Chemical dependency: causes, treatment, and recovery

¶ … chemical dependency is a complex problem, with multiple causes and manifestations, there is no single best treatment model. However, the dual diagnosis model combines a variety of treatment modalities and approaches, accounting for individual differences as well as environmental factors. Studies by Brower, Blow & Beresford (1989) revealed the benefits of the dual diagnosis model, which presumes the need for an integrative approach. Moral models like those employed in Twelve Step programs might prove useful for some clients, but an integrative approach allows greater flexibility. From an organizational perspective, a flexible approach is essential because of the need to address a diverse workforce.

Models of treatment may be broken down into constituent parts, according to the situation and the needs of the client. Research on the hearing impaired, for example, shows that differential needs of the client base will lead to the therapist designing a multifaceted treatment program (Guthmann, n.d.). The same can be said for a diverse workforce such as that in law enforcement. Some clients will respond better to a moral approach relying on religion and faith; others will react better with a cognitive-behavioral approach. However, a therapist can borrow some elements from a model like cognitive-behavioral therapy and combine those elements with models like the social model or the moral model. In fact, Guthmann (n.d.) points out that cognitive-behavioral therapy is especially compatible with other models. Elements of cognitive behavioral therapy that can be included and combined with other models allow for an exploration of dysfunctional thoughts and harmful emotions, which may underlie the impetus to use drugs or alcohol.

The therapist working with an organization like law enforcement also needs to be sensitive to organizational culture and environmental issues that might impact the individual's mental health. Viewing chemical dependency as a coping mechanism allows the therapist to frame substance abuse within the appropriate social environment, and one that views moral issues as being largely black-and-white. Because law enforcement relies on a deontological approach, officers with substance abuse problems might also feel ancillary guilt and shame. Those feelings might in turn impact cognitive processes, which is why both social/organizational parts and cognitive/behavioral parts of therapy may and should be combined in treatment.

Both group and individual therapeutic methods are helpful and can be used together. Alternating group and individual therapies might work best in providing as diverse and multifaceted a treatment program. Some clients might respond better to one or the other: as group therapy might be intimidating for some officers, especially those with high professional ranks who might risk their reputation or livelihood. Other clients might respond best to group therapies if their tendency is to learn from sharing, listening, and discovering commonalities with peers.