Models and Approaches 1
Theoretical Models and Approaches
Brett A Smith
School of Counseling, Liberty University
Models and Approaches 2
Theoretical Models and Approaches
Throughout the numerous different areas of scientific study, over time researchers and
leaders in each field though studies, testing, research, practice, and more, have sought to develop
theories and models to understand the various aspects of their perspective fields. The field of
counseling is no exception. For Substance Abuse Counseling, which is the area of counseling,
which is the focus here, different theories and models have been developed to try to determine
what are the factors that contribute to addiction. These various models have sought to explain a
variety of factors, how they differ depending on the individual, the differences caused by the
substance in question, and many more specific factors such as mental history, childhood trauma,
genetics, culture, sex, and more. Today, eight distinctive classification models are used to answer
these questions based on their own perspectives and theoretical approaches (Capuzzi & Stauffer,
2020). Here four of those models will be discussed providing an overview of the model’s
concepts and perspectives, a section to demonstrate the model’s use in a real-life scenario of
addiction, and finally a section to cover current academic research for each model to reveal the
academic support which exists explaining why each area is helpful in the counseling field for
those suffering from addiction.
Moral Model
The first model to exam is the Moral Model. The moral model’s premise is that everyone
makes their own choices in life and addiction is a choice like many others however the model
specifically addresses that there are good choices and bad choices making addiction the later
(Capuzzi & Stauffer, 2020). The question of moral responsibility as it relates to addiction, and
more specifically are individuals who become addicted to substances morally responsible
Models and Approaches 3
themselves due to their choice has been a key topic of discussion in the scientific field for many
years (Rise & Halkjelsvik, 2019). The perspective views addiction from specific understanding
of the connection between judgement and moral responsibility noting that when an individual
chooses not to partake in an activity, they know to be morally wrong but choose to partake in
substance use/addiction they view the consequences with different perspectives even though they
both are morally wrong. The moral model would essentially suggest that a person who chooses
addiction views its consequences differently than let’s say, another bad moral choice.
An example of this moral responsibility can be seen by comparing two choices, both
morally wrong and having consequences. So, if the two choices are addiction on one side and
armed robbery on another and the individual then not choosing to participate in armed robbery
because they view it as wrong, but alternatively choosing to participate in substance abuse
because they view it through a different moral lens (Rise & Halkjelsvik, 2019). The moral
model, because of its stance that addiction is at its core a choice we make, and a bad one at that,
has resulted in a large scientific debate regarding the entire concept of morality as it pertains to
addiction. Contradictory to the vast amounts of literature having differing views on the model,
when it comes to discussing the viability of the model for addiction comes down to three areas;
how it holds up against other addiction models, research and perspective into the stigma attached
to addiction, and an individual’s conceptualization of choice and free will (Rise & Halkjelsvik,
2019).
There’s no real need to argue the merit of the moral model and its stance that addiction is
a choice, and a bad choice and by making that choice one essentially chooses that one bad choice
over another, as stated by Rise & Halkjelsvik (2019), the model has areas in which many
questions can be asked. One such question is that while substance abuse is widely considered by
Models and Approaches 4
many to be a moral failure, the model does not consider other possible contributing factors
pointed us by different models such as the biological, medical, and historical factors that many
would argue contribute to an individual’s addiction (Capuzzi & Stauffer, 2020). The moral
model certainly has merit and offers an interesting perspective that cannot be overlooked;
however, it also poses questions that are addressed by models with different perspectives on
addiction.
Psychological Models
The next model/s of discussion are the Psychological Model discussed in Carpuzzi &
Stuffer (2020). Psychological Models offer more than one theory on what factors attribute to an
individual’s addiction. At their center psychological models suggest that a person’s addiction and
cravings for substances can be attributed to areas of the person’s mind and their emotions
(Capuzzi & Stauffer, 2020). There are essentially three areas of focus that make up the model’s
theory on addiction which are the cognitive behavioral models, personality theory models, and
learning-psychodynamic models (Capuzzi & Stauffer, 2020). The premise being that
psychological model’s stance on addiction is that it’s a product of a person’s emotional state,
mental state, or condition, and how they contribute to the compulsion in individuals to use
substances (Anker & Kushner, 2019).
The psychological models focus on how neurobiological and psychophysiological
conditions contribute to addiction, specifically aspects like how well an individual can manage
stress or handle anxiety (Anker & Kushner, 2019). The model also places a focus on how
environmental factors and heritable traits may contribute to addiction (Anker & Kushner, 2019).
Since the psychological models look a variety of factors that contribute to addiction, there are
many different examples to provide. One example of how the models view the impact
Models and Approaches 5
substances/addiction have on an individual is its take on a person’s dependence on the substance
itself. In psychological models refer to the actual addiction, or the person’s desire/need to keep
taking the substance is a psychological dependence (Banyan Treatment Center, 2021). In
addition to the physical change that occurs in the brain of an individual suffering from substance
abuse, psychological models choose to place a focus on how the dependence effects the person’s
emotional state (Banyan Treatment Center, 2021).
With its wide variety of perspectives and inclusion many different aspects, all of which
the model demonstrates has an impact on addiction, the psychological model opens itself up less
to critical questions in literature discussions, and more to theoretical questions posited on
inquiry. While the model does fall somewhat shorter regarding empirical evidence and extensive
research, its perspectives on how substances impact the mind and alter an individual’s emotional
and rational state of mind make it a very important model in counseling addiction. Its assertions
that addiction can be a result of heritability, mental disorders, or mental state make it important
not only for the area of counseling, but also for the medical field as it seeks to study how
addiction impacts the mind (Eddie et al., 2019). One other notable assertion and contribution to
the study of addiction made by psychological models is the growing adoption if the premise that
addiction is in fact a psychological disorder. (Eddie et al., 2019).
Family Systems Model
Another model mentioned in Capuzzi & Stauffer (2020) is the Family Systems Model or
Family Models. Family Models focus regarding addiction posits that roles, connections,
relationships, and interactions within the family paradigm have a direct correlation between an
individual and their addiction (Nastasic, 2020). The family models are primarily composed of
three theories as part of its makeup. The three theories that are used to make up the family model
Models and Approaches 6
are behavioral, family systems, and family disease (Capuzzi & Stauffer, 2019). These theories
that make the family model focus on the dynamics of a family which is composed of at least one
member with a substance abuse disorder (Dekkers et al., 2019). These dynamics serve as
launching point for other members of the family to start developing a specific and unique
understanding/perspective of addiction, that gets passed down from generation to generation
(Dekkers et al., 2019).
What makes the family model different from other models is how it demonstrates the
development of this specific perspective on addiction contributes to addiction in other family
members down the line (Dekkers et al., 2019). What makes the perspective of addiction unique is
that it is specific to the family model as it is a direct result of the context the family was raised in
and that others who were raised in homes without an individual with addiction will not develop
this perspective. The family model also sees the family as a whole and does not view the
members individually to note how traits among the members are developed such as maintenance
of the dysfunctional family, how the family contributes to relationships outside the family, and
how these traits become family norms (Narstisic, 2020).
An interesting example of the family model and the progressive development over
generations is how it can have a direct impact on those who were not raised under these
circumstances. This process occurs through marriage. Since the traits of the family model are
chronic and are adapted as personal norms, if/when an individual who was raised to have the
unique perspective on addiction develops a substance abuse disorder themselves, there marrying
partner, through the generational continuation of the model, becomes part of that system as well
(Narstisic, 2019). The family model has a unique perspective and provides us with many
perspectives that are non-existent in other models. For example, we can see in the family model
Models and Approaches 7
specifically how addiction could almost be considered contagious, like the flu, under the right
circumstances. If one is raised in the environment that is described by the family model, they
inherently become more vulnerable to addiction than those raised in a family without addiction.
Finally, we can see a unique feature with the family model and that is how addiction can be
impressionable on another, and not through popular causes such as peer pressure, but through
marriage and the creation of a family.
Biological Model
Finally, we have the Biological Model. The biological model, also sometimes referred to
as the genetic model, is based on the premise that addiction is a product of family cycles of
addiction. It maintains that if an individual individual’s parents or grandparents suffered from
addiction than they are more likely to develop problems with addiction (Capuzzi & Stauffer,
2020). The model stems from a neurobiological model and attempts to explain how a person’s
brain processes substances and how that process leads to addiction (Capuzzi & Stauffer, 2019).
Most notably, the biological model argues that the brain should be considered a biological
substrate and that both addictions, the change in an individual’s behavior and emotional state are
directly correlated to changes in the neurochemistry in the brain of those addicted (Heilig et al.,
2021).
The biological model perhaps receives more criticism than any of the other models
mentioned in this article, but that those criticisms may be misguided. For example, The
American Psychiatric Association (APA, 2022) states that genetic factors account for a
percentage of those who succumb to addiction. According to Heilig et al., (2021) noted that
genetic inheritance of addiction can be seen in how the organs of an offspring grow similarly to
the parent, such as the heart, i.e., if your father had a large heart then the genetic factors dictate
Models and Approaches 8
you will likely have a large heart too. Just as scans of the internal organ system have proven the
genetic traits of bodily organs, recent research being conducted by Heilig et al., (2021) on the
brain of addicts of children of addicts has seen similar neuropathways and other brain
construction as the parent. The genetic component seen through the landscape of the actual brain
rather than just supposed as a possibility is leading to further research and viability of the genetic
component.
Examples for the genetic component, while easily found at this stage are lacking in
empirical evidence, however the growing medial advancements, as well as the increase in
technologies allowing scientists to map the brain deeper and more thoroughly than ever before
are opening a door for examples with more concrete explanations. Just as the DSM-5 notes that
there is a percentage of addiction that can be contributed to genetics, when reading research on
addiction, even when covering different models, there is almost always a reference supporting a
genetic component (Heilig, et al., 2021). In the interest of offering a more concrete example, we
can refer to Carpuzzi & Stauffer, (2020) where they note that children of alcoholics are seven
times more likely to become alcoholics themselves than children of non-alcoholics.
The genetics model explains addiction through the observation of correlations between
addiction and genetic components and through the medical makeup and similarity of parents and
children (Heilig et al., 2021). While at current it may have less support than other models, its
application as it pertains to the human genome and how it is passed down cannot go overlooked
and as studies increase for the genetic model it is likely we will see the start of a shift in opinions
of the validity and viability of the model. At its core, it may have as many answers as possible to
provide us on how addiction works not just in individuals, but in specific aspects of the human
body, society, and provide valuable insight for future treatment options.
Models and Approaches 10
References
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