MFT GREEN BOOK: CHAPTER 22: SUBSTANCE ABUSE

Substance Use Disorder

DSM-5 diagnosis combining abuse and dependence; requires 2 or more symptoms

Biopsychosocial Model

Addiction results from biological, psychological, and social factors

Disease Model

Addiction is a chronic, progressive brain disease with loss of control

Psychiatric Model

Substance use is linked to or co-occurs with mental health disorders

Self-Medication

Using substances to cope with emotional distress

Trauma Model

Substance use develops from difficulty regulating emotions due to trauma

Social-Cognitive Model

Addiction is learned through environment, modeling, and coping patterns

Systems Model

Addiction is maintained by family roles and interactions

Social Model

Environmental stressors (poverty, racism, access) contribute to substance use

Process Addiction

Addiction to behaviors (e.g., gambling, sex, shopping)

Tolerance

Needing more of a substance to get the same effect

Withdrawal

Physical or emotional symptoms when stopping substance use

Denial

Minimizing or refusing to recognize substance use problem

Habit

Voluntary use that can be stopped with effort

Compulsive Use

Repetitive use with growing loss of control and internal conflict

Addiction

Chronic inability to control substance use despite consequences

Jackson Stage 1

Family denies the substance problem

Jackson Stage 2

Family tries to control or hide the problem

Jackson Stage 3

Family becomes chaotic and disorganized

Jackson Stage 4

Family seeks help and begins reorganization

Jackson Stage 5

Family attempts escape (separation/divorce)

Jackson Stage 6

Family reorganizes without the user

Jackson Stage 7

Recovery and reintegration of the user

Hero Role

Overachiever who takes responsibility; feels inadequate inside

Scapegoat Role

Acting-out member who distracts from family problems

Lost Child Role

Withdrawn and invisible; avoids conflict

Mascot Role

Uses humor to reduce tension; feels anxious inside

Enabler

Protects the user from consequences; maintains addiction

Dependent

Person with addiction who feels shame but appears defensive

CRAFT

Trains family members to motivate a resistant user into treatment

Behavioral Couples Therapy (BCT)

Couples therapy focusing on abstinence and communication

Multisystemic Therapy (MST)

Intensive treatment targeting family, peers, and school (adolescents)

Multidimensional Family Therapy (MDFT)

Treats adolescent substance use across multiple systems

Johnson Intervention

Structured confrontation to push someone into treatment

Al-Anon

Support group for families of people with addiction

Alcoholics Anonymous (AA)

12-step peer program focused on abstinence and recovery

Contingency Contract

Agreement that rewards sobriety or sets consequences

Relapse

Returning to substance use after stopping

Comorbidity

Substance use occurring with another mental health disorder

Assessment Domains

Biological, psychological, cognitive, and social factors evaluated in treatment

Warning Signs of Abuse

Drinking alone, increased use, risky behavior, using to cope