6 page Report on applying the Bio-Psycho-Social Plus (BPS) Approach to alcoholism in a Movie

Disclaimer: **THIS ASSIGNMENT REQUIRES YOU TO WATCH A 1 1/2 HOUR MOVIE** and is for those in the SOCIAL WORK field.- I have attached a document that explains what the BPS model is, and I have also attached a YouTube link to the movie 28 Days.PROJECT:Explore a film related to substance use and demonstrate your understanding of the BSP model (bio-psychosocial plus approach to addiction) through an analysis of that piece of media (in this case it’s the movie 28 Days)TASK:Analyze the themes (Addiction as Suffering ? Treatment, Change & Recovery, and The Cultural Construction of Addiction, alcohol) using the BPS plus model how does the addiction theory help you understand alcoholism (drug culture)? Does the depiction of addiction issues in the movie shed a new or different light on addiction issues? Identify key issues related to addiction in the movie – DO NOT write a paper that just details neuro-physiological effects of drugs on the body and the brain. The focus needs to be primarily on social, societal, psychological, cultural and/or historical aspects of addiction as they appear in the movie.. Use the BPS model as your guide!FORMAT:1 page summary of the movie, about 3/4’s of a page explaining what the BPS Model of addiction is, and the rest of the pages spent on critical analysis of the movie using the BPS modelit is essential to reference in the body of the paper the sources you employ; also be sure to provide a bibliography or list of references at the end of the report. – 12- point fontyou may use headingsYou may use the first persondouble spaced

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A Bio-Psycho-Social Plus Approach to Addiction and Recovery
Wayne Skinner, MSW, RSW
Assistant Professor, Department of Psychiatry
Adjunct Senior Lecturer, Factor-Inwentash Faculty of Social Work
University of Toronto
The Bio-Psycho-Social (BPS) model was developed to help medical practitioners frame health
and illness not only in biological terms, but to include psychological and social perspectives as
well (Engel, 1977). The model has been widely accepted and has been taken up in a variety of
domains beyond health care. A key point in this approach is that these three dimensions are
not separate vectors, but interconnected and interdependent. Rather than seeing illness as an
event that just occurs in the body of a particular person, the BPS approach is to factor in
psychological and social aspects to build a comprehensive approach to understanding illness,
recovery, and health.
Recently Skinner and Herie (2014) have suggested an expanded view of the BPS model which
they called BPS Plus (BPS). They argue that two other variables, culture and spirituality, have
particularly salience in understanding and addressing addictive behaviours. They make the case
that an effective understanding of addiction requires a comprehensive approach that includes
all five dimensions. This has implications for the prevention of substance use, gambling and
other addictive disorders, as well as offering a framework for a comprehensive approach to
addiction prevention, treatment and recovery. Here is the rationale for the importance of each
of the five dimensions:
The Biological Dimension: it is now widely accepted that addiction is ?a brain disease?
(Leschner, 1997). That is easier to understand in the case of psychoactive drugs where potent
chemicals cross the blood-brain barrier and produce dramatic neurobiological effects within the
brain. Yet the evidence is that other addictive behaviours, such as gambling and gaming, can
produce neurobiological effects in ways that are similar to psychoactive drugs. Beyond the
brain, the biological dimension needs to be understood as extending to the body and the
person?s full biological functioning, including sleep, nutrition, recreation, and level of fitness.
The Psychological Dimension: if neurobiology is concerned with body and brain, psychology is
the study of the mind, and the ways that human subjective experience and behaviour are
shaped and evoked. Looking at the urges and drives that incline or disincline a person to
certain behaviours, as well as the ways motivation and cognitive factors, along with external
rewards and punishments, shape behaviours is important for an effective understanding of
addiction. Psychological factors make important contributions to understanding how and under
what circumstances people initiate change and maintain it over time. These are key issues in
prevention, treatment and recovery.
The Social Dimension: traditionally, social factors have been taken to mean the proximal
influences of people close to the person on their resilience or vulnerability to addiction. The
behaviours that are modeled and valued by others in a person?s social field are more likely to
be adopted than behaviours that lack this normative pressure. The immediate social context is
a key vector for prevention initiatives, as well as for mobilizing support when someone is
looking to change behaviours that have become addictive. Skinner and Herie (2014) extend this
proximal view to a wider, more distal, social-structural perspective on addictive behaviours and
their prevention and treatment. They point to the way larger societal policies and practices
shape and normalize behaviours that carry addictive potential, such as gambling and substance
use. The ways behaviours are made legal or illegal, the ways they are promoted or
discouraged, and the ways they are held to be normal or deviant are powerful factors in
shaping how individuals act, even when they have the belief they are acting autonomously or
just following social convention. Another reason for the necessity of a broadened socialstructural view is the social determinants of health. Here the evidence suggests that poverty,
marginalization and other disadvantaging factors increase not just vulnerability to addictive
behaviours but add to the challenges people face in finding solutions to them when they try to
change. Social support is perhaps the single most important factor in successful recovery,
within the web of multiple factors that need to be understood and mobilized to optimize a
person?s chances of lasting change.
The Cultural Dimension: Culture is increasingly recognized as an essential dimension for
understanding health and illness. Culture refers to the social environment in which a person
finds themselves and its relation to their personal identity. The degree of integration and
connection they feel has a measurable effect on their subjective experience of quality of life
and their vulnerability to addiction and other health issues. This is illustrated with Aboriginal
peoples and the centuries of cultural dislocation they have been subjected to. It also applies to
marginalized communities such as lesbian and gay. Being able to renormalize one?s identity
through cultural reconnection or through creating the positive culture that is healing being in
community with others with whom the person identifies helps restore wellbeing and builds
resilience. Finding peer culture that offers healthy alternatives to addictive lifestyles and
actively engages in recovery practices is predictive of better outcomes for people recovering
from addiction.
The Spiritual Dimension: There is epidemiological evidence that people who have strong
religious affiliation are less vulnerable to addictive behaviours than those who are not. Mutual
aid fellowships based on the 12 Steps are among the oldest approaches to recovery from
addiction problems. It offers a program of spiritual recovery for those who come to believe
that they have a chronic condition that can be managed through active practice of the 12 Steps
and participation in peer support groups on a continuing basis. Alcoholics Anonymous is the
original organization that developed this approach, which has spread to a wide set of conditions
where sufferers self-identify as being addicted. Gamblers Anonymous (GA) is an important
resource for people who consider themselves addicted to gambling. Spirituality as a pathway
to recovery is not restricted to 12 Step groups, it is important to note. When people find
connection to a larger frame of meaning that allows self-transcendence and meaningful
engagement in recovery practices and social re-engagement, they are more likely to change
from addictive preoccupation to increased behavioural self-control, mindfulness and
reconnection with others in ways that are meaningful for the person.
Skinner and Herie (2014), in calling for an approach to addiction and its prevention and
treatment, suggest that an effective model needs to be holistic, integrative and pluralistic. It
needs to be able to fathom the complexity of factors that result in problem gambling and other
addictions, as well as gathering in coordinated and comprehensive ways across diverse
populations the full set of factors that, effectively mobilized, lead to lasting behavioural change,
enhanced resilience, and reliable social connections, all of which are the hallmarks of recovery.
Rather than seeing these factors as competing with one another, they propose that an effective
understanding of addiction requires that they viewed in concert, informing and co-constructing
one another as interlocked factors.
By bringing the elements into dynamic interaction, the goal is avoid reducing addiction to just
one or two elements, and to offer a deeper understanding of the predisposing, precipitating,
and perpetuating factors for addictive behaviours in individuals and communities. The authors
recommend the approach because of its heuristic value: it provides a comprehensive and
integrated understanding of addiction that leads to effective, evidence-informed policies and
practices in prevention, treatment and recovery.
Source: Skinner & Herie (2014)
Engel, George L. (1977). “The need for a new medical model: A challenge for biomedicine”.
Science 196:129?136. ISSN 0036-8075 (print) / ISSN 1095-9203 (web)
Leshner, A. I. (1997). Addiction is a brain disease, and that matters. Science 278, 45-47 DOI:
Skinner, W. & Herie, M. (2014). Biopsychosocial Plus: a practical approach to addiction and
recovery. In Herie, M. & Skinner, W. (eds). Fundamentals of Addiction: A practical guide for
counsellors. Toronto: CAMH.
Draft: For Discussion Only.
May 20, 2016

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