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PERSPECTIVE ARTICLE PSYCHIATRY published: 06 May 2013 doi:3389/fpsyt.00031 Addiction and choice: theory and new data Gene M. Heyman* Department of...

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PAPER INSTRUCTIONS
Write a 7-page research paper (Choice Theory within Reality Therapy) , not including the cover, abstract, and reference pages. Current APA format is required. At least 5 scholarly, empirical, current sources that are directly related to the level headings of the paper are required.(SEE BELOW FOR HEADINGS AND ARTICLES). You can use research articles or books. sources. The use of quotations is not allowed. You will be required to use your own words; however, you still must cite the information.

Note: the 7-page limit does not include the cover, abstract, and reference pages.


Choice Theory within Reality Therapy
1. Cover page
2. Abstract
3. Body
4. References: At least 5 references required—textbook, books, and journals.( I HAVE PROVIDED)

The body of your paper must be organized according to the following content headings. You must also use current APA format.
• History of Theory
• Types of Problems Theory is Most Useful
• Strengths of the Theory
• Weaknesses of the Theory
• Conclusion

PSYCHIATRY PERSPECTIVE ARTICLE published: 06 May 2013 doi: 10.3389/fpsyt.2013.00031 Addiction and choice: theory and new data Gene M. Heyman* Department of Psychology, Boston College, Boston, MA, USA Edited by: Hanna Pickard, University of Oxford, UK Reviewed by: Serge H. Ahmed, CNRS, France Bennett Foddy, University of Oxford, UK *Correspondence: Gene M. Heyman, Department of Psychology, McGuinn Hall, Boston College, Boston, MA 02467, USA. e-mail: [email protected]; [email protected] Addiction’s biological basis has been the focus of much research. The Fndings have per- suaded experts and the public that drug use in addicts is compulsive. But the word “compulsive” identiFes patterns of behavior, and all behavior has a biological basis, includ- ing voluntary actions. Thus, the question is not whether addiction has a biology, which it must, but whether it is sensible to say that addicts use drugs compulsively. The relevant research shows most of those who meet the American Psychiatric Association’s criteria for addiction quit using illegal drugs by about age 30, that they usually quit without professional help, and that the correlates of quitting include legal concerns, economic pressures, and the desire for respect, particularly from family members. That is, the correlates of quitting are the correlates of choice not compulsion. However, addiction is, by deFnition, a disorder, and thereby not beneFcial in the long run.This is precisely the pattern of choices predicted by quantitative choice principles, such as the matching law, melioration, and hyperbolic dis- counting. Although the brain disease model of addiction is perceived by many as received knowledge it is not supported by research or logic. In contrast, well established, quantitative choice principles predict both the possibility and the details of addiction. Keywords: addiction, choice theory, remission, correlates of recovery, brain disease model INTRODUCTION Addictive drugs change the brain, genetic studies show that alco- holism has a substantial heritability, and addiction is a persistent, destructive pattern of drug use (e.g., Cloninger, 1987 ; American Psychiatric Association, 1994 ; Robinson et al., 2001 ). In scien- tiFc journals and popular media outlets, these observations are cited as proof that “addiction is a chronic, relapsing brain dis- ease, involving compulsive drug use” (e.g., Miller and Chappel, 1991 ; Leshner, 1999 ; Lubman et al., 2004 ; Quenqua, 2011 ). Yet, research shows that addiction has the highest remission rate of any psychiatric disorder, that most addicts quit drugs without professional help, and that the correlates of quitting are those that attend most decisions, such as Fnancial and familial con- cerns (e.g., Biernacki, 1986 ; Robins, 1993 ; Stinson et al., 2005 ; Klingemann et al., 2010 ). However, addiction is “disease-like” in the sense that it persists even though on balance its costs outweigh the beneFts (e.g., most addicts eventually quit). Thus, in order to explain addiction, we need an account of voluntary behav- ior that predicts the persistence of activities that from a global bookkeeping perspective (e.g., long-term) are irrational. That is, addiction is not compulsive drug use, but it also is not rational drug use. Several empirical choice principles predict the possi- bility of relatively stable yet suboptimal behavior. They include the matching law, melioration, and hyperbolic discounting (e.g., Herrnstein, 1990 ; Ainslie, 1992 ). These principles were discov- ered in the course of experiments conducted in laboratories and natural settings, and in experiments these same principles also distinguish addicted from non-addicted drug users (e.g., Kirby et al., 1999 ). ±or example, ex and current heavy drug users were more likely to suboptimally “meliorate” than were non-addicts in a choice procedure that invited both long-term maximizing and melioration ( Heyman and Dunn, 2002 ). Thus, we have on hand a research based, non-disease account of the deFning features of addiction, which is to say its destructive and irrational aspects. As this essay is based on how those we call addicts behave, it would be most efFcient to begin with a brief summary of key aspects of the natural history of addiction. LIKELIHOOD OF REMISSION AND TIME COURSE OF ADDICTION Figure 1 shows the cumulative frequency of remission as a func- tion of the onset of dependence in a nation-wide representative sample of addicts (United States, Lopez-Quintero et al., 2011 ). The researchers Frst recruited a sample of more than 42,000 indi- viduals whose demographic characteristics approximated those of the US population for individuals between the ages of 18 and 64 ( Grant and Dawson, 2006 ). The participants were interviewed according to a questionnaire designed to produce an APA diagno- sis when warranted. ±or those who currently or in the past met the criteria for “substance dependence” (the APA’s term for addic- tion), there were additional questions aimed at documenting the time course of clinically signiFcant levels of drug use. Figure 1 summarizes the Fndings regarding remission and the duration of dependence. On the x- axis is the amount of time since the onset of depen- dence. On the y -axis is the cumulative frequency of remission, which is the proportion of individuals who met the criteria for lifetime dependence but for the past year or more had been in remission. The Ftted curves are negative exponentials, based on the assumption that each year the likelihood of remitting remained constant, independent of the onset of dependence ( Heyman, 2013 ). www.frontiersin.org May 2013 | Volume 4 | Article 31 | 1
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Heyman Addiction as ambivalence (not compulsion) FIGURE 1 |The cumulative frequency of remission as a function of time since the onset of dependence, based on Lopez-Quintero et al.’s (2011) report . The proportion of addicts who quit each year was approximately constant. The smooth curves are based on the negative exponential equations listed in the figure. The cumulative frequency of remission increased each year for each drug. Indeed,the theoretical lines so closely approximated the observations that the simplest account is that each year a constant proportion of those who had not yet remitted did so regardless of how long they had been addicted. By year 4 (since the onset of dependence) half of those who were ever addicted to cocaine had stopped using cocaine at clinically significant levels; for marijuana the half-life of dependence was 6 years; and for alcohol, the half- life of dependence was considerably longer, 16 years. As the typical onset age for dependence on an illicit drug is about 20 ( Kessler et al.,2005a ),the results say that most people who become addicted to an illicit drug are“ex-addicts” by age 30. Of course, addicts may switch drugs rather than quit drugs,but other considerations indi- cate that this does not explain the trends displayed in Figure 1 . For example, dependence on any illicit drug decreases markedly as a function of age, which would not be possible if addicts were switching from one drug to another ( Heyman, 2013 ). The graph also shows that there is much individual variation. Among cocaine users, about 5% continued to meet the criteria for addiction well into their 40s; among marijuana users, about 8% remained heavy users well into their 50s, and for alcoholics, more than 15% remained heavy drinkers well into their 60s. Thus, for both legal and illegal drugs some addicts conform to the expecta- tions of the “chronic disease” label. However, as noted below, the correlates of quitting drugs are the correlates of decision making, not the correlates of the diseases addiction is said to be similar to. CAN WE TRUST THE DATA? The results in Figure 1 replicate the findings of previous nation- wide surveys and targeted studies that selected participants so as to obtain representative samples (e.g., Robins and Murphy, 1967 ; Anthony and Helzer, 1991 ; Robins, 1993 ; Warner et al., 1995 ; Kessler et al., 2005a,b ). For instance, in every national scientific survey of mental health in the United States, most of those who met the criteria for dependence on an illicit drug no longer did so by age 30, and addiction had the highest remission rate of any other psychiatric disorder. However, research on remission faces well-known methodological pitfalls. Those in remission may relapse at some post-interview date, and the subject rosters of the large epidemiological studies may be biased in favor of those addicts who do quit. For instance, addicts who remain heavy drug users may not cooperate with researchers or may be hard to contact because of their life style, illnesses, or have higher mortality rates. These issues have been discussed in some detail elsewhere ( Hey- man, 2013 ). The key results were that remission after age 30 was reasonably stable, and that it was unlikely that there were enough missing or dead addicts to alter significantly the trends displayed in Figure 1 . THE CORRELATES OF QUITTING AND THE ROLE OF TREATMENT The correlates of quitting include the absence of additional psychi- atric and medical problems, marital status (singles stay addicted longer), economic pressures, fear of judicial sanctions, concern about respect from children and other family members, worries about the many problems that attend regular involvement in ille- gal activities, more years spent in school, and higher income (e.g., Waldorf, 1983 ; Biernacki, 1986 ; Waldorf et al., 1991 ; Warner et al., 1995 ). Put in more personal terms, addicts often say that they quit drugs because they wanted to be a better parent, make their own parents proud of them, and not further embarrass their fam- ilies (e.g., Premack, 1970 ; Jorquez, 1983 ). In short, the correlates of quitting are the practical and moral concerns that affect all major decisions. They are not the correlates of recovery from the diseases addiction is said to be like, such as Alzheimer’s, schizo- phrenia, diabetes, heart disease, cancer, and so on (e.g., Leshner, 1999 ; McLellan et al., 2000 ; Volkow and Li, 2004 ). Much of what we know about quitting drugs has been pro- vided by researchers who study addicts who are not in treatment (e.g., Klingemann et al., 2010 ). This is because most addicts do not seek treatment. For instance, in the survey that provided the data for Figure 1 , only 16% of those who currently met the crite- ria for dependence were in treatment, and treatment was broadly defined so as to include self-help organizations as well as services by trained clinicians ( Stinson et al., 2005 ). Since most addicts quit, the implication is that most addicts quit without professional help. Research supports this logic (e.g., Fiore et al., 1993 ). A NON-DISEASE ETIOLOGY FOR PERSISTENT SELF-DESTRUCTIVE DRUG USE Although self-destructive, irrational behavior can be a sign of pathology,it need not be. The self-help industry is booming,which reflects the tendency of so many of us to procrastinate, overeat, skip exercising, and opt for whatever is most convenient. Why buy a book or go to a lecture on how to improve your life if you did not realize that (1) you were behaving imprudently, (2) knew you probably could change, but (3) so far have not taken the requisite steps. Similarly, human irrationality drives the story-line of most novels, memoirs, movies, and plays. Agamemnon sacrifices his Frontiers in Psychiatry | Addictive Disorders and Behavioral Dyscontrol May 2013 | Volume 4 | Article 31 | 2
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International Journal of Choice Theory and Reality Therapy • Fall 2014 • Vol. XXXIV, number 1 • 6 CHOICE THEORY AND REALITY THERAPY: AN OVERVIEW Ezrina L. Bradley, Chicago State University Abstract An old cub scout saying states that “We need to keep things simple and make them fun, and then before we know it, the job will be done.” Notably, William Glasser seemed to be aware of this saying as he sought to create Choice Theory and Reality Therapy. Truly, he consistently sought to help others to better relate to their experiences, and then guided them regarding how they might more readily take efficient control of their lives. This brief overview simply seeks to explain how all of this can be simply done. INTRODUCTION Often times, we blame other people or things for our own misery. “The kids are driving me crazy.” “My husband makes me so mad.” “Being sick is making me depressed.” When saying these things, many do not realize that they are actually choosing how they feel, and that these people or things are not causing their emotions. According to choice theory (formerly known as control theory), we choose all of our actions and thoughts, based on the information we receive in our lives. Other people or things cannot actually make us feel or act a certain way (Glasser, 1998) Choice theory, developed by Dr. William Glasser, evolved out of control theory, and is the basis for Reality Therapy (Howatt, 2001). Control theory,on the other hand, was developed by William Powers and it helped explain many of Dr. Glasser's beliefs, but not all of them. Dr. Glasser spent 10 years expanding and revising control theory into something that more accurately reflected his beliefs, what we now know as choice theory (Corey, 2013). Although reality therapy is based on choice theory, it was actually reality therapy that was coined first in 1962. It wasn't until some 34 years later, in 1996, that Glasser announced that the term “control theory” would be replaced with “choice theory”. The rationale for the name change was that the guiding principle of the theory has always been that people have choices in life and these choices guide said life (Howatt, 2001). Glasser believed that people needed to take more responsibility for their behavior and that reality therapy could help them do this. The essence of choice theory and reality therapy is that we are all responsible for what we do and that we can control our present lives (Corey, 2013). Glasser also believed that the root problem of most unhappiness is unsatisfying or non-existent relationships. Because of this void, an individual chooses their own maladaptive behavior as a way to deal with the frustration of being unfulfilled. In reality therapy, a person can be taught how to effectively make choices to better deal with these situations. Reality therapy can help an individual regain control of their lives, instead of letting their emotions run the show, which is the key to their own personal freedom (Howatt, 2001). Although traditionally thought of simply as a therapy technique, reality therapy is actually a philosophy of life that is applicable to more than just psychological deficits. It can be used in all aspects of human relationships and in various settings, including schools, hospitals, and correctional institutions (Corey, 2013).
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International Journal of Choice Theory and Reality Therapy • Fall 2014 • Vol. XXXIV, number 1 • 7 ESSENTIAL CONCEPTS OF CHOICE THEORY AND REALITY THERAPY Choice theory is an internal psychology that postulates that all behavior is a result of choices, and our life choices are driven by our genetically encoded basic needs. Originally, Dr. Glasser presented only two basic needs: love and acceptance (Howatt, 2001; Litwack, 2007). By 1981, the basic needs had increased to five and are: survival, love and belonging, power, freedom, and fun (Litwack, 2007; Brown, 2005; Corey, 2013; Glasser, 1998). Survival is the only physiological need that all creatures struggle with. Love and belonging is a psychological need and is considered the primary need in humans. Power is also a psychological need that includes feelings of accomplishment, success, recognition, and respect. Freedom is a psychological need that involves expression of ideas, choices, and creativity. Lastly, fun is also a psychological need that involves laughing and enjoying ones life. These basic needs are not in a hierarchy as Abraham Maslow's needs are. Instead, our basic needs as presented by Dr. Glasser vary in strength depending on the person, and can also change within an individual over time and circumstance. If any of these needs are not being met, which can be displayed in our feelings, we respond accordingly to achieve satisfaction (Corey, 2013). Choice theory also postulates that everyone has what they would consider their quality world. This is the place in our minds where we store everything that makes, or that we believe would make, us happy and satisfied. This is where all of our good memories and fun times go. This is also where that dream vacation and dream home would go. It is like a photo album or inspiration board of all our wants and needs (Corey, 2013). People are the most important part of this quality world, remembering that a key point of choice theory is that behavior is the result of unsatisfying relationships or the absence of relationships. Without people in your quality world, there are no relationships. Without relationships, the quality world cannot be satisfied. Part of the goal of the reality therapist would be to become a part of their client's quality world, thereby facilitating the process of learning to form satisfying relationships (Corey, 2013). Choice theory explains that all behavior is made of four components: acting, thinking, feeling, and physiology. These four components combine to make up our total behavior. Our acting and thinking controls our feelings and physiology. Choice theory also explains that all behavior is purposeful, and is an attempt to close the gaps between our needs, wants and what we are actually getting out of life (Corey, 2013). Our behavior can help us deal with our emotions, give us some control over our circumstances, help get us the help we need from others, or become a substitute for behavior that should occur. Behavior is like a language sending out coded messages to the world on our behalf expressing our wants and needs (Wubbolding & Brickell, 2005). Again, usually these wants and needs stem from unsatisfied relationships. The focus of reality therapy is to address the issue of these unsatisfying relationships which can result in unfavorable behavior. Emphasis is placed on the client focusing on their own behavior rather than playing the blame game. We cannot blame others for our lives and, in turn, cannot control the behavior of others. “The only person you can control is yourself.” (Corey, 2013). Reality therapy also involves being in the present and not focusing on the
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PSYC 371 C OURSE P APER I NSTRUCTIONS Write a 7-page research paper ( Choice Theory within Reality Therapy) , not including the cover, abstract, and reference pages. Current APA format is required. At least 5 scholarly, empirical, current sources that are directly related to the level headings of the paper are required.(SEE BELOW FOR HEADINGS AND ARTICLES). You can use research articles or books. sources. The use of quotations is not allowed. You will be required to use your own words; however, you still must cite the information. Note: the 7-page limit does not include the cover, abstract, and reference pages. Choice Theory within Reality Therapy 1. Cover page 2. Abstract 3. Body 4. References: At least 5 references required—textbook, books, and journals .( I HAVE PROVIDED) The body of your paper must be organized according to the following content headings. You must also use current APA format. History of Theory Types of Problems Theory is Most Useful Strengths of the Theory Weaknesses of the Theory Conclusion
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_______________________________________________________________ _______________________________________________________________ Report Information from ProQuest November 23 2014 18:39 _______________________________________________________________ 23 November 2014 ProQuest
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Table of contents 1. "Drugs" Versus "Reality Therapy". ................................................................................................................ 1 23 November 2014 ii ProQuest
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Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Reality Therapy in Action Daya Singh Sandhu Professional School Counseling; Apr 2000; 3, 4; ProQuest pg. 296
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References Barness, R., & Parish, T. S. (2006). "Drugs" versus "Reality Therapy”. International Journal of Reality Therapy, 25 (2), 43-45. Retrieved from http://search.proquest.com/docview/214440418?accountid=12085 Bradley, E. L. (2014). CHOICE THEORY AND REALITY THERAPY: AN OVERVIEW. International Journal of Choice Theory and Reality Therapy, 34 (1), 6-13. Retrieved from http://search.proquest.com/docview/1625136609?accountid=12085 Daya, S. S. (2000). Reality therapy in action. Professional School Counseling, 3 (4), 296. Retrieved from http://search.proquest.com/docview/213329723?accountid=12085 Heyman, G.M., Ahmed, S. H., & Foddy, B. (2013). Addiction and Choice Theory and New Data. Frontiers in Psychiatry, 41-5. Doi: 10.3389 Hechter, M., & Kanazawa, S. (1997). SOCIOLOGICAL RATIONAL CHOICE THEORY. Annual Review of Sociology, 23 , 191-214. Retrieved from http://search.proquest.com/docview/199580379?accountid=12085
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Sociological Rational Choice Theory Author(s): Michael Hechter and Satoshi Kanazawa Source: AnnualReviewofSociology, Vol. 23 (1997), pp. 191-214 Published by: Annual Reviews Stable URL: http://www.jstor.org/stable/2952549 . Accessed: 23/11/2014 18:32 Your use of the JSTOR archive indicates your acceptance of the Terms & Conditions of Use, available at . http://www.jstor.org/page/info/about/policies/terms.jsp . JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact [email protected] . Annual Reviews is collaborating with JSTOR to digitize, preserve and extend access to Annual Review of Sociology. http://www.jstor.org This content downloaded from 208.95.48.254 on Sun, 23 Nov 2014 18:32:11 PM All use subject to JSTOR Terms and Conditions
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Annu.Rev.Sociol.1997.23:191-214 Copyright? 1997byAnnualReviews Inc.Allrightsreserved SOCIOLOGICAL RATIONAL CHOICE THEORY MichaelHechter Department ofSociology,University ofArizona,Tucson,Arizona85721; e-mail:[email protected] SatoshiKanazawa Department ofSociology,UrisHall,CornellUniversity, Ithaca, NewYork14853-7601;e-mail:[email protected] KEY WORDS: macrosociology,micro-macro link,generaltheory, empiricalresearch ABSTRACT Althoughrationalchoicetheoryhasmadeconsiderable advancesinothersocial sciences,itsprogress insociologyhasbeenlimited.Somesociologists'reser- vationsaboutrationalchoicearisefroma misunderstanding ofthetheory.The first partofthisessaytherefore introduces rational choiceas a generaltheoretical perspective, orfamilyoftheories,whichexplainssocialoutcomesbyconstruct- ingmodelsofindividual actionandsocialcontext."Thin"modelsofindividual actionaremuteaboutactors'motivations, while"thick"modelsspecifythemex ante.Othersociologists'reservations, however, stemfromdoubtsabouttheem- piricaladequacyofrational choiceexplanations. Tothisend,thebulkoftheessay reviewsa sampleofrecentstudiesthatprovideempirical supportforparticular rationalchoiceexplanations ina broadspectrum ofsubstantive areasinsociol- ogy.Particular attention ispaidtostudiesonthefamily, gender, andreligion, for thesesubareasoftenareconsidered leastamenabletounderstanding intermsof rationalchoicelogic. INTRODUCTION Inthelastdecaderationalchoicetheoryhasgainedinfluence andvisibility in manyofthesocialsciencesandinrelateddisciplinesuchas philosophy and law.To appreciate justhowrapidly itsinfluence hasspread,considerpolitical 191 0360-0572/97/0815-019 1$08.00 This content downloaded from 208.95.48.254 on Sun, 23 Nov 2014 18:32:11 PM All use subject to JSTOR Terms and Conditions
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