PD- 1. Abstinence/ Relapse: Progress Dimension
PD- 2. Bio-medical/ Physical: Progress Dimension
PD- 3. Mental/ Emotional: Progress Dimension
PD- 4. Social/ Cultural: Progress Dimension
PD- 5. Educational/ Occupational: Progress Dimension
PD- 6. Attitude/ Behavioral: Progress Dimension
PD- 7. Spirituality/ Religious: Progress Dimension
Considering that addictions involve unbalanced life-styles operating within semi-stable equilibrium force fields, the ARMS philosophy promotes that positive treatment effectiveness and successful outcomes are the result of a synergistic relationship with “The Higher Power,” that spiritually elevates and connects an individuals’ multiple life functioning dimensions by reducing chaos and increasing resilience to bring an individual harmony, wellness, and productivity.
Addictions Recovery Measurement - Subsystems
Since chronic lifestyle diseases and disorders such as diabetes, hypertension, alcoholism, drug and behavioral addictions cannot be cured, but only managed - how should we effectively manage poly-behavioral addiction?
The Addiction Recovery Measurement System (ARMS) is proposed utilizing a multidimensional integrative assessment, treatment planning, treatment progress, and treatment outcome measurement tracking system that facilitates rapid and accurate recognition and evaluation of an individual’s comprehensive life-functioning progress dimensions. The “ARMS”- systematically, methodically, interactively, & spiritually combines the following five versatile subsystems that may be utilized individually or incorporated together:
1) The Prognostication System – composed of twelve screening instruments developed to evaluate an individual’s total life-functioning dimensions for a comprehensive bio-psychosocial assessment for an objective 5-Axis diagnosis with a point-based Global Assessment of Functioning score;
2) The Target Intervention System - that includes the Target Intervention Measure (TIM) and Target Progress Reports (A) & (B), for individualized goal-specific treatment planning;
3) The Progress Point System - a standardized performance-based motivational recovery point system utilized to produce in-treatment progress reports on six life-functioning individual dimensions;
4) The Multidimensional Tracking System – with its Tracking Team Surveys (A) & (B), along with the ARMS Discharge criteria guidelines utilizes a multidisciplinary tracking team to assist with discharge planning; and
5) The Treatment Outcome Measurement System – that utilizes the following two measurement instruments: (a) The Treatment Outcome Measure (TOM); and (b) the Global Assessment of Progress (GAP), to assist with aftercare treatment planning.
With the end of the Cold War, the threat of a world nuclear war has diminished considerably. It may be hard to imagine that in the end, comedians may be exploiting the humor in the fact that it wasn’t nuclear warheads, but “French fries” that annihilated the human race. On a more serious note, lifestyle diseases and addictions are the leading cause of preventable morbidity and mortality, yet brief preventive behavioral assessments and counseling interventions are under-utilized in health care settings (Whitlock, 2002).
The U.S. Preventive Services Task Force concluded that effective behavioral counseling interventions that address personal health practices hold greater promise for improving overall health than many secondary preventive measures, such as routine screening for early disease (USPSTF, 1996). Common health-promoting behaviors include healthy diet, regular physical exercise, smoking cessation, appropriate alcohol/ medication use, and responsible sexual practices to include use of condoms and contraceptives.
350 national organizations and 250 State public health, mental health, substance abuse, and environmental agencies support the U.S. Department of Health and Human Services, “Healthy People 2010” program. This national initiative recommends that primary care clinicians utilize clinical preventive assessments and brief behavioral counseling for early detection, prevention, and treatment of lifestyle disease and addiction indicators for all patients’ upon every healthcare visit.
Partnerships and coordination among service providers, government departments, and community organizations in providing treatment programs are a necessity in addressing the multi-task solution to poly-behavioral addiction. I encourage you to support the mental health and addiction programs in America, and hope that the (ARMS) resources can assist you to personally fight the War on pathological eating disorders within poly-behavioral addiction.
For more info see: Poly-Behavioral Addiction and the Addictions Recovery Measurement System, By James Slobodzien, Psy.D., CSAC at:
Food Addicts Anonymous: http://www.foodaddictsanonymous.org/ Alcoholics Anonymous: http://www.alcoholics-anonymous.org/
References American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC, American Psychiatric Association, 2000, p. 787 & p. 731. American Society of Addiction Medicine’s (2003), “Patient Placement Criteria for the Treatment of Substance-Related Disorders, 3rd Edition,. Retrieved, June 18, 2005, from:
http://www.asam.org/ Bandura, A. (1977), Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84, 191-215. Brownell, K. D., Marlatt, G. A., Lichtenstein, E., & Wilson, G. T. (1986). Understanding and preventing relapse. American Psychologist, 41, 765-782. Centers for Disease Control and Prevention (CDC). Retrieved June 18, 2005, from: http://www.cdc.gov/nccdphp/dnpa/obesity/ Gorski, T. (2001), Relapse Prevention In The Managed Care Environment. GORSKI-CENAPS Web Healthy People 2010. Retrieved June 20, 2005, from: http://www.healthypeople.gov/ Publications. Retrieved June 20, 2005, from: www.tgorski.com Lienard, J. & Vamecq, J. (2004), Presse Med, Oct 23;33(18 Suppl):33-40. Marlatt, G. A. (1985). Relapse prevention: Theoretical rationale and overview of the model. In G. A. Marlatt & J. R. Gordon (Eds.), Relapse prevention (pp. 250-280). New York: Guilford Press. McGinnis JM, Foege WH (1994). Actual causes of death in the United States. US Department of Health and Human Services, Washington, DC 20201 Humphreys, K.; Mankowski, E.S.; Moos, R.H.; and Finney, J.W (1999). Do enhanced friendship networks and active coping mediate the effect of self-help groups on substance abuse? Ann Behav Med 21(1):54-60. Kessler, R.C., McGonagle, K.A., Zhao, S., Nelson, C.B., Hughes, M., Eshleman, S., Wittchen, H. H,-U, & Kendler, K.S. (1994). Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: Results from the national co morbidity survey. Arch. Gen. Psychiat., 51, 8-19. Morgenstern, J.; Labouvie, E.; McCrady, B.S.; Kahler, C.W.; and Frey, R.M (1997). Affiliation with Alcoholics Anonymous after treatment: A study of its therapeutic effects and mechanisms of action. J Consult Clin Psychol 65(5):768-777. Orford, J. (1985). Excessive appetites: A psychological view of addiction. New York: Wiley. Prochaska, J. O., & DiClemente, C. C. (1984). The transtheoretical approach: Crossing the boundaries of therapy. Malabar, FL: Krieger. Slobodzien, J. (2005). Poly-behavioral Addiction and the Addictions Recovery Measurement System (ARMS), Booklocker.com, Inc., p. 5. Whitlock, E.P. (1996). Evaluating Primary Care Behavioral Counseling Interventions: An Evidence-based Approach. Am J Prev Med 2002;22(4): 267-84.Williams & Wilkins. U.S. Preventive Services Task Force. Guide to Clinical Preventive Services. 2nd ed. Alexandria, VA. U.S. Department of Health and Human Services. Healthy People 2010 (Conference Edition). Washington, DC: U.S. Government Printing Office; 2000. World Health Organization, (WHO). Retrieved June 18, 2005, from: http://www.who.int/topics/obesity/en/
James Slobodzien, Psy.D., CSAC, is a Hawaii licensed psychologist and certified substance abuse counselor who earned his doctorate in Clinical Psychology. The National Registry of Health Service Providers in Psychology credentials Dr. Slobodzien. He has over 20-years of mental health experience primarily working in the fields of alcohol/ substance abuse and behavioral addictions in medical, correctional, and judicial settings. He is an adjunct professor of Psychology and also maintains a private practice as a mental health consultant.
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