions counselors became common practice. Prior to that time, it was common for addictions counselors to enter the field with a history of substance abuse. Today, however, many view the treatment of addictions as a complex process requiring specialized skills and education.

The practice of recovering substance abusers serving as addictions professionals is one unique feature of the field of addictions. Addictions professionals should understand both sides of this argument and be familiar with other unique aspects of the addictions field.

To prepare for this Discussion:

Review the Learning Resources, particularly Learning the Language of Addiction Counseling, Chapter 13, “Personal and Professional Development of the Counselor” (pp. 436-438).

By Day 4

Post your response to the following question: Does personal history of addiction and treatment make counselors more effective? Provide an informed argument based on the week’s Learning Resources and any other factors you have identified. Finally, describe two other aspects of the addiction field that are uniquely different from the general field of mental health, and explain why they are different. Be specific and use the week’s Learning Resources in your response.


Assignment: Defense Mechanisms

“Hi. I’m John, and I’m an addict.”

While this might be a cliché attributed to a well-known addiction program, it is true that the first step in treating an addiction is admitting there is a problem. This might seem easy for most, but it is a major acknowledgment for an addict. Addictions serve a purpose in someone’s life, and working to change the addiction means letting go of that purpose. People often hold on to addictions by means of defense mechanisms.

Defense mechanisms are a long-standing part of psychology stemming back to the early work of Sigmund Freud. Although many aspects of Freud’s early theories are not a part of modern clinical practice, defense mechanisms are a part of the current vernacular, including addiction treatment. Therefore, understanding defense mechanisms is an important step in providing effective treatment.

By Day 7

Submit a 2- to 4-page paper that includes the following:

  • A brief description of two defense mechanisms from the Learning Resources
  • An explanation of how each defense mechanism you chose might impact behavior
  • A description of how each defense mechanism might affect treatment processes, and an explanation of why
  • A description of which stage of change in treatment processes each defense mechanism might manifest in behavior
    • An explanation of why
    • Provide one or two strategies for mitigating them