Comparison of Adolescent and Adult Addiction Treatment

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Criteria Adult Population Adolescent Population
Diagnosis Standard diagnosis for addictions in adults is performed using the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). According to Hartney (2019), DSM-5 includes eleven criteria, and having two or more of the symptoms implies that the client has an addiction. The number of presenting signs is indicative of the severity of the condition. Even though there are methods for diagnosis, DSM-5 is the most commonly used one. Addictions in adolescents are also usually diagnosed using DSM-5 criteria. However, there are certain precautions providers need to make when applying the criteria. According to Winters, Martin, and Chung (2011), such criteria as tolerance, risky behavior, withdrawal, and cravings should be applied considering the physical and psychological features of the adolescent population. For instance, risky behavior may be part of the normal developmental process in teenagers, while withdrawal symptoms are difficult to notice (Winters, Martin, & Chung, 2011).
Treatment Models and Interventions The approaches to the treatment of addictions in adults are classified into evidence-based models and non-evidence-based models. The evidence-based models include pharmacological and behavioral therapies that may be used in combinations to meet the individual needs of every client (McGovern & Carroll, 2003). Psychotherapy and Gestalt models are also used to treat addiction in adults, even though they are not evidence-based. Currently, individual and group therapy utilizing cognitive-behavioral therapy (CBT) are most commonly used among addiction specialists (McGovern & Carroll, 2003). Pharmacological therapies are used with CBT to reduce physical discomfort from withdrawal symptoms. The models utilized to treat addictions in adolescents are similar to the ones used for adults. Evidence-based approaches are more frequently used in comparison with psychotherapy (Winters, Botzet, & Fahnhorst, 2011). However, along with CBT, family-based therapy (FBT) is considered a preferable choice (Winters, Botzet, & Fahnhorst, 2011). FBT is based upon the notion that the family carries the most profound and long-lasting influence on the child and adolescent development (Winters, Botzet, & Fahnhorst, 2011, p. 418). It is also vital to notice that there is no evidence that pharmacological approaches are used to treat adolescents (Winters, Botzet, & Fahnhorst, 2011, p. 418). This may be connected to the fact that they experience fewer cravings and withdrawal symptoms.
Gender Differences There are differences in addiction patterns between men and women. According to Bezrutczyk (2019), women are more likely to transition from abuse to dependence and addiction, suffer from side effects of addiction, and experience intense cravings. While men are less likely to relapse, they have a higher chance of developing addiction due to peer pressure and experience severe withdrawal symptoms (Bezrutczyk, 2019). Therefore, treatment should be adjusted to gender differences. For instance, more emphasis is put on post-care among women, while men benefit more from pharmacological treatment. The same gender differences apply to adolescents. However, teenage girls between the ages of 12 and 17 are more likely to misuse all types of prescription opioids and stimulants than boys of the same age (Bezrutczyk, 2019, para. 6).
Contextual Issues: Cultural Differences Culturally diverse populations are at a higher risk of developing addictions (as cited by Gainsbury, 2017). Therefore, culturally targeted treatments are of extreme importance for improving patient outcomes. Cultural competence includes matching clinicians depending on their linguistic and cultural background while being mindful of cultural differences in experience and social norms (Gainsbury, 2017). Therefore, cultural sensitivity is an integral part of best practices in addiction treatment. The principles of cultural sensitivity should also be applied to treating adolescents in the same manner. Addiction specialists should be aware that parents of their children can be of different cultures because individuals are free to determine their culture.
Ethical Considerations All addiction specialists are to follow the NAADAC Code of Ethics. The central matter of concern is to safeguard the integrity of the counseling relationship and to ensure that the client is provided with beneficial services (NAADAC, 2016). At the same time, clients confidentiality is to be protected, and informed consent should be obtained when a professional wants to disclose sensitive information and every time the therapist wants to perform a procedure (NAADAC, 2016). Moreover, addiction specialists are to avoid discrimination, fraud, and harassment while promoting proficiency, innovation, and multicultural competency (NAADAC, 2016). NAADAC Code of Ethics includes several provisions concerning specifically children and adolescents. The primary concern is that these populations cannot always sign informed consent forms, and their confidentiality can be breached by parents or legal representatives, as provisioned by the US law and the Code. However, according to Weinstock (2012), recommends respecting the confidentiality of adolescents when possible. At the same time, it is recommended to ask for the assistance of parents to help with difficult decisions (Weinstock, 2012). Since ethical issues with children and adolescents are complex, the Code should be considered as a minimal requirement, and the ethical practitioner will try to go beyond them in aspiring to the best ethical course of action (Weinstock, 2012, p. 423).

References

Bezrutczyk, D. (2019). What are the differences in addiction between men and women?

Gainsbury, S. M. (2017). Cultural competence in the treatment of addictions: Theory, practice and evidence. Clinical psychology & psychotherapy, 24(4), 987-1001.

Hartney, E. (2019). DSM 5 criteria for substance use disorders. VeryWell Mind.

McGovern, M., & Carroll, K. (2003). Evidence-based practices for substance use disorders. Psychiatric Clinics of North America, 26(4), 991-1010.

NAADAC, the Association for Addiction Professionals (2016). NAADAC/NCC AP Code of Ethics. Alexandria, VA: NAADAC. Web.

Weinstock, R. (2012). Ethical considerations in adolescent addiction. In Richard Rosner (Ed.), Clinical Handbook of Adolescent Addiction, pp. 423-429. New York, NY: John Wiley & Sons, Ltd.

Winters, K. C., Botzet, A. M., & Fahnhorst, T. (2011). Advances in adolescent substance abuse treatment. Current Psychiatry Reports, 13(5), 416421.

Winters, K. C., Martin, C. S., & Chung, T. (2011). Substance use disorders in DSM-V when applied to adolescents. Addiction (Abingdon, England), 106(5), 882897. Web.

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