Although my client base is self selecting and not representative of the general population, I am still amazed and distressed at the frequency with which addictions are part of my clients' lives.
When I first started out in private practice, I relied primarily upon formal diagnostic criteria (DSM-IV) as a means to identify the presence of an addiction. The DSM-IV provides a sound measure of substance abuse and dependence that is based on the frequency, amount and history as well as the substance's impact on a person's life. On its own, it provides a very acceptable way of assessing one aspect of an addiction problem.
Over the years, I have found that these criteria miss an important element in the addiction process; the impact a substance and/or an activity (and the resulting behavior) has on the family system.
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