Responses to peers. Note that this is measured by both the quantity and quality of your posts. Does your post contribute to continuing the discussion? Are your ideas supported with citations from the learning resources and other scholarly sources? Note that citations are expected for both your main post and your response posts. Note also, that, although it is often helpful and important to provide one or two sentence responses thanking somebody or supporting them or commiserating with them, those types of responses do not always further the discussion as much as they check in with the author. Such responses are appropriate and encouraged; however, they should be considered supplemental to more substantive responses, not sufficient by themselves.

Please no plagiarism and make sure you are able to access all resource on your own before you bid. Main references come from Van Wormer, K., & Davis, D. R. (2018) and/or American Psychiatric Association. (2013). You need to have scholarly support for any claim of fact or recommendation regarding treatment. I have also attached my discussion rubric so you can see how to make full points. Please respond to all 3 of my classmates separately with separate references for each response. You need to have scholarly support for any claim of fact or recommendation like peer-reviewed, professional scholarly journals. If you draw from the internet, I encourage you to use websites from the major mental health professional associations (American Counseling Association, American Psychological Association, etc.) or federal agencies (Substance Abuse and Mental Health Services Administration (SAMSHA), National Institute of Mental Health (NIMH), National Institutes of Health (NIH), etc.). I need this completed by 03/23/19 at 3pm.

Expectation:

Responses to peers. Note that this is measured by both the quantity and quality of your posts. Does your post contribute to continuing the discussion? Are your ideas supported with citations from the learning resources and other scholarly sources? Note that citations are expected for both your main post and your response posts. Note also, that, although it is often helpful and important to provide one or two sentence responses thanking somebody or supporting them or commiserating with them, those types of responses do not always further the discussion as much as they check in with the author. Such responses are appropriate and encouraged; however, they should be considered supplemental to more substantive responses, not sufficient by themselves.

Read a your colleagues’ postings. Respond to your colleagues’ postings.

Respond in one or more of the following ways:

· Ask a probing question.

· Share an insight gained from having read your colleague’s posting.

· Offer and support an opinion.

· Validate an idea with your own experience.

· Make a suggestion.

· Expand on your colleague’s posting.

1. Classmate (J. Car)

Similarities and Differences in Addiction

In both males and females, the development of addiction is now presumed to be as a result of stress and trauma in childhood, culminating into the inability to advance to the appropriate stage of Erikson’s Psychosocial development (Van Wormer & Davis, 2018). Attention Deficit Hyperactivity Disorder (ADHD) is also an indicator of future substance abuse for adults of both sexes who are suffering from addiction, often having an undiagnosed comorbid disorder. Young men and women differ in the development and risks for addiction, especially based upon gender norms and expectations. For example, adolescent girls more often become victims of violence, resulting in involvement with drugs and other substances as coping mechanisms or a result of becoming involved with others who are addicted (Van Wormer & Davis, 2018). This cycle of violence and addiction persists, with higher amounts of substance abuse leaving a woman more vulnerable to additional victimization. Due to the overabundance of boys who face juvenile detention an underrepresentation of girls, there are still very limited resources for treatment of this growing population of victimized young women. Young men who join the military become enveloped into a culture that embraces alcohol and even at times condones the use of drinking as a coping mechanism. Male service members who abuse alcohol in order to cope with trauma or PTSD may inflict violence on a partner, necessitating intervention and leaving him at risk of losing rank or even termination. Currently, the baby boomer generation is suffering from the highest amount of accidental deaths due to drug overdose due to the rampant access to prescription of opioids and heroin addiction. Both genders begin needing medical procedures as they age, and prescription drugs are readily accessible in high amounts, heightening the risk of becoming dependent on medications, potentially progressing to heroin which is cheaper (Van Wormer & Davis, 2018). As men and women reach older age, the use of substances wreaks havoc on the body, with lower body water content allowing drugs to remain in the system longer. This increases the risk of developing life-threatening illness due to overdose, especially if using prescription medications in combination with alcohol.

Treatment Process and Outcomes

For both men and women, use of the stages of change model may prove impactful and in accordance with the harm reduction model, allow the client to genuinely and fluidly progress through the stages in a supportive counseling environment, choosing to make changes once precontemplation, contemplation, and preparation have been achieved. However, recognizing the unmet needs of boys and girls is critical in forming a treatment plan for addiction, for example, recognizing that girls may be victims of abuse and striving to attain a specific body image and young men want to appear masculine as well as recreationally use substances and alcohol. For girls struggling with addiction, treatment should be centered around relationship issues, empowerment, assertiveness, offering services for pregnancy, and treating trauma in a group setting in order to meet their needs (Van Wormer & Davis, 2018). Treatments with medications vary for men and women, for example, Naltrexone and disulfiram have been effective in reducing the intake of cocaine for men, but were ineffective for women (Becker, Perry, & Westernbroek, 2012). Men and women differ in the outcome of treatment when a spouse or partner is a support, with men being less likely to relapse and women more likely to. For example, women who have a partner who is also abusing are more likely to be swayed from seeking help or treatment due to the partner’s influence. Treatment considerations for adult men and women must also focus on specific needs of each. For women, addressing trauma and violence, comorbid disorders, and caring for children or partners, and for men, addressing issues of shame and stigma, violence, family issues, sexual performance, and child support (Van Wormer & Davis, 2018). Mixed groups receiving treatment may be less effective due to the inability of the clinician to tailor treatment based upon specific needs of men and women.

Challenges with Clients

Until recently, substance abuse treatment was almost exclusively directed toward treating men, denying women the assistance needed for addiction treatment. However, men are statistically using higher amounts of drugs and substances and less likely to seek and remain in treatment, which may prove very difficult in creating programming that is impactful as a female with limited perspective (Van Wormer & Davis, 2018). Identifying with the risky behavior and thrill seeking behind drug abuse by men may also prove difficult, as women are more likely to use substances to reduce stress or combat depression (Becker et al., 2012). Providing individual therapy for men in the military may also prove difficult, as the shame surrounding addiction and an immediate lack of trust or willingness to share openly regarding trauma might be better served by a group of service members facilitated by a male counselor, especially one who also has experience serving in the military. Additionally, the false perception and cultural stereotype of a woman necessitating dependence on a man, incapable of functioning independently, may be an unspoken barrier and prevent progress should the male client view women as less competent or capable of facilitating treatment (Van Wormer & Davis, 2018).

References

Becker, J. B., Perry, A. N., & Westenbroek, C. (2012). Sex differences in the neural mechanisms mediating addiction: A new synthesis and hypothesis. Biology of Sex Differences, 3(1), 1–35.
Retrieved from the Walden Library databases

Van Wormer, K., & Davis, D. R. (2018). Addiction treatment: A strengths perspective (4th ed.). Boston, MA: Cengage.

2. Classmate (N. Pra)

Drugs have been around for a long time. The first psychoactive drug that was recorded in our history was in the Greek tragedy, the Odyssey by Homer. From the popularity of alcohol in different modern societies, to the social acceptance of even much harder drugs in advertising and products (like cocaine in Coca Cola), we are exposed to addicting substances on a daily basis. Since around the 1800s, men and women in the United States have been recorded as having addictions to substances, and since then, that number has only risen (Becker, Perry, & Westenbroek, 2012).

Overview

In the world of substance abuse there are stark differences between males and females. The first fact is that males are more likely to use illicit substances from the age of twelve and up. This makes men fall into a higher risk category of developing an addiction. Males are also twice as likely to use marijuana, and cocaine. The only deviation to this fact, however, is with substance use in youth (12 to 17 years old), where females and males are relatively similar in their abuse (Van Wormer & Davis, 2018).

Males and females also develop their addictions relatively the same way. They are both associated with differing levels of hormones, mostly those that attribute to impulse control. Both genders also exhibit the same pattern of behavioral addiction, and withdrawal when on substances. The substances also add to the individual’s life in a positive (if male) or negative (if female) way. As an example of this, males will get a positive reaction to using drugs (getting a “high”), and females will get a negative reaction to using drugs (giving them an escape from a stressful situation).

Although men have been known to use more illicit drugs, and have a higher rate of abuse, women are also known to transition from first-time use, to dependence at a fast rate. This could be related to a higher vulnerability to the effects of the substances (Mitchell & Potenza, 2015). Women will become intoxicated faster after drinking less, and this can be applied to other areas of substance use. Since women have more fat and lower water content on their bodies, they will process and metabolize slower, than at the rate of a man (Van Wormer & Davis, 2018).

Impact

There can be many treatment implications when treating men and women in a substance-related program. Since there is an influx of men in addiction programs, women are often not provided adequate care, and as such, have a higher rate of relapse. Women will also have a higher chance of having trauma history, and a co-occurring disorder. The stages of treatment may become difficult when addressing these areas within a group. Individual counseling is also necessary, in conjunction with group therapy, when in a drug and alcohol setting. An example of this would be, if a woman comes in with a previous diagnoses of Bipolar disorder, and has a history of abusing heroin. Her treatment should not only include her opioid addiction (which could include a group setting), but techniques to manage her Bipolar disorder (which could include individual counseling).

As society places different expectations for each gender, men are also subject to certain areas of vulnerability. Men are often depicted as independent, and masculine. If they deviate from this, they can have higher feelings of shame over their drug use, and this guilt can be associated with their sexual performance, violence/trauma, family issues (like supporting the family, relationships, etc), and employment (Van Wormer & Davis, 2018).

Challenges

One of the main challenges I may have working with men who are addicted to substances is surrounded around their assumptions and attitudes. Some men may find working with a women an impossible alliance. They may feel that a woman would not relate to their experiences or struggles, or they may feel uncomfortable voicing the honesty of their past history. I have seen, at my job, some male clients who have refused to have female therapists, citing that they could not open up to them completely. I have also seen a select few male clients who have little to no respect for females, and have attempted to intimidate and threaten them when they are therapeutically confronted. I know that many have certain notions, often shaped by society’s expectations and norms, but I hope to be able to break these barriers, and give every client of mine (male or female), an open, and accepting environment in which they can feel comfortable enough to be themselves. I hope to create a platform in which they can speak their truth.

References

Becker, J. B., Perry, A. N., & Westenbroek, C. (2012). Sex differences in the neural mechanisms mediating addiction: A new synthesis and hypothesis. Biology of Sex Differences, 3(1), 1–35.
Retrieved from the Walden Library databases.

Mitchell, M. R., & Potenza, M. N. (2015). Importance of sex differences in impulse control and addictions. Frontiers in Psychiatry, 6, 1–4. Retrieved from the Walden Library databases.

Van Wormer, K., & Davis, D. R. (2018). Addiction treatment: A strengths perspective (4th ed.). Boston, MA: Cengage.

3. Classmate (L. Sim)

Addiction treatment is not the same for all individuals. Whether it be biological, situational, or sexual orientation, there are many different influences that impact addiction, suggesting the need for specific treatment. Specifically, sexual minorities who face specific challenges. Additionally, Van Wormer and Davis (2018) explained there are risk factors for addiction specific to sexual minorities, as they deal with their sexuality. This suggests the importance of treatment focused towards sexual minorities.

Challenges and Influences

Addressing addiction with sexual minorities presents with different challenges and influences which must be addressed. Those who identify as LGBTQ face difficulties that heterosexual individuals do not face. Society can be cruel and small minded when it comes to the LGBTQ population. People stereotype and believe in myths such as homosexuality is a choice, lesbians hate men, hormones can change a lesbian, gay men are attracted to children, and gay men are effeminate (Van Wormer & Davis, 2018). As I personally believe these myths are absurd and detrimental to the LGBTQ community, there are many individuals who believe them. Lanfear, Akins, and Mosher (2013) shared that the stigmatization and marginalization of sexual minorities increases psychological factors for substance abuse.

Further, this information can push those in the LGBTQ community closer to one another and away from society. Van Wormer and Davis (2018) shared that sexual minorities connect with one another in bars, where they may feel more comfortable, as they receive support. This suggests a potential gateway to addiction, if individuals engage in drinking, often, as they feel connected to others. Additionally, it is challenging for sexual minorities to find support and even counselors who understand the specific treatment needs they may have. Those in the LGBTQ community are met with additional influences early on with the potential for addiction. As young children and adolescents do not display normalized sexual behaviors, they are bullied. This bullying at younger ages increases the chances of risky behaviors, including drug use (Van Wormer & Davis, 2018). Also, with sexual minorities they develop weaker social bonds (Lanfear et al., 2013), which can lead to substance abuse. These weaker bonds are established in adolescents, as individuals feel different, as they are treated differently.

Risk Factors

Those in the LGBTQ population face different risk factors that others may not be faced with. These risk factors truly impact individuals. One major risk factor for addiction for a sexual minority is family rejection, as Van Wormer and Davis (2017) explained was a major factor in behaviors that are self-destructive, including high rates of illicit drug use. Feeling rejected by the people who are supposed to be the most supportive and loving is devastating. That rejection tells an individual that they are not enough and consequently they seek much needed validation and support elsewhere. Addressing these feelings is a major area in counseling. Helping an individual understand their worth and addressing their cognitions will be beneficial. For example, working with a client who identifies as a transgendered female, whose family does not accept her presents as a major challenge. The focus should be on the client and helping her understand her worth, building her self-esteem, working to alter her perceptions and thoughts, resulting in a more positive view of self and emotions. Helping her to understand and be confident in herself will assist with deterring from risky behaviors.

Additionally, this rejection can cause individuals to feel significant embarrassment or shame about their sexual identity, which Van Wormer and Davis (2018) explained as a risk factor. This shame can turn to isolation and/or self-medicating. Usually, those who feel good about themselves will take care, as those who do not care about themselves put their health at risk with mood-altering substances (Van Wormer & Davis, 2018). Again, working with a client who identifies as transgendered may be experiencing the above. It is important to assist her with an understanding of her risky behaviors, too. Providing psychoeducation and support group information specific to the LGBTQ community is helpful.

Supportive Counselor

Sexual minorities suffering from addiction need to feel supported and unjudged by their counselor. Van Wormer and Davis (2018) shared that counselors need to be aware of society’s judgements and views of sexual minorities, allowing them to build rapport with their clients. This is important. As a counselor I need to be knowledgeable about what my client is facing from society. Working to understand what a client may face daily is an important way to assist with empathy. This true empathetic response will support a counselor’s ability to build rapport. If there is no rapport, then there is no therapeutic relationship. Further, Van Wormer and Davis (2018) shared that a major risk to sobriety for gays and lesbians is learning how to begin same-sex interactions without the support of alcohol. This suggests the need for an understanding of specific concerns in treatment. Keeping trainings up to date and continuously seeking out information will help in supporting this population.

Conclusion

It is important to be aware of specific influences and risk factors different individuals face, along with their addiction. The LGBTQ community faces specific challenges, which must be addressed appropriately. Lanfear et al. (2013) shared that sexual minorities show higher rates of substance abuse compared to heterosexuals. This suggests the significance of the need for a deep understanding and tailored treatment.

References

Lanfear, C., Akins, S., & Mosher, C. (2013). Examining the relationship of substance use and sexual orientation. Deviant Behavior, 34(7), 586–597.

Van Wormer, K., & Davis, D. R. (2018). Addiction treatment: A strengths perspective (4th ed.). Boston, MA: Cengage.

Required Resources

  • Van Wormer, K., & Davis, D. R. (2018). Addiction treatment: A strengths perspective (4th ed.). Boston, MA: Cengage.
    • Chapter 12, “Gender, Sexual, and Sexual Orientation Differences” (pp. 473-505)
    • Chapter 6, “Addiction Across the Lifespan” (pp. 243-293)
  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
    • “Substance-Related and Addictive Disorders” (pp. 481–589)
  • Becker, J. B., Perry, A. N., & Westenbroek, C. (2012). Sex differences in the neural mechanisms mediating addiction: A new synthesis and hypothesis. Biology of Sex Differences, 3(1), 1–35.
    Retrieved from the Walden Library databases.
  • Lanfear, C., Akins, S., & Mosher, C. (2013). Examining the relationship of substance use and sexual orientation. Deviant Behavior, 34(7), 586–597.
    Retrieved from the Walden Library databases.
  • Mitchell, M. R., & Potenza, M. N. (2015). Importance of sex differences in impulse control and addictions. Frontiers in Psychiatry, 6, 1–4.
    Retrieved from the Walden Library databases.
  • Padilla, Y. C., Crisp, C., & Rew, D. L. (2010). Parental acceptance and illegal drug use among gay, lesbian, and bisexual adolescents: Results from a national survey. Social Work, 55(3), 265–275.
    Retrieved from the Walden Library databases.
  • Document: Abstinence Exercise (PDF)
  • USW1_COUN_6730_discussionPostingAndResponseRubric.doc
  • approachestodacounseling.pdf
  • 2014-aca-code-of-ethics.pdf

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