Stage of Change and Substance Use Readiness
The client in the video “Stages of Change for Addiction” has alcohol addiction, which is the subject of discussion in the exemplified therapy session. He seems to be in the contemplation stage of addiction because he acknowledges and does not deny his dependence on alcohol consumption. The client analyzes his actions and motivations to drink alcohol to be intoxicated, which demonstrates his awareness of the problem and willingness to solve it (“Stages of change for addictions,” 2000).
For a person who has different substance addictions that exist concurrently, the stages of change might be different. As exemplified in the video material, the client has a cocaine addiction and an alcohol addiction at the same time. However, his cocaine addiction is in the maintenance stage, which implies his management and control of the problem, while his alcohol addiction is in the contemplation stage.
This person demonstrates a willingness to cope with the addiction by stating his tiredness of being dependent and not well. He demonstrates a motivation to eliminate his addiction because he acknowledges its harmful effects on his life (“Stages of change for addictions,” 2000). While there was no explicit mention of gambling issues, the client demonstrated financial management difficulties and a tendency to overspend, which he tries to control.
Evidence of Addictive Behaviors and Defense Mechanisms
Some of the identified defense mechanisms used by the client include justification of addiction by the desire to relax and get distracted from difficulties in life. As for the diagnostic criteria, the client seems to meet such characteristics as craving alcohol use, failure to manage addiction, and social problems (Lewis, 2022).
DSM-5 Diagnostic Criteria and Further Assessment
To diagnose addiction in the client, one should ask the following additional questions. Does your alcohol consumption have any effect on your relationships with your family and community? Do you drink alcohol in larger amounts with time despite your plan to drink less? Does your drinking endanger your life? If so, does it motivate you to stop? Do you have sufficient support in coping with your addiction?
Treatment Recommendations Based on ASAM Criteria
Since the individual experiences psychological and physical addiction to alcohol, a suggested starting point for the client’s treatment should be assistance with abstinence. The intervention should “conduct a decisional balance exercise combined with values exploration to enhance the importance of changing alcohol use patterns” (Lewis, 2022, p. 9). Furthermore, past successful experiences in overcoming cocaine addiction should be elicited to empower the client.
References
Lewis, T. F. (2022). Substance abuse and addiction treatment: Practical applications of counseling theory (2nd ed.). Cognella Publishing
Stages of change for addiction. (2000). [Video]. Suny Empire State University. Web.