The Biopsychosocial Approach To Addiction Intervention
Due to the complex nature of addiction, working towards recovery means taking a broad approach to the disease. Rather than relying on strictly medical or biological models, recent research indicates a need for incorporating social and psychological influences as well.
The more unified Biopsychosocial approach examines addiction as the product of biological, psychological, social and cultural influences. That’s why a successful intervention involves interviewing multiple sources and looking at multiple pieces of information. Professional Interventionists are called when other attempts have failed and succeed when viewed as an invitation to accept and seek care.
With mental health & addiction problems, people reach out when their hearts are hurting: someone may have lied, cheated, or stolen from them. Perhaps they have been raged at, had money missing, or been told they’re no good because their loved one has a substance abuse disorder. Often family members develop somatic complaints: their stomachs hurt, necks ache, they have difficulty sleeping and may over or under eat as they are worried about their loved ones.
Likewise, those who experience a substance abuse disorder may also develop physical symptoms related to their disease. For example, alcoholism will result in distended liver, bloated stomachs, blood shot eyes and in some cases early on set dementia or Kosokoffs syndrome. Methamphetamines or cocaine users may develop grave dental problems, while those who abuse THC may have black tar in their lungs.
What is important is that there must be a robust physical history taken for a good assessment to take place.
Mental Health disorders (anxiety, depression, bi-polar, mania, personality disorders –anti-social, narcissism, psychotic episodes and schizophrenia) may co-occur alongside an addiction. They become tightly entwined and one can trigger or worsen the other. By completing a robust bio-psych-social history one can fetter out which came first.
Trauma is another important factor to consider when doing a bio psycho social. Trauma causes intense feelings of discomfort and mind-altering substances are often used to numb feelings and memories. Trauma is both subjective, based on what a person feels and objective, i.e. based on what external event happened (my child died, I was in the war, I had a terrible accident, I was raped, beaten, verbally abused, etc.) . Often people are asked to remember what was important to them at different stages of their lives. What they remember versus what was actually going on in the outside world is a way of taking a gentle look at how trauma may have played a part in their growth and development.
Family And The Larger Community
In doing a bio-psycho-social one must also take a look at family or origin as well as outside community influences. For an effective intervention, it’s essential to have a comprehensive view of family history. This includes a robust history of brothers, sisters, aunts, uncles, grandparents and even pets. It includes not just disorders but also marriages, deaths, cultural background, religion norms and rituals, sexual behaviors. Questions go beyond just addictions and include marriages, divorces, deaths, work, school, legal, religion, moves, relationships to sex, money, food and even digital devices are considered. Families are complex, unique as the issues they face. Hence, one must consider lifestyle factors and cultural factors such as preferred treatment approaches.
By looking at a robust picture of a client, what they are doing and where they came from, Dr. Stanger creates a colorful family map which illuminates problem to tackle first. It’s critical to create this picture from multiple sources of information. Thus, more than one person is interviewed so that the data is triangulated and verified. In doing this, Dr. Stanger builds a collaborative intervention strategy that is mindful of whom the clients are, their strengths, weaknesses and resiliencies. Always looking for strengths to build on this leads to healing both those struggling with addiction and their families and gives them a prescription for action.
Using the words of Sarah Lawrence Lightfoot Dr. Louse envisions when she is with her clients preparing and doing an intervention she is
“I am the mirror who reflects back their pain, their fears their voices. I am the inquirer who asks difficult questions, who searches for evidence and patterns. I am the companion on the journey bringing my own story to the encounter, making possible an interpretive collaboration, I am the audience who listens, laughs, weeps an applauds. I am the spider women spinning their tales. I am the therapist who offers catharsis support and challenge… I am also the stage manager coordinating the intersection of three plays-the story teller, the narrator and the readers inviting your voice to the drama”
Thus the role of a comprehensive retrospective biopsychosocial history becomes a key component of the intervention process helping to determine the skills and strategies needs to intervene with respect, compassion and success and a guidepost in helping determine what might be the three best treatment centers in the country for the identified loved one or patient to enter so that health and wellness may be achieved.