Assignment Code: MCFTE-003/TMA-8(3)/ASST-8(3)/2021-22

Course Code: MCFTE-003

Assignment Name: Substance Abuse Counselling and Family Therapy

Year: 2021-2022

Verification Status: Verified by Professor

Maximum Marks: 50

Note:

(i) Answer all the questions in both sections.

(ii) Answers to questions of Section “A” should not exceed 300 words each.

Section A - Descriptive Questions

(10x3=30 marks)

Q1. Explain biopsychosocial issues associated with substance abuse in families. (10)

Ans) Some biopsychosocial issues associated with substance abuse in families are:

Biological and Physical Issues

1. Physical Abuse: Families with substance-abusing members are more likely to expose their children and other members to physical violence and abuse.

2. Biological or Genetic Vulnerability: Children whose parents abuse or misuse substances are more likely to do so themselves. There is a strong genetic propensity to substance abuse diseases.

3. Accidents and Disability: Substance-abusing family members are more likely to be involved in accidents, particularly while driving, crossing the street, or using heavy machinery at work. These substance-related incidents are also a primary cause of disability or impairment.

4. Diseases: Risky sexual activities, such as sharing needles in the case of injectable drug use, can lead to sexually transmitted diseases and HIV infections, putting the person's and his or her family's health at danger.

Psychological Issues

1. Emotional Distress: Members of a family with a substance abuse issue may suffer a wide range of emotions, including rage, impatience, anxiety, and despair. The individual who utilises narcotics may show their anger vocally or via acts.

2. Impulsivity is defined as taking specific covert or overt activities without sufficiently considering the repercussions of those actions.

3. Stress is one of the primary causes of substance abuse and is also a significant family concern.

4. Denial is an important factor to consider in a family setting while dealing with a substance abuse problem. This could be demonstrated by a person who is abusing substances in such a way that he or she refuses to acknowledge that their behaviour is unhealthy.

5. Negativism: Any unfavourable communication among family members is referred to as negativism. Complaints, criticism, and various forms of expressing dissatisfaction are examples.

6. Parental Expectations That Aren't Realistic

7. Neglect of a family member with a substance abuse problem

Social Issues

1. Interpersonal conflict can involve disagreement between family members as a result of a family member's excessive substance use, as well as conflict between the person using substances and others, which can be a source of concern for family members.

2. Legal issues: A person who uses substances, especially illicit drugs, may face a range of legal issues, some of which may harm family members.

3. Financial difficulties: Family members may face financial difficulties as a result of the person's excessive spending on substances or as a result of increasing medical or legal bills.

4. Child abuse: Children of substance-abusing parents are prone to all types of abuse, including physical, sexual, and emotional abuse. These children may also be at risk for developing substance abuse problems as adults.

5. Domestic violence: In families with substance abuse issues, marital conflict and discord are widespread. Physical or sexual violence against substance-abusing spouses or partners is a typical occurrence.

6. Families with one or more individuals who use narcotics are frequently stigmatised and discriminated against by the community.

Q2. Discuss the family disease model. (10)

Ans) Substance misuse and addiction might be viewed as a family problem rather than an individual issue. Substance misuse is viewed as an illness that affects the entire family in this model or framework. Family members of substance abusers may develop "co-dependence," which leads to them enabling the person's substance misuse. For example, if the wife of an alcoholic is uneducated, a homemaker, and does not receive attention from her husband, she may begin pouring alcohol into his glass or supplying snacks when he drinks alone or with friends, so intensifying his drinking behaviour.

Despite the fact that there is limited controlled research evidence to support the disease model, it has been proven to be influential in both the treatment community and the general public. The family disease model is a variation on the normal disease model, in which the entire family is thought to be afflicted. While the illness model arose from the Alcoholics Anonymous (AA) movement of the late 1930s and early 1940s, the family disease model developed with the founding of Al-Anon in 1949 to help family members of those who had alcohol issues and was substantially formalised in the 1980s.

Several books have been written claiming that children reared in households with an addicted parent, as well as couples living with an addicted individual, develop co-dependence. Any conduct that maintains substance use or mitigates the effects of alcohol and drugs on the dependent individual is defined as "enabling" co-dependence. Making it simpler to access alcohol or other substances, protecting the drinker from the negative effects of their usage, and keeping the addiction hidden are all examples of enabling behaviours. The family disease model has had a big influence, and it's the basis for a lot of modern treatments and popular ideas. The family disease hypothesis, on the other hand, has received very little empirical evidence.

Q3. Discuss MPOWER. (10)

Ans) The most popular smokeless tobacco product in India is khaini, a tobacco-lime mixture (12%), followed by gutkha (a mixture of tobacco, lime, and areca nut) (8%), betel quid with tobacco (6%), and tobacco dentifrice (3%). (5 percent ). Bidi (9%) is the most popular smoking product, followed by cigarettes (6%), and hukkah (3%). (1 percent ). Tobacco is particularly addictive because it includes nicotine, which has a high potential for addiction. Within 10 seconds of smoking, nicotine reaches the brain.

Article 14 of the WHO FCTC (Framework Convention on Tobacco Control) stipulates tobacco dependency and quitting demand reduction methods. "Each party (country) shall develop and disseminate appropriate, comprehensive, and integrated guidelines based on scientific evidence and best practises, taking into account national circumstances and priorities, and shall take effective measures to promote tobacco use cessation and adequate treatment for tobacco dependence," according to the agreement.

WHO devised the MPOWER plan to assist countries in meeting their FCTC responsibilities, with initiatives that have been shown to reduce tobacco use:

1. M – Monitor tobacco use and prevention policies.

2. P – Protect people from tobacco smoke.

3. O – Offer help to quit tobacco use.

4. W – Warn about the dangers of tobacco.

5. E – Enforce bans on tobacco advertising, promotion, and sponsorship.

6. R – Raise taxes on tobacco.

Along with 171 other nations, India is a signatory to the FCTC. The "Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act" was passed by the Indian government in 2003. The National Tobacco Control Program was launched as a pilot to meet the country's legal and WHO FCTC responsibilities. The initiative is currently being implemented in 42 districts across 21 states across the country. Cessation services are being made accessible at the district hospital level under the District Tobacco Control Program, with experienced counsellors on hand. In the 12th Five-Year Plan, the programme will be expanded to include more states and districts.

Section B - Short Answer/Objective Type Questions

(5x4=20 marks)

Q1. Write short notes (in 100-150 words each) on the following:

i) Enabler

Ans) The individual who causes substance misuse to continue by shielding the user from the repercussions of their behaviour. Enabling, often known as "empowering," is harmful to a person's recovery. Many times, an enabler tries to dismiss all of the evidence that are right in front of them in order to protect and hang on to their loved one. They assume that by denying the facts, everything will stay the same, but in reality, they are putting their loved one in even more danger. For example, if an alcoholic husband fails to return home on time, an enabler (such as the wife) will make excuses to other family members.

ii) Scapegoat

Ans) It could be the substance user or another family member who exhibits a variety of undesirable behaviours. This distracts from the substance addiction and leads the family to feel that if the scapegoat behaved properly, all of their issues would be fixed. A youngster who is struggling in school may divert attention away from a father who is abusing substances. On the surface, the Scapegoats appear to be such jerks that it's difficult to feel sorry for them. They appear to be committed to creating a shambles of their lives and to be unconcerned about the consequences of their actions. However, when viewed in the context of the entire family, it is easy to comprehend those who take on this role as a scapegoat as well as a sacrificial lamb: they sacrifice their own life, health, and happiness in order to bring the family's problems to light. The messes they generate are a "cry for help" that may draw attention to the family's true problem.

iii) Mascot

Ans) Mascots are known for being goofy and cracking jokes, even at their own expense. Clownish behaviour serves as a coping mechanism for anxiety and inadequacy. They frequently have a strong desire for other people's acceptance. They are quite likeable as adults, although they appear apprehensive. They may self-medicate with alcohol and/or tranquillizers, according to Deutsch. The mascot child contributes to family homeostasis by bringing laughter and joy into the home. He/she brightens the family atmosphere by 'clowning around' and making jokes, becoming a counter-balance to the tension that is so widespread and oppressive in dysfunctional families. The mascot may be the one member of the family about whom no one has any complaints. The member of the family who utilises humour to divert attention away from the family's growing turmoil. A father who is constantly cracking jokes, for example, may be diverting attention away from his adolescent son who may be smoking heavily.

iv) Network therapy

Ans) Galanter was the one who came up with this theory. This therapeutic method is founded on the traditional medical model and disease idea, which considers substance dependence as a sickness that affects the entire family. The goals of therapy include the following:

1. In terms of gender, age, relationship, and other factors, the family structure should be balanced.

2. Family and significant others assist the substance abuser in maintaining his abstinence and establishing a stable support structure that aids in his recovery.

3. The emphasis is on the individual's attempts to stay abstinent.

A multi-modal approach to office-based rehabilitation in which specific family members and friends are enlisted to give continuing support and promote attitude change is known as network therapy. It works in conjunction with other treatments. It has three critical tasks:

1. Maintaining Abstinence: The network provides a secure environment with trusted relatives and friends who assist the patient in remaining in therapy and avoiding triggers that could lead to relapse.

2. Network Maintenance: The network, a one-of-a-kind therapy tool, remains involved in improving the patient's coping skills by providing common sense and a constructive team attitude.

3. Securing Future Behaviour: It organises the clinical condition in order to reduce the chances of relapse.