Theories, Models, and Principles of Addiction and Recovery
What to know
Candidates must be able to distinguish the disease model (addiction as a chronic, relapsing brain condition), the biopsychosocial model (biological, psychological, and social factors interact), the moral/legal model (use as deviance), and the harm reduction model (meeting people where they are to reduce consequences). Know the stages of change (precontemplation, contemplation, preparation, action, maintenance, and relapse as a stage in the cycle) and the transtheoretical model's processes of change, decisional balance, and self-efficacy. Grasp motivational interviewing principles (empathy, discrepancy, rolling with resistance, supporting self-efficacy) and the disease concept's implications (no cure, managed like other chronic illnesses, relapse is not moral failure). Understand social learning theory (modeling, expectancies), self-medication hypothesis, and recovery-oriented systems of care emphasizing person-centered, strengths-based, and community-supported recovery.
Traps
Questions conflate dependence with addiction; conflate physical dependence (withdrawal) with substance use disorder; or imply relapse means treatment failed. Watch for items that call the disease model "the only accepted model" - most credentialing bodies endorse a biopsychosocial framing. Distinguish abstinence-based from moderation/harm-reduction goals.
Rule of thumb
If a client is arguing, lecturing, or minimizing, they are likely in precontemplation or contemplation - match the intervention to the stage (raise awareness, explore ambivalence) rather than jumping to action planning. A mismatch between stage and intervention is the most common test trap.
Worked example
A client says, "I don't have a problem; my wife made me come." The best response is reflective and non-confrontational ("Your wife is worried, and you're not sure it's an issue") - this reflects stage-appropriate MI rather than confrontation.