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Resource Models (Psychological Dependence)

Life Process Model
  One of the leading opponents of the Disease Model was Stanton Peele, a psychologist who has been a prolific writer in the field of addictions. Peele argues in favor of a “life-process model of addiction” which holds that addiction is not a disease but rather a habitual response and source of gratification that can only be understood in the context of social relationships and experiences.

Peele’s life-process model takes a heavily experiential/environmental approach and understands addictions as negative patterns of behavior resulting from an over-attachment to certain experiences. He argues that most people experience addiction to some degree at some point during their lives, but these are “problems of living”  that most people overcome, not primarily medical problems.

What is missing in the biological and medical accounts, states Peele, is the sense of the addict’s “personal ecology,” or the role that the addiction plays in the mediation of internal and external life pressures. One of the difficulties in accepting the life-process model is that it threatens some as a return to the “moral model” that the disease model had so deftly overcome, and thus many psychologists turn a blind eye to the personal, social, and ecological variables that may play a strong role in addiction (Peele, 2007).

In an online article entitled, “What Addiction Is and Is Not: The Impact of Mistaken Notions of Addiction,” Stanton Peele (2000) claims that addiction occurs within clear parameters and can be identified according to the elements provided in the tables below:
 
  Adaptive Model
  The adaptive model has recently been proposed by researcher Bruce Alexander (1990)  and substantiated by thorough empirical and theoretical support. The assertions of the adaptive model include the following:

     
  • There is a failure of psychosocial integration that precedes the addiction
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  • Addiction serves a number of adaptive functions
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  • Addictive behavior is not “out of control”
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  • Addictive behavior generally fits the predictions of coping theory
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  • Addictions are often transitory
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  • Addictions are often interchangeable (Alexander, 1990)

According to this model, people who do not achieve successful psychosocial integration will behave adaptively by choosing one of the substitute adaptations – in the form of an addictive behavior – that is available to them. For example, the life of a street addict may be less painful and provide more hope for survival than the void of emptiness and isolation. Chronic intoxication, with all of its negative consequences, can provide an important distraction from loneliness, frustration,  or failure.

It is important to note that the adaptive model recognizes that an addictive lifestyle may subsequently create new problems – some of which may be medical – or it may exacerbate some of the problems that instigated it. However, these costs or consequences are not sufficient to override the adaptive value of the addiction to the person. Thus, the person will continue in the addictive behavior and will count the consequence as merely the “cost” of survival.

Stages of Change Model
  Prochaska and DiClemente (1998) proposed a model that describes the development of addiction in similar terms as the preparation for any behavior or major life change. The Stages of Change model describes five stages that occur in the process of such behavior change:  precontemplation, contemplation, preparation, action, and maintenance.

In the precontemplation phase, the person is often unaware, uninterested, or unwilling to make a change. This is the phase prior to the behavior change, whether that change can be understood in terms of the development of the addiction or, having become addicted, the seeking of treatment. Many prevention programs, for example, will target children when they are in the precontemplation phase, providing arguments and ammunition to fight the temptations of addictions that are inevitably to come.

In the contemplation phase, the person may be faced with the temptation to use drugs or alcohol, and will consider his or her response. The preparation phase is the time in which the person makes the actual decision and preparation to act – in the case of addiction, to begin using, or in the case of treatment, to stop using and seek help. This phase is followed by definitive action and attempts to maintain the new behavior over time (maintenance). In the case of sustaining an addiction, the maintenance phase may grow increasingly complicated and dominated by with negative consequences; in the case of sustaining treatment efforts, this phase may entail the rugged road of relapse, recovery, and regaining one’s equilibrium.

Prochaska and DiClemente’s Stages of Change model is a useful and popular model for identifying appropriate interventions for a person caught in the cycle of addiction. It has been applied to any number of behaviors, from smoking to illicit drug use to the transmission of STDs by unprotected sex. The basic concept of this model is that the person’s readiness– in face of any potential behavior change –must be carefully evaluated, since any interventions not keyed to the person’s progress on the continuum of change will be far less likely to succeed.  Also, Zimmerman (2000) notes that interventions that try to move a person too quickly through these stages of change are more likely to create resistance. Every intervention must be carefully weighed against the person’s own timetable and readiness to take the next step toward positive change.

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