Comparing MI, CBT, REBT, Reality, and Solution-Focused Approaches..

Posted: January 10th, 2023

Comparing MI, CBT, REBT, Reality, and Solution-Focused Approaches..

Please provide one page reaction (opinion, thoughts, and conclusion) on the essay below.

The Diagnostic and Statistical Manual of Mental Disorders (DSM), classifies and diagnoses a myriad of psychological disorders. It also classifies a wide range of substance use disorders (SUD), such as alcohol, inhalants, and other stimulants. There are different criteria in the DSM 5 as it pertains to substance use disorder. According to the DSM 5, in order for a serious SUD to be diagnosed, an individual must be continually using, and also must present with two out of eleven specified criteria.Comparing MI, CBT, REBT, Reality, and Solution-Focused Approaches..

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Some of these criteria include; a substance that is taken in large amounts over a long period of time, strong urges or cravings for the particular substance, impairment in social situations (work , home, school etc.), tolerance, and continuing to use even after knowledge of a physical or psychological problem as a result of the excessive use. It is important to mention, that people often confuse physical dependence or withdrawal as equivalent to having an addiction. However, this is not a criterion that is required in order for someone to be diagnosed with a substance use disorder.
The DSM 5 criteria are based on SUD in adults, and therefore much of the criteria will be difficult to apply to adolescents. The reason for this is that adults and adolescents are in different places in their lives in terms of their development. An adult with an SUD is very different that an adolescent with an SUD, since the adolescent is still developing, and therefore the substance might affect them differently. “Likewise, adolescents with SUDs generally consume the substance regularly over much shorter time periods than adults with the same substance use related diagnosis.” (Brown et al.,1990,1992;Deas et al., 2000). Due to cognitive and biological reasons, it is even possible that certain substances will affect an adolescent differently than it will affect an adult.Comparing MI, CBT, REBT, Reality, and Solution-Focused Approaches..
It is easy to apply certain criteria when it comes to SUD in certain situations, but it is also difficult to apply in others. For example, impairment in social situations or obligations is easy to apply to both adults and adolescents, since it is easy to see how impairment in these areas could be considered to be a disorder. However, psychological problems that may be caused by excessive use is questionable, since it is difficult to know if the psychological problems came first, or if the substance use disorder came first.
There are different behavioral patterns that are common in adolescents nowadays. These behavioral patterns and addictive behavior are not exclusive to substance use. Many of these behavior patterns can include addictive behavior with electronic devices such as phone use or TV watching. Although television addiction is not a diagnosable condition of the DSM-IV, it can be rationalized that an individual might be addicted to the feeling that watching TV gives them.
Additionally, watching excessive amounts of TV might give an individual the feeling of ‘escaping’ real life. An individual that watches TV to the point where it affects their functioning in day to day life (missing important events in order to watch TV, staying up late despite tiredness and being late to school on a constant basis, not doing homework etc.) is enough to provide some evidence, that in fact, watching TV in excess, might be considered to be an addictive pattern of behavior.

Essau, C. (2008). Adolescent addiction: epidemiology, assessment, and treatment. Amsterdam: Academic Press.


There is notable theoretical uncertainty in the DSM-5 when it comes to definition of substance use disorders and the difference between substance abuse and dependence. Even though habitual substance use patterns and physiologic aspects have been considered for a long time as key characteristics of substance dependence, there is no analogous recognized conceptual understanding of substance abuse (Kopak et al, 2014). This is the reason why diagnosis of substance use disorder demonstrates extremely low concordance when it comes to DSM in adults and adolescents.


The diagnosiComparing MI, CBT, REBT, Reality, and Solution-Focused Approaches..s of substance abuse and substance dependence is also totally different. However, most of the cases that meet the DSM-5 abuse criteria are not considered as fitting DSM-5 diagnosis since they do not the minimum two-criterion standard for mild substance use disorder. Majority of DSM-5 abuse cases normally get mild substance use disorder description, whereas those with multiple abuse criteria and 2-3 dependence criteria are categorized as moderate substance use disorder (Kopak et al, 2014). This indicates the mix-up and complications when it comes to precise diagnosis of substance use disorder.Comparing MI, CBT, REBT, Reality, and Solution-Focused Approaches..

In addition, symptom groups of substance abuse and substance dependence are not differentiated by time of symptom onset in adolescents and adults. Likewise, an individual can first meet the criteria for substance dependence prior to meeting the criteria for substance abuse, further making the criteria in diagnosing substance use disorder more complex.Comparing MI, CBT, REBT, Reality, and Solution-Focused Approaches..




There are numerous weaknesses evident in the DSM-5 in regard to the diagnosis of substance use disorder. This can be attributed to the complexity and polythetic associated with substance use syndromes. For example, compulsive use, a key feature of substance dependence is a very complex concept with manifold phycological and neural subdomains and with variable symptoms. Therefore, there is the need for further research to come up with more definite criteria for diagnosing substance use disorders.



Comparing MI, CBT, REBT, Reality, and Solution-Focused Approaches..

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