With the global rise in online gaming, elucidating the psychological mechanisms underlying internet gaming disorder (IGD) is essential for effective interventions. The present study examined the indirect relationship between experiential avoidance (EA) and IGD, mediated by emotional schemas and psychological distress, within the Interaction of Person-Affect-Cognition-Execution (I-PACE) model. Data were collected from 685 Iranian university students (68.5% female, mean age = 26.73 years, SD = 8.87) who completed the Acceptance and Action Questionnaire-II (AAQ-II), Brief Leahy Emotional Schema Scale (LESS-II), Depression Anxiety Stress Scales (DASS-21), and the 20-item Internet Gaming Disorder Test (IGDT-20). Structural equation modeling (SEM) was employed to test the hypothesized model. Correlation analyses showed a significant positive association between EA and IGD (p < 0.01). However, no significant direct effect was found in the full SEM model after including the mediators (beta = 0.106, p = 0.511). A statistically significant indirect effect was observed through emotional schemas (beta = 0.088, p = 0.030, 95% BC CI [0.009, 0.177]), whereas the indirect effect through psychological distress was at a trend level and did not reach the conventional threshold of statistical significance (beta = 0.052, p = 0.055, 95% BC CI [-0.002, 0.109]). These findings suggest that the association between EA and IGD is primarily mediated by maladaptive emotional schemas. The results emphasize targeting maladaptive emotional schemas and psychological distress in IGD interventions, particularly in non-Western contexts. However, longitudinal studies are needed to clarify causal pathways.
ABSTRACT Exposure to drug‐related death is a common part of addiction treatment. Minimal scholarship has been put forth as to how patient deaths affect clinicians, particularly those who specialize in working with socially marginalized and high‐risk populations. This study employs an interpretive phenomenological analysis (IPA) approach to understand the experiences of six grieving addiction clinicians and investigates how these experiences later impacted their countertransference (CT) with future high‐risk users. Analysis revealed that a synergy between trauma and grief led clinicians to countertransferentially withdraw from or apply pressure toward their patients after experiencing a patient death. The results section provides a detailed account of these phenomena at work. Implications for the training and supervision of clinicians are discussed.
Counseling codes of ethics play a central role in shaping substance use disorder (SUD) counseling practice; however, these codes may also embed implicit biases that influence how counselors conceptualize clients, recovery, and professional legitimacy. Drawing on critical discourse analysis, this study examines how language and omissions within counseling ethical codes shape stigma toward counselors with lived experience, reinforce racialized narratives of substance use, and sustain structural divisions between addiction and mental health care. Findings reveal that these codes reinforce stigma against SUD counselors with lived experience, maintain the separation of SUD and mental health treatment, and perpetuate racialized narratives that disadvantage minoritized communities. The study calls for revising ethical guidelines to promote equity, cultural humility, and inclusive practices in SUD counseling, ensuring more just and effective care for diverse populations.
A Critical Race Mixed Methodology approach explored counselor educators' use of anti-racist pedagogy in teaching addiction counseling. Quantitative findings indicated that all of the 24 pedagogical techniques were used regularly. Qualitative themes included Applied Anti-Racist Pedagogical Techniques, Barriers, Facilitators, and Addiction-Specific Considerations. A mixed-methods integration joint display synthesized the impacts of instructor race, clinical experience, and professional experience in relation to their use of anti-racist pedagogy.
Veterans are a high priority group within the United States judicial system due to their unique health and rehabilitative needs, risk for suicide and violence, and military service history. In this best practice review, we introduce Dialectical Behavior Therapy for Justice-Involved Veterans (DBT-J), a psychosocial intervention specifically adapted to meet the criminogenic, mental health, and socioenvironmental needs of this population. We begin with an overview of DBT-J and evidence of its efficacy. Next, we outline the DBT-J approach to case conceptualization and treatment planning, illustrating this approach through a case example. Finally, we provide concrete recommendations to clinicians on counseling justice-involved Veterans.
People experiencing substance use disorders (SUDs) and related concerns often engage in value-incongruent behaviors, leading to self-criticism and shame that perpetuate substance use as an avoidance coping strategy, making recovery difficult. Self-forgiveness may interrupt this substance-shame cycle by transforming shame into positive psychological outcomes and value-congruent behavior. Cornish's self-forgiveness therapy intervention, adapted for people recovering from SUDs, was administered to men in early recovery. Pre-post results indicate decreased general distress, increased well-being, and improvements in most offense-specific and substance-use-related outcomes, highlighting the intervention's potential to enhance current treatments for SUDs and supporting qualitative evidence reported by Carroll and colleagues.
This manuscript presents a Crisis-Informed Model for counseling justice-involved individuals and emphasizes arrest and detainment as critical crisis events with significant psychological impact. Through integration of crisis-informed care with crisis intervention strategies, including psychological first aid (PFA), this model addresses a crucial gap in counselor training and practice. Justice involvement is reframed as an opportunity for early mental health intervention rather than merely a legal consequence. This paper calls for counselor education programs to incorporate crisis-focused, culturally responsive training, and community partnerships to prepare counselors to effectively support and advocate for this marginalized population, ultimately aiming to disrupt cycles of trauma and recidivism.
This study examines the reported frequency of substance use, levels of suicide risk, and their relationships among LGBTQ+ college students ( N = 192) following the COVID-19 pandemic. Participants most commonly reported alcohol and marijuana use, and least commonly reported unprescribed prescription opioid or heroin use. Additionally, roughly half of the participants met clinical cutoff scores for suicide behavior. Substance use frequency was not significantly associated with proximal suicide risk factors, regardless of substance type; however, suicide behavior scores were significantly positively associated with frequency of tobacco, marijuana, and recreational drug use. Implications for addictions counselors are discussed.
Given the prevalence of internet gaming disorder (IGD) and official diagnostic criteria, counselors should be prepared to address gaming-related issues in counseling. One clinical modality that could be particularly effective with this presenting concern is motivational interviewing (MI). MI can be used in combination with other established clinical approaches and has empirical support for its utility with addictive behaviors. Although the use of MI has been previously proposed with IGD, this article presents a detailed description of the use of MI in conjunction with the Center for Internet and Technology Addiction (CITA) treatment model in a hypothetical adolescent case example.
This research uses data from the National Epidemiological Survey on Alcohol and Related Conditions-III (NESARC) to explore the recovery experiences between the time points of NESARC data. We analyzed how perceived social support and trauma affect whether people seek treatment or not and achieve an abstinent or non-abstinent recovery. Our findings confirm that individuals with trauma experience are less likely to be in recovery with abstinence than those without a trauma history, while higher social support was significantly associated with being a moderate drinker while in recovery. Trauma and social support do not significantly differentiate between moderate use with treatment versus moderate use without treatment; therefore, treatment itself did not lead people to moderate use recovery.
This study examined relationships among interoceptive awareness (the ability to detect and understand internal bodily sensations), alcohol use severity, and mental health symptoms using alternative modeling. Participants (N = 360) recruited via Amazon's Mechanical Turk completed measures of interoceptive awareness, alcohol use severity, depression, and anxiety. Structural equation modeling tested three alternative models. The best-fitting model suggested that depression fully mediated the relationship between interoceptive awareness and alcohol use severity. These findings highlight the complex interplay between physiological awareness, emotional states, and substance use, offering implications for addictions counseling.
Pregnant Hispanic women face compounded risks of substance use disorder (SUD) and trauma exposure, yet little research explores their resilience and coping from a strengths-based lens. This qualitative study explored the lived experiences of eight women enrolled in an integrated obstetric and SUD treatment program who reported a recent prenatal alcohol or other drug use event (defined as any instance of substance use during pregnancy). Using interpretative phenomenological analysis (IPA), we identified key themes that facilitated recovery, including social support, self-efficacy, and motivation. Framed within Yosso's (2005) community cultural wealth (CCW) framework, findings highlight how familial, social, and navigational capital supported women in returning to harm-reducing strategies and sustaining abstinence following a use event. These results emphasize the need for strengths-based interventions and policies that enhance resilience, reduce stigma, and promote long-term recovery support for pregnant Hispanic women with SUD and other co-occurring mental health conditions.
This study evaluates the effectiveness of an 8-week Mindfulness-Based Stress Reduction (MBSR) intervention in reducing social media addiction among 22 adolescents. The program incorporated techniques such as body scan, sitting meditation, STOP, and RAIN meditation. Results indicated a significant reduction in social media addiction scores ( p < 0.001, d = 1.68) and an increase in mindfulness levels ( p < 0.001, d = 0.85). Specific dimensions, including mood modification, escape, and relapse, showed marked improvement, whereas withdrawal, deception, and conflict exhibited no notable changes. These findings underscore MBSR as a promising approach for addressing behavioral addictions and enhancing emotional regulation.
This study analyzed whether religious or spiritual affiliation and therapy enrollment protect against symptoms meeting Major Depressive Disorder criteria beyond demographic, Internet addiction, and described therapy enrollment. Findings illustrated one risk factor and one protective factor associated with experiencing symptoms that meet Major Depressive Disorder criteria: impairments and dysfunctional self-regulation increased participant probability and risk, while religious or spiritual affiliation decreased the probability of and protected participants from depressive symptoms. The findings underscore the complexities of Internet addiction and depression symptoms among a population of diverse online gamers, highlighting a critical need for tailored counseling interventions.
With the United States leading the world in incarceration rates, an estimated 113 million US adults have experienced the emotional, relational, and financial impacts related to the incarceration of a loved one. This study utilized a PRISMA review to examine the literature on partners of incarcerated individuals, analyzing 17 peer-reviewed empirical articles published between 2013 and 2022. Four primary themes emerged regarding carceral impacts on loved ones: (1) intrapersonal, (2) interpersonal, (3) coping and interventions, and (4) systemic and institutional. We discuss implications for professional counseling practice and research.
This phenomenological study examined the lived experiences of 11 licensed professional counselors (LPCs, LPCCs, LPCC-Ss), exploring their educational and professional trajectories and perceived preparedness for working with clients suffering from substance use disorders. The findings of semi-structured interviews identified five main themes and two subthemes regarding experiences perceived as helpful throughout their educational and professional trajectories. The findings are relevant for CACREP-accredited counselor education programs and the profession. Recommendations are reviewed, along with suggestions to enhance counselors' readiness to meet the growing demand.
Burnout impacts counselors across work settings and client populations; however, little is known about how burnout is related to the therapeutic relationship among sex offender counselors. In this study, we used linear multiple regression to examine the association between counselor burnout and counselor ratings of their in-session empathy, mindfulness, and the working alliance among sex offender counselors (N = 109). The results indicated that a specific aspect of burnout (i.e., devaluing clients) had a negative relationship with in-session empathy and the working alliance. Counselor mindfulness was not associated with burnout.
Researchers used a longitudinal design panel to examine the impact of housing stability and peer support on long‐term recovery and recidivism reduction for individuals with justice involvement and substance use histories (N = 97). Using the Recovery Capital Index, bivariate associations were assessed at 90 days for personal capital, rearrest, and housing stability. Of 97 participants, 14 (14%) experienced rearrest and 74 (76%) achieved housing stability. Results showed as social capital increases, personal capital increases (p < 0.0001). This study demonstrates that peer support specialists, care coordination, and building community connections significantly support long‐term recovery and reducing recidivism rates.
There is significant need for alcohol use disorder (AUD) treatment among lesbian, gay, and bisexual (LGB) individuals. Furthermore, utilization among LGB individuals is below indicated treatment need due to interpersonal and structural barriers. A hierarchical logistic regression examined relationships among perceived public, interpersonal, and healthcare discrimination in relation to treatment utilization using secondary data from a subsample of the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III. Findings indicate that increased public and interpersonal discrimination is associated with higher likelihood of healthcare discrimination. Healthcare discrimination predicted higher AUD treatment use. Clinical implications and recommendations for future research are discussed.
This PhotoVoice study explored the lived experiences of queer, transgender, Black, and Indigenous people of color (QTBIPOC) in substance use disorder counseling. Furthermore, this study utilized a Critical Participatory Action Research framework to discuss QTBIPOC strategies and ideas on enhancing substance use disorder counseling for QTBIPOC communities. The group dialogues in this study further explored how QTBIPOC experience minority stress and affirmative counseling experiences when seeking out counseling for substance use. Substance use disorder counselors and institutions can strongly benefit from the implications of this study as part of enhancing overall QTBIPOC counseling care.
