The biopsychosocial perspective recognizes that there are biological, psychological, and social causes of substance abuse and dependence. Biological factors include brain chemistry problems, which may be genetic. Genetics influence biochemistry, and biochemistry makes some people particularly vulnerable to addiction to certain drugs once they try them. Psychological factors include cognitive styles, personality traits, and early developmental experiences. Social factors include poverty, oppression, poorly developed social skills, and family dysfunction (Watkins, et al., 2001, p. 3). Counselors' assessments emphasize psychological and social factors. Active listening, Empathy, Concreteness, Paraphrasing, Reflecting, Simplifying, Summarizing, Attending, Probing, ReFraming, Exploring Alternatives, Self-Disclosure, Confrontation, Immediacy ===
Corey & Corey indicated that effective helpers have a healthy self-concept, hold positive beliefs about people, are aware and respectful of cultural differences, have the ability to listen and understand, and posses empathy, congruence, warmth, compassion, genuineness, and positive regard.
according to the DSM-IV-TR, is a maladaptive pattern of substance use, leading to clinically significant impairment or distress, as manifested by three or more of the following seven criteria, occurring at any time in the same 12-month period: Tolerance is present, as defined by either a need for markedly increased amounts of the substance to achieve intoxication or desired effect or markedly diminished effect with continued use of the same amount of the substance; withdrawal is present, as manifested by either the characteristic withdrawal syndrome for the substance or the same or a closely related substance being taken to relieve or avoid withdrawal symptoms; the substance is often taken in larger amounts or over a longer period than was intended; there is a persistent desire or unsuccessful efforts to cut down or control substance use; a great deal of time is spent in activities necessary to obtain the substance, use the substance (e.g., chain-smoking), or recover from its effects; important social, occupational, or recreational activities are given up or reduced because of substance use; and/or the substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance.
The counselor specifies whether or not physiological dependence, defined as evidence of tolerance or withdrawal is present. There are six additional specifiers used for a diagnosis of substance dependence. They are early full remission, early partial remission, sustained full remission, sustained partial remission, on agonist therapy, and in a controlled environment