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.
