心理学Essay范文：Overview of Addiction Psychology

本文是心理学专业的留学生Essay范例，题目是“Overview of Addiction Psychology（成瘾心理学概述）”，正如《今日心理学》的作者在一篇关于成瘾的文章中所述，一个有成瘾倾向的人滥用物质或从事不良适应行为，其“奖励”效应会诱发重复的感觉，尽管可能会有可怕的后果。根据美国心理协会(APA)，“成瘾心理学”领域属于第50组，也被称为“成瘾心理学协会”(SoAP)。在“理解依赖vs.成瘾辩论”这篇文章中，jeffrey Juergens博士指出，“DSM-IV曾经将滥用和成瘾定义为两种独立的诊断”;尽管它们是同义的。于尔根接着说，“目前的DSM不再做这种区分”。此外，有人指出，“一些社区交替使用这两个词，而一些社区更喜欢物质滥用障碍或药物依赖”(于尔根)。因此，成瘾心理学领域被不同的群体以多种方式提及，尽管最常见的同义词是物质滥用障碍。

An individual with an addiction abuses uses substances or engages in maladaptive behavior in which the “rewarding” effects induce feelings of repetition, although there may be dire consequences, as stated in an article on addiction by the authors from Psychology today. According to the American Psychological Association (APA), the field of “Addiction Psychology” falls into division 50, also known as, the “Society of Addiction Psychology” (SoAP). In the article “Understanding the Dependence vs. Addiction Debate”, Dr.Jeffrey Juergens states that, “The DSM-IV used to define abuse and dependence as two separate diagnoses''; although they are synonymous. Juergen continues with, “The present DSM no longer makes this distinction”. Additionally, it is stated that, “Some communities use the words interchangeably, while some communities prefer the terms Substance abuse disorder or Drug dependence” (Juergen). Therefore, the field of addiction psychology is referred to in many ways by different communities, although the most common synonym would be Substance Abuse disorder. 

The first diagnosis of Substance Abuse/Addiction that was printed in medical literature occurred during the early 19th century. On a podcast aired on the  NPR website about addiction, hosted by Ira Flatow, she discusses how medical historian Howard Merkel explains the story of how “Freud and Halstead fell under the addictive spell of cocaine”(Flatow).

Sigmund Freud and William Halsted were the first scientists that began experimenting with users and the use of cocaine. Freud, along with Halsted, initially were unaware of the effects of cocaine on the human brain and how highly addictive the drug was. Over time they became addicts themselves, becoming their own test subjects for studies on addiction and substance abuse. Based on the above, it is safe to assume that the specialty area of addiction psychology has been around “since the 1880’s”(Flatow); which is estimated to be the time Freud and Halsted became addicts. Overall, the early discoveries, although nonsensical, have contributed largely to the foundations of Addiction psychology. (McCartney, 2012).

西格蒙德·弗洛伊德(Sigmund Freud)和威廉·霍尔斯特德(William Halsted)是最早开始对吸毒者和可卡因使用进行实验的科学家。弗洛伊德和霍尔斯特德最初并不知道可卡因对人脑的影响，也不知道这种药物有多么容易上瘾。随着时间的推移，他们自己也上瘾了，成为了成瘾和药物滥用研究的实验对象。基于以上，我们可以有把握地假设成瘾心理学的专门领域“自19世纪80年代以来”就已经存在了(Flatow);据估计是弗洛伊德和霍尔斯特德开始上瘾的时候。总的来说，早期的发现虽然荒谬，但对成瘾心理学的基础有很大的贡献。(麦卡特尼,2012)。

Addiction Psychology is a broad field that can cover multiple addictions such as, gambling, eating disorders, sexual addiction, substance abuse and others. According to the Addiction Psychological Organization, the earliest studies in the field began in the early 19th century. It was first named “Society of Psychologists in Substance Abuse.'' This name changed to addiction psychology as the field got broader and more subdivisions were added (American Psychological Association, 2020).

Addiction is not only a domestic issue, it is also an international problem.  According to the Alberta Gambling Research Institute, an estimated 4.9% of the adult people around the world (240 million people) deal with alcohol use disorder and 22.5% of adult people around the world (1 billion people) smoke tobacco products. Smoking tobacco and alcohol use are the most frequent addictive behaviours and cause a lot of individual issues (Gowing, 2015).

As she mentioned,” 11% of deaths in males and 6% of deaths in females each year are due to tobacco.” According to Gans (2016), the United States has the highest rate of illegal drug use compared to other western countries. The survey by the National Survey on Drug Use and Health found our illegal drug use rate is almost four times the rate of the second-place country, New Zealand. Wrong drug policies such as forcing, presonin and punishing people with addiction are some of the reasons that we have a high illegal drug use (Gans, 2016). Instead of solving the issue with effective ways like therapy, we are trying to ignore it.

正如她所提到的，“每年11%的男性死亡和6%的女性死亡是由烟草造成的。”根据Gans(2016)，与其他西方国家相比，美国拥有最高的非法药物使用率。全国药物使用与健康调查发现，我们的非法药物使用率几乎是排名第二的国家新西兰的四倍。错误的药物政策，如强迫、presonin和惩罚成瘾者，是我们非法药物使用率高的一些原因(Gans, 2016)。我们不是用治疗等有效的方法来解决这个问题，而是试图忽视它。

Addiction has been steadily increasing around the world; multiple organizations, like the WHO illustrate some of these statistics to the public. The WHO states that, “ 15% of the 152 responding countries have 1/3 of primary health care facilities implement screening and brief interventions for hazardous and harmful alcohol use” (WHO,2020). This indicates that, globally speaking, we are not that well prepared to professionally take care of individuals with any addiction disorders. According to the article, “Job description for an Addiction Psychologist” by Aanya Rose, “These psychologists are also commonly known as substance-abuse or behavioral-disorder psychologists.”

Aanya also states that, it is the duty of these psychologists to perform many functions such as evaluating their client’s physical wellness and mental health, analyzing any behavioral problems and developing treatment plans tailored to the individual. Aanya continues with, “Clients may work with these psychologists to develop the skills necessary to overcome their addictive behaviors' '(Aanya).

Most aim to help their clients by acknowledging their problem, establishing trust and a rapport, by working together as a whole to come to the treatment method that works best for the addicted individual, and by educating the afflicted loved ones. According to Bobek and Hugue in their article  “What is Family Therapy for Addiction, & How Can It Help My Family?”, they mention that addiction psychology mostly focuses on group, family and individual therapy. “Individual therapy” can help the client clear his thoughts and emotion that can probably be the cause of the addiction.

On the other side, “Family therapy” can be a good tool to use to resolve family conflicts that can affect or aggravate the addiction of the individual.  Moreover, Group therapy can also be very helpful, in group therapy the individual can learn from other people's addictions and how they overcame their addiction.

Dealing with addiction is hard, it is even harder when dealing with it by yourself. Generally, the psychologist works with the client at every step of their recovery treatment to ensure a higher chance of success, whether that be alone or within a group. Aanya states that, “Most addiction psychologists will work with their patients' families, while also incorporating group counseling alongside one-on-one therapies”(Aanya).  These psychologists also tend to work with their clients family members to educate them about how addictive behaviors affect the whole family. They would provide them with helpful strategies to help cope with the side effects of addictive behaviors.

对付毒瘾是很困难的，如果自己一个人对付毒瘾就更困难了。一般来说，心理医生在病人康复治疗的每一步都与他们一起工作，以确保更高的成功机会，无论是单独治疗还是在团队中。Aanya指出，“大多数成瘾心理学家会与患者的家人一起工作，同时也会在一对一疗法的基础上结合团体咨询”(Aanya)。这些心理学家也倾向于与他们的客户的家庭成员合作，教育他们上瘾行为是如何影响整个家庭的。他们会为他们提供有用的策略，帮助他们应对成瘾行为的副作用。

In rare cases, Aanya also concludes that, “The duties of a psychologist may also include referring clients to job placement resources or support groups”(Aanya). The support group sessions focus on 12-step programs, which help clients develop coping strategies for the challenges they face on a daily basis. In accordance with the U.S. Bureau of Labor and Statistics, most addiction psychologists work in “outpatient mental health and substance abuse clinics”. While others will work in local, state and private hospitals.

Addiction psychology is needed as a “specialty” field due to the numerous excessive behaviors that are considered as possible addictions as well as the complexities of risk factors that lead to addiction. According to the APA, genetics plays an important role in addiction. Scientists have proposed that genetic problems can affect the prefrontal and subcortical cortex of the brain which is in-charge of our cognitive process. When this area of our brain is damaged we have less control of our cognitive behavior and it is easier for us to develop any behavior problem. Therefore, those with a genetic predisposition for addiction may heavily benefit from this specialty field, whether that be with knowledge or future treatments.

This field benefits anyone who may be under the category of an Addict under the APA. Ranna Parekh, a physician for the APA, states in her article “What is Addiction'' that, “Individuals with impaired control, social problems, risky use, and physical issues” (Parekh),  fall under the category of severe substance use disorder, aka addiction. So, those that are concerned that the recurrent use of a substance, or engagement with a certain behavioral activity, is leading to impairment and distress in their daily life or the lives of loved ones they may choose to seek out help from an addiction psychologist. For procedure and treatment, Addiction psychologists rely and borrow heavily on parallel aspects throughout clinical psychology such as the integration of science, theory, and practice to understand, predict, and alleviate maladjustments in an individual's behavior.

这一领域使任何可能在APA的成瘾类别下的人受益。APA的内科医生Ranna Parekh在她的文章“什么是成瘾”中指出，“控制能力受损、社会问题、危险使用和身体问题的个人”(Parekh)，属于严重物质使用障碍的范畴，也就是成瘾。所以，那些担心反复使用某种物质，或参与某种行为活动，会导致他们的日常生活或亲人生活受损和痛苦的人，他们可能会选择寻求成瘾心理学家的帮助。对于程序和治疗，成瘾心理学家大量依赖和借鉴整个临床心理学的平行方面，如科学、理论和实践的整合，以理解、预测和缓解个人行为的失调。

Addiction psychology shares a lot of the foundations of clinical psychology such as the integration of science, theory, and practice to understand, predict, and alter an individual's behavior for the better. It's not just a physical need for them to smoke or drink, but it's more like an emotional and mental necessity. Addiction psychologists, compared to clinical and counseling psychologists, have to deal with clients and patients with behaviors that are naturally resistant and are prone to relapse. They all use group, family and individual therapy to help their clients overcome their mental stress and then work towards recovery.

Addiction psychology mostly comprises the clinical psychology and abnormal psychology disciplines and fosters the application of information obtained from research in an effort to appropriately diagnose, evaluate, treat, and support clients dealing with addiction. However, this field has branched off due to the complexities and the many causal factors that lead to substance abuse/addiction in individuals. It has become its own field due to the difficulties that come with treating an addict and the special skill set needed for the proper and effective treatments of such individuals.

Addiction psychologists deal with a wide variety of addictions such as, substance abuse disorders, gambling or eating disorders, and many other excessive behaviors. Their job is challenging enough that they are not able to work in other areas of psychology.

The disease model, temperance model, and moral model are some of the early foundations of addiction psychology models. Sigmund Freud and William Halsted were the first scientists that started working with addiction. But the field doesn't have a specific founder. There exists different beliefs about addiction; some people believe it is a disorder while other people believe it is choice. Scientists and politicians have realized that banning and forcing people to obey is not an effective way to control and reduce substance use. When the drug is not available, they tend to get it from offhand sources or worse places, like the black market. Not enough information about the drug is known, increasing overall risk.

Something positive is that people have decided to see addiction as an abnormality and are fighting for more therapy related solutions rather than punishment and prison. Because the research has shown that punishment may work sometimes but it's not the most effective solution.  For example, in the article, “Treat V. Punish...” by Operation Clean Recovery argues that, “Since the passage of the Harrison Narcotics Act in 1914, United States drug policy has almost always come down on the side of punishment as the solution to social problems caused by substance use/addiction” (Operation Clean Recovery, 2019).

积极的一面是，人们把上瘾看作是一种异常现象，正在争取更多的治疗方案，而不是惩罚和监禁。因为研究表明，惩罚有时可能会起作用，但不是最有效的解决办法。例如，在文章“Treat V. punishment…”清洁恢复行动认为，“自从1914年通过哈里森麻醉品法案以来，美国的毒品政策几乎总是站在惩罚一边，作为药物使用/成瘾引起的社会问题的解决方案”(清洁恢复行动，2019)。

In other words, individuals who are suffering from addiction receive inappropriate treatments which leads to worsening the issue. It should be common sense that an individual without any external support system will most likely not be able to recover fully. Also, according to Dr. Erlen on “Treat V. Punish…”, he states that, “Before the Harrison Act in 1914, opiates and cocaine were legal to buy, sell, and use. In fact, they were often recommended by doctors.

The Harrison Act didn’t outlaw these drugs altogether, but made it illegal to have cocaine or opiates that were not prescribed by a physician. People who had been obtaining and using these drugs freely were suddenly criminals” (Erlen, 2019). In addition, according to the historian William White, “When the Harrison Tax Act was passed, the maximum possible penalty that could be received for a violation of the Act was only five years in prison”(White, 2019).

In just less than fifty years, penalties had risen to include the option of life imprisonment and the death penalty.” Law enforcement should not be making decisions about how to deal with addicted people, said Lawrence Kolb; it is the physicians job to make such decisions.

On the authority of the article “Genes and Addictions” by doctors, Bevilacqua and Goldman, most recent research is focused on individuals genetic susceptibility to addiction, the origins of addiction, the rates of substance abuse in a community, and the search for effective solutions (Goldman). Research in this field uses a lot of statistical data to compare different treatment methods, compare medications to see rate of affection, and to compare the rate of occurrences in a certain population/community.

Also there have been different researches that show children who have been born in families that have been associated with some sort of drug use or simply just exposed to drugs at an early age leads to an increased risk rate of drug addiction and substance abuse in their future. In recent years there are more scholarly journals that are working to answer these issues and are getting involved with modern addictive behaviors. For example in Washington D.C. the media is working so hard to inform people about the potential dangers of substance abuse.

Washington D.C. has the highest rate of drug abuse in the country and many people die because of lack of knowledge and no willingness to seek help. Eventually, these same people may need to  spend a lot of money they might not have, on treatments that can help these people eradicate maladaptive behaviors.

The first goal of addiction psychologists is to prevent. By making announcements and sharing knowledge to the public about addictions, like in Virginia, these psychologists are taking the first step in order to aid in the prevention of substance abuse by denouncing misinformation and supplying accurate knowledge to the people about the issue at hand; for example like the opioid crisis. Breaking free from addiction is the second step, where they use effective coping methods and also psychological methods.

成瘾心理学家的第一个目标是预防。通过向公众宣布和分享有关成瘾的知识，就像在弗吉尼亚一样，这些心理学家迈出了第一步，通过谴责错误的信息，向人们提供有关手头问题的准确知识，帮助预防药物滥用;比如阿片类药物危机。从成瘾中解脱出来是第二步，在这一步中他们使用了有效的应对方法和心理学方法。

Although addiction psychology incorporates a lot of the same practice as clinical psych, one who is simply licensed just as a clinical psychologist does not match the criteria necessary to be considered qualified for this type of work. Although most requirements are met, one must also complete specific coursework tailored to Addiction Counseling to gain the knowledge and experience necessary with substance abuse and addiction in a clinical setting and in a real world setting.

According to the article “Become a Substance Abuse Counselor...”  by Rick Reyes, In the United States many states require a “minimum of a master's degree and license to work as a substance abuse counselor”. But, most states require just a bachelor's degree and supervised experience, under a licensed counselor, working in clinical condition.

With a bachelor’s degree, you can start gaining experience as a recovery assistant, there are private and public facilities that you can work in and it  just requires a bachelor’s degree and some experience to start.  Addiction is an important issue but the treatment is even more important. Psychologists need to be licensed and have enough experience to be able to effectively help their clients. If they are not careful enough with what they are doing, it might have terrible outcomes, possibly even the death of the client.

有了学士学位，你就可以开始积累作为康复助理的经验，你可以在私人和公共设施中工作，只需要有学士学位和一些经验就可以开始。成瘾是一个重要的问题，但治疗更重要。心理学家需要有执照，有足够的经验才能有效地帮助他们的客户。如果他们对自己所做的事情不够小心，可能会有糟糕的结果，甚至可能导致客户的死亡。

Undergraduate students are able to take abnormal, clinical and drug psychology which would help them to understand material regarding addiction and addiction psychology if one is interested in this field. But for graduate students, class would be tailored to more specific aspects of the field; Like how drugs would affect the brain and their actions or how to assist people to make better choices and maintain healthy coping mechanisms other than drugs.

Some addiction counselors are licensed psychiatrists and others have a master’s degree in counseling with a concentration in substance abuse or addiction/addiction studies. According to the article, “How to Become a Therapist: Education and Career Roadmap”, in order to obtain a California Substance Abuse Counseling Certification one must earn an Associates/Bachelors/Masters/degree in a behavioral science field with counseling/Addiction counseling preferred. Then one must complete a 255 hours practicum approved by the CAADAC, earn sufficient supervised work experience, pass an official written examination through the state, then finally apply for the certification under the California Commission for Behavioral Health, and hope that one’s combination of education and accrued documented work experience make one eligible.

The article, “How to Become a Therapist: Education and Career Roadmap'' from study.com (2018), continues that the University of Detroit Mercy, New York Institute of Technology and University of the Pacific have the best program in this field and they are ranked as top addiction psychologist schools in the country. After graduation, they will be qualified to work under the control of an addiction psychologist inorder to gain clinical and hands on experience.

Different states have different prerequisites but students in bachelor's degree program will learn about physical and mental aspects of addiction.  The classes are mainly about dependency of chemicals, research and understanding of statistics, evaluation and treatment. Learning about different types of counseling like individual, family and group counseling. Continuing students would learn about psychopharmacology, prevention and the ways to deal with individual and family emotional issues caused by addiction..

不同的州有不同的先决条件，但学士学位课程的学生将学习关于成瘾的身体和心理方面的知识。课程内容主要是化学依赖、统计学研究与理解、评价与处理。学习不同类型的咨询，如个人，家庭和团体咨询。继续学习的学生将学习精神药理学、预防和处理成瘾引起的个人和家庭情绪问题的方法。

According to Warner, new addiction psychologists with less than 4 years of experience have an average income of $41,633. As they gain more experience, they make more profit. An average income of addiction psychologist with 5-9 years experience is $47,665, 10-19 years of experience is $48,477 and more than 20 years of experience is 59,850. So we can conclude that the average range of addiction psychologists income is between 40,000$ to 65,000$, but psychologists who are MD’s are able to make more than 200,000$ a year. The United States is one of the best places for this field because we have a high rate of addiction compared and a survey showed the United States has the highest rate of illegal drug use compared to other countries(Warner, 2008).

According to the article, “Statistics on Addiction in America”, by the Addiction Center, more than 20,000,000 individuals in the United States have an addiction disorder and not even ten percent of seek treatment, moreover, drug overdose deaths have passed the 700 thousand U.S. citizens from 1999 to 2017 and that numbers keep rising everyday. (Addiction Center, 2020).  The increase of the opioid crisis and other types of behavioral addictions leads to more potential “clients” for this field.

Many individuals are suffering from addictions, whether that be to opioids or something like video games, and are seeking the help necessary to avoid permanent damage to their lives or even damage physically.  We can conclude that addiction psychology is a growing and stable job field, not only that but addiction psychology is growing enormous in the public and private sectors of this field.

Nowadays, more individuals are willing to pay for a good treatment and spend a good amount of money seeking a perfect treatment that fits them or their loved ones. You can clearly notice the growth in this industry, where you can see cheap treatment and really expensive crazy ones with luxury facilities, as consequence of this, the payment for addiction therapies or clinical psychologists can vary depending on the state or the facility that you’re trying to apply to. Yes, this field is growing at a fast paced but, and the employment opportunities are rising too, except that, this field is also getting  very demanding since the recruiters are looking for  highly knowledgeable qualified professionals that can fit and conduct their facilities with professionality.

One of the oldest and most controversial arguments around this field is whether or not the addiction is a disease or if it is the individuals choice. In the opinion of the article “Addiction Treatment or Punishment: Which Works Best Long-Term” by Pyramid Healthcare, addiction is a chronic and progressive brain disease.

Individuals who repeatedly take drugs or excessively consume alcohol undergo changes in the structure and function of their brain. These changes ultimately result in compulsive substance use and a lack of executive functioning which in combination leads to higher risk of maladaptive behavior. The lack of executive functioning in the affected individuals prefrontal cortex causes loss of control over the related behaviors that characterize addiction.

反复服用药物或过度饮酒的人，其大脑结构和功能会发生变化。这些变化最终导致强迫性物质使用和执行功能的缺乏，两者结合起来导致更大的不适应行为的风险。受影响的个体前额叶皮层缺乏执行功能会导致对成瘾特征的相关行为失去控制。

Socially, it is assumed it is the sole responsibility of the person with a substance use disorder to seek treatment. However, it is also society’s responsibility to make treatment readily available and easily accessible.

The second controversy around addiction and individuals who suffer from substance abuse is that the individual has to hit an extreme low before seeking help. Since addiction is progressive, if the individual goes untreated, one’s condition will most likely worsen to extremes, affecting many aspects of the individuals life. Seeking treatment, whether that be alone or with the help of others, helps individuals suffering from addiction find ways of using their cognitive process more effectively to help break the addiction and replace maladaptive behaviors with good behaviors.

Another big controversy regarding addiction is that much of society still believes that addicts should be punished as they see that these individuals are breaking the law and should be put in prison/fined. A significant amount of these individuals that have any drug addiction problem usually break the law not because they want to, but because they want to feed their substance abused need, and when they break the law it’s most of the time too late to find recovery. Usually when a person with some type of drug addiction goes to jail, the individual never receives a professional help or some type of mental health treatment that will help him overcome his addiction. However, in 2015 Massachusetts adopted a new policy where if an addict turns themselves in along with the rest of their drugs and paraphernalia, they will not be arrested and charged. Instead,  as Chief Campanello from the Gloucester police department said,  “ Any addict who walks into the police station with the remainder of their drug equipment (needles, pipes, etc) or drugs and asks for help will NOT be charged”(Campanello, 2015).

For these individuals who turned themselves in it was like having a second chance, which hopefully leads to a successful recovery. The “Gloucester Angel Initiative '' also provided them with a sponsor opportunity that would take them into the right path of recovery. The division of Psychological Addiction is full of controversy, a lot of it is because in reality there are not the necessary resources to help people who suffer from some type of addiction and it is also difficult to help individuals who do not want help or think they do not need it.

对于这些自首的人来说，这就像获得了第二次机会，希望能成功康复。“格洛斯特天使计划”也为他们提供了一个赞助机会，将他们带进正确的复苏之路。分工的心理成瘾充满争议,很多是因为在现实中没有必要的资源来帮助患有某种类型的成瘾的人也很难帮助那些不希望或认为他们不需要它。

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