Modifying Behavior to Counter Addiction

Treatment Plan

Client Profile

Client: Grant

Age: 17

Ethnicity/Race: White

Gender: M

Grade level: High school sophomore

Middle class socio-economic status

Lives in house with family, mother/father, two siblings

Sexual orientation: straight

Religion: Catholic

Intellectual abilities: very gifted, bright, ranks in top five in his class

Physical abilities: thin, energetic, plays some sports with friends but not in a league

Reason for concern: Grant is concerned about what he feels is a strong sexual addiction that goes against his religious beliefs; he struggles resisting Internet pornography and fears what this addiction is doing to his life; he says he feels isolated, as he would rather stay in and look at pornography than go out with friends or meet people even though he says he finds looking at pornography to be very unsatisfying and morally repugnant.

The client also stresses that he feels depressed about his situation as he does not feel there is anyone he can really talk to. He feels embarrassed about out and almost stigmatized by it, fearful that anyone should find out what is going on with him. Client feels that he wants to change his behavior but he cannot. He hates that he is always thinking about pornography after a while and he would like to have a girlfriend and get married some day, but he feels like after a few days he is back to wanting only to look at pornography and then he is too embarrassed about his issue to ever try to ask a girl out on a date.

Three Interventions

Cognitive behavioral therapy

· Intervention focuses on treating the thinking (cognition) and actions (behaviors) of the individual

· Does not seek to probe any subconscious desires or engage in psychoanalytics

· Simply looks to identify the problematic thinking/actions and implement a new direction—new habits, new modes to counter triggers, new direction

· Very effective and commonly used approach in treating addictions

· This intervention would be very good for the client because it specifically addresses the thoughts and actions that the client wants to change.

· It can help Grant to identify the thoughts he wants to avoid and the behaviors he wants to change.

· It can help him identify the problem areas—how certain environments call him to indulge the target behavior more than others and how to avoid those environments.

· Triggering thoughts can be countered by new behaviors that can turn his attention to something else.

One resource to help with this intervention is a YouTube video posted by PsychHub that explains how this approach works. It is animated and would likely appeal to an adolescent who wants to know more about the intervention. It can be found at https://www.youtube.com/watch?v=ZdyOwZ4_RnI.

Young (2011) developed a CBT approach that focuses specifically on internet addiction, and it combines CBT with harm reduction therapy so as to address the underlying issues that might be accompanying the addiction. The first step in the intervention is behavior modification to reduce amount of time spent on the Internet; second comes cognitive therapy to address the denial and justification that often accompanies the addiction; and finally comes the harm reduction therapy approach, which addresses the co-existing issues.

Prayer intervention

· Prayer can be a helpful cultural and religious intervention for people who are spiritual or who want to access the help of a higher power.

· It is a common approach used in addiction counseling, such as the AA programs and other 12 step programs.

· It suits Grant because of his Catholic upbringing and beliefs, and so long as he is open to it, it would be a supportive intervention that would help him to use his own cultural understanding to address the issue.

· It can be supported by the literature and one resource especially helpful is the study by Gilbert (2014), which can be found here https://www.pdcnet.org/collection/fshow?id=cssr_2014_0019_0087_0109&file_type=pdf.

· Reading this source linked above would be a good way to help Grant realize that his beliefs can be a major support as he works through this issue.

Since Grant is a practicing Catholic with deep religious and cultural convictions, it may be helpful to encourage some form of spiritual therapy that is in line with his cultural and religious beliefs. For instance, Gilbert (2014) recommends that Catholics seeking to address the issue or sexual addiction can pray a novena to a particular saint for spiritual assistance. This concept of implementing a spiritual intervention is consisted with approaches adopted in other addiction treatments, such as Alcoholics Anonymous, wherein individuals seeking to break their addiction appeal to a higher power for assistance (Gilbert, 2014). If this type of approach is consistent with the client’s beliefs and is something that appeals to him, it may be recommended as an intervention to assist other forms of therapy.

Group therapy

· Group therapy can promote interpersonal healing and support

· People share their stories, concerns, issues

· They provide support since they are all going through the same thing

· They remove the stigma and shame of dealing with the issue and normalize it so that people feel less afraid of confronting their issues

· This would be helpful for Grant because he feels isolated and wants to address the issue and talk about it but he is afraid to

· He is young and could benefit from the support of older people

· This will enable him to feel more comfortable about socializing and it will boost his confidence to break out of his isolation and depression

· A good resource to explain this approach is on YouTube and helps a person to realize the benefits of group therapy: https://www.youtube.com/watch?v=ng86IRYvME8

McKeague (2014) notes that “shame is the core affect of sex addiction” (p. 203), and so it can be helpful for the client to realize that he is not out of the normal with his issue—and this is where group therapy can come into play: it brings people of similar issues together so that they can talk about it in confidence and support one another (Park et al., 2016). Group therapy also helps to remove the stigma of an addiction and to help individuals overcome their depression associated with their addiction (Pluhar et al., 2019). Haney (2006) likewise stresses that it is important for practitioners to normalize pornography addiction for teenage clients, as “many teenagers who are developing compulsive pornography problems do so in agonized isolation, often believing that they are perverts and alone in their actions” (p. 50). Indeed, this is exactly how Grant describes himself and, therefore, it is important for him not to feel so alone or isolated. Group therapy could for that reason be a tremendous aid in helping him to address this issue straight-on.