PSYC 8728 – Substance Abuse Counseling Models and Theories


Jack is a 64 years old European-American man who is married to one wife. Jack was brought to a counselor for heavy drinking, a behavior he was involved in after his return from Vietnam War where he land on a mine and lost his legs. Jack is current in a wheelchair with his two legs amputated from the knees. Jack claim he did not receive a very good welcome after the war and based on the case study he feels rejected and useless. Jack was highly affected by the incident that led to the loss of his legs and he suffered a serious post-traumatic stress disorder. This initiated the need for alcohol as a way of running away from the problems and as a result, Jack is currently suffering from a co-occurring disorder which is preceded by PTSD and then alcoholism. This paper focuses on identifying theories and models to handle Jack’s condition.

Theories and Models

The two theories and models that would be appropriate to handle this case include cognitive behavioral disorder theory and primary co-occurring disorder and secondary substance use disorder model. This theory and model are selected because the model helps the counselor to understand the client situation which involves the primary occurrence of PTSD which resulted to the development of alcohol addiction. With this, the counselor will be in a position to develop psychopathological treatment that will cater for the two situations concurrently. The CBT theory on the other hand integrates both behavioral and cognitive techniques. This theory is used to teach clients on the manner in which they should change their expectations and thought and how to adopt effective relaxation methods (Miller, 2005).

Application of the selected Theory and Model on Jack’s Case

Jack is brought to the counselor due to the issue of alcoholism. However, the case study reports that the alcoholism issue started immediately after Jack returned from the Vietnam War with amputated legs. Moreover, Jack according to the case study report did not like the welcome he received. Therefore, the actual reason for Jacks alcoholic behavior is as a result of psychological distress that he witnessed during the war and the feeling of rejection that he experienced after returning home a different person. Jack also rejects himself for he feels dependent and useless. This made jack to use alcohol to run away from his problem. This condition makes primary co-occurring disorder and secondary substance use disorder model to be relevant to handle Jacks condition.  According to the model, the preexisting mental conditions are an essential cause of drugs abuse disorders. In this case, individuals choose drugs to lower their painful feelings caused by their mental condition. Jack in this case uses alcohol to relief his feeling of desperation and depression. This model is used to define the best psychopathological solution based on the abused drugs and the mental condition the initiated the alcoholic behavior.

CBT theory is founded on psychopathology cognitive theory. It describes how individuals’ spontaneous thoughts or perceptions situations impact their psychological, behavioral and emotional reactions. According to the theory, persons’ perceptions are frequently dysfunctional and distorted when they are distressed. This is the actual situation in which Jack is in and anytime he feels that his mental distress is overwhelming he tends to drink more. This theory provides a solution in which the client is assisted on how to evaluate and identify automatic thoughts and on how to adjust their thinking to be more close to the reality (Stevens & Smith, 2013).

Theories Strengths and Weaknesses

The major strength for the primary co-occurring disorder and secondary substance use disorder model is that, the model is clearly structured based on the actual problem the client is experiencing. This ensures that the identified solution is highly viable to each unique patient. Moreover, the model can easily be used in self-treatment. The major weakness for this model is that, it does not provide a procedure to be followed to identify the best therapeutic solution to the identified problem. The major strength for CBT theory is that the theory is very extensive and very detailed where 5 stages are employed to resolve the clients’ problem. In this regard a viable solution can easily be reached. The major weakness is that the theory is very detailed to be understood or effectively applied immediately. It will require a number of therapeutic sessions to be enhanced (Larkin et al., 2006).

Models and Theory to be more likely to Use

The CBT theory and the primary co-occurring disorder and secondary substance use disorder model will both be used. This is because the model acts as a way of identifying the client’s problem and understanding the actual reason for the client’s behavior. The CBT on the other hand will assist in resolving this problem by using its five stages to assist Jack to overcome his psychological condition. In this regard, the two selected techniques complement each other and thus they will very useful in this case (Kurtz, 2002).


Drug abuse and addiction is a problem that can be initiated by a number of reasons. In some cases the drug use can initiate a mental problem or a mental condition can initiate drug abuse behavior. If any of the two conditions takes place, a co-occurring disorder occurs just like in Jack’s case.  In this regard, counselors have a challenge of identifying the actual cause of the client’s behavior and identify the best solution based on the identified problem to ensure effective treatment of both the addiction problem and the psychological problem.

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