In recent decades, an alternative model has emerged that challenges the traditional disease model and its "one-size-fits-all" approach to recovery. This model is based on the assumption that addictive behavior has multiple components and that individuals vary in risk depending on their unique bio-psycho-social history. Due to the fact that both habit acquisition and habit change are primarily influenced by cognitive and behavioral principles, this approach has become known as a cognitive-behavioral model. A major emphasis in this model is placed in the reward consequences of engaging in the addictive behavior, including both positive reinforcement, such as enhanced euphoria associated with getting high, and negative reinforcement, such as self-medication resulting in tension reduction or relief.
By bringing the attention back to the person with the substance abuse problem, treatment goals now shift from being strictly set by a treatment program provider, with abstinence as the only acceptable option, back to the consumer, (you), who now has a choice in their own treatment goals. Individuals can choose from a variety of goals, ranging from abstinence to reduction in harmful consequences, and by placing this choice into their hands, there is now acknowledgment that most addictive behaviors represent a problem in self-management that can be resolved by the individual. The substance abuser is no longer "powerless" but is taking back power over his or her own life. This model respects the client's choice and tries to meet clients where they are in the varying stages of behavioral change. This differs greatly from the traditional disease model, where emphasis is on client confrontation and enforcement of abstinence as the only acceptable goal.
The holistic model, or biopsychosocial model, is the emerging model, which takes a more holistic approach to health and well-being and incorporates the strengths of the various models of the past and uses those various insights to effect change. New understandings from years of research are coming into play and the holistic model is basing its approach on this important information. It is being discovered that social, economic, cultural and environmental conditions, as well as behavioral choices, impact both psychological and biological processes. In turn, psychological and biological changes influence behavioral patterns.
Now, motivational techniques, brief interventions, cognitive-behavioral therapy and pharmacotherapy co-exist with new approaches, including acupuncture, meditation, good nutrition and stress management (see previous section for more details). What has become clearer and clearer is the competence of individuals to manage their lives when information, support and choices are available.
Since the best predictor for your success is your ability to choose your own program and set your own goals, it is advisable to ask the following crucial questions to ensure that an appropriate drug and alcohol program is chosen that will meet your particular needs.
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