Psychological Models:

A lot of people seem to conclude that their loved ones need a psychiatrist and/or clinical psychologist in order to have their addicted loved counselled back to normality. We respectfully disagree. So what is the difference between Addiction Counseling and Clinical Psychology?

Traditionally, the main difference between counseling and clinical psychology is down to their perspectives and training.

Bethesda Rehabilitation Centre fully understands the essential need for addressing psychological issues, but only those resulting from an addiction, whilst simultaneously keeping a trained eye on pre-addiction history for signs and symptoms of what might be described as any psychological in-balance.

Clinical programs are more medically orientated in nature focusing on treatment of disease/ mental illness. Because Bethesda Addictions Treatment Centre does not extend its influence into the fields of mental illnesses and/or any other form of psychiatric or clinically psychological diagnosis, we work with Clinical Psychologists and Psychiatrists where needed. We do work with Dual-Diagnosis, but we need to reiterate that our field of expertise is that of Addiction Specialists.

Psychological models within addiction treatment can be subdivided into four main areas of approach:

  1. Psychoanalytic
  2. Behavioral
  3. Cognitive
  4. Social Conditioning

Psychoanalytical explanations: In order to simplify, this approach promotes the idea that (addictive/anti-social) behaviors are the results of interactions between external events and repressed emotional and mental processes. These repressed dynamics remain hidden from the client until psychoanalytical counseling and group therapy sessions expose and interpret them.

Once upon a time, these principles lay at the foundation of most addiction treatment facilities but this is not so much the case these days. Bethesda Addictions Treatment Centre regularly explores the psychoanalytical process within the group process format, supervised by therapists with decades of experience.

To focus on and/or modify surface behavior, 9 times out of 10, is a complete waste of time because the internal struggles within the clients continue and a relapse is inevitable.

Behavioral Models: Now we start to venture into the arguments for the ‘nature v nurture’ debate where terminology like ‘conditioning’ becomes very popular.

Much along the lines of Pavlov’s Dog (ring the bell feed the dog, ring the bell feed the dog, ring the bell the dog expects food) – through that same process, a variety of elements within drug saturated areas can create triggers and cravings within chemically dependent people. In South Africa, Rugby triggers craving for burning coals, cooking meat, lots of masculine connection and alcohol.

Intravenous heroin addicts can get so fixated by the ritual of cooking up the heroin for the injection that when times of drought arrive addicts have been known to go through the ritual to satisfy that craving even to the extent of going so far as injecting water.

Within The Bethesda Addictions Treatment Centre our team uses behavior observance in order to help the client recognize that which causes the most emotional and psychological reactions within them. Megan, for example, is calm and compliant all week but starts to pick fights in the community every Friday afternoon. Why? Because (a) she is not really trying to find recovery from her addiction she is simply complying to look good and (b) its Friday afternoon and she really wants to go to town and use, cruise booze and lose.

Cognitive Theories: Once again, whilst we as a team recognize and respect the concept of Cognitive Behavior Therapy, we are reluctant to accept that it actually that much of a role in the treatment of addictions. The general consensus of Cognitive Behavior Therapists seems to be that the self-esteem is defined as the sense of contentment and self-acceptance that stems from a person’s judgment of his or her own worth. Appraisal for achievements therefore becomes the foundation of the individual’s identity, and too many suffering addicted people are therefore told, ‘believe something else and you will get different results’. However, in our experience, rather than tell a shy person that they must overcome their shyness, we would rather just accept the shyness and walk with the shyness and get the client to walk in harmony with it. We are who are, and that has to be acceptable. Trying to ‘think’ our way in to a new way of life, in our experience, only ever really creates a false sense of who we are and this is just another way of trying and camouflage the shyness, low self-esteem, fear, anger, loneliness.

Bethesda Addictions Treatment Centre embraces individuals, lock, stock and barrel with the goal of guiding them through to the ‘character defects’ step of a 12 Step Recovery life-style.