“Once the chemical addictions were addressed, their behavioral addictions began to surface,” says Sias, now an associate professor and director of the substance abuse and clinical counseling programs at ECU. While serving as the clinical coordinator of an outpatient substance abuse counseling center, she and her staff noticed that the clients were also struggling with behavioral addictions. Needless to say, I learned a lot and saw addictions in a new light.”Ĭrozier’s research partner, Shari Sias, a member of ACA and its division, the International Association of Addictions and Offender Counselors ( IAAOC), also had a postgraduate awakening to the connection between substance abuse and behavioral addiction.
Examples of this integration were to weave binge eating disorder into the counseling course, pathological gambling into the assessment course and hypersexuality disorder into the prevention course. “Their model allowed students to see the interactions between substances and behaviors and to really learn about well-researched, prevalent behavioral addictions. “ addictions counseling program integrated substance and behavioral addictions into each course,” she says. It wasn’t until Crozier had already completed her doctorate and taken a teaching position at Medicine Hat College in Alberta, Canada, that she truly saw for herself the relationship between substance and behavioral addictions. For example, alcohol abuse may be treated through abstinence, but food addiction and sex addiction are related to typical human activities for which complete self-denial is an unrealistic goal. At the same time, treatment options must be more nuanced for behavioral addictions.
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Levounis, chair of the Department of Psychiatry at Rutgers New Jersey Medical School, tells Counseling Today that behavioral addictions should be viewed as a new field of study encompassing “a number of diverse conditions, from the more traditional problems of gambling, sex, Internet, food and shopping to emerging constructs such as work addiction, love addiction and addiction to indoor sun-tanning.”Īlthough gambling addiction is the only behavioral addiction found in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders ( DSM-5), clinicians and researchers are noting that the neurobiological responses to behavioral addiction are similar to those of substance abuse. Ascher and Petros Levounis, makes the case that certain behaviors can turn into addictions that follow similar paths to substance use disorders. But like most paradigm shifts, the connection between substance abuse and behavioral addiction is slowly coming into focus.Ī new book that delves into the diagnosis and treatment of behavioral addiction, The Behavioral Addictions, edited by Michael S.
“Just as we’ve adapted to the presence of co-occurring disorders, we are adapting to the presence of behavioral addictions with mental illness and other addictions,” she says, although adding that the dearth of prevention research and services that target behavioral addictions is a significant obstacle. It could be a mistake to leave addiction to certain behaviors - such as this client’s compulsive gambling or use of online pornography - out of the treatment plan, says American Counseling Association member Mary Crozier, associate professor and coordinator of the substance abuse counseling certificate program at East Carolina University (ECU) in Greenville, North Carolina. With the focus of treatment squarely on alcohol use, the client’s other issues may linger on the back burner indefinitely. It is not unheard of for a treatment plan to include group therapy, family therapy and an inpatient treatment facility. But substance abuse work is a significant undertaking. In terms of treatment triage, many clinicians would choose to make his alcohol dependence a top priority because active substance addiction can make other goals impossible to achieve. He adds that he drinks alcohol daily and fears he is dependent on it to remain functional. A 40-year-old man enters counseling to deal with “relationship issues.” He says his marriage is failing due to his use of online pornography and that his financial situation is in constant peril because of high gambling debts.