TPC-Journal-V3-Issue1

20 questions regarding their comfort levels working with PAs and assessing, diagnosing, and treating nine different forms of PAs. Approximately 89% of the respondents indicated that learning about PA was very important for clinicians, while 6% noted that it was important and 6% indicated learning about PA was a neutral issue. Less than 13% of the participants understood that PA included compulsive behaviors such as eating disorders, exercise, Internet, gaming, gambling, relationships, sex, work addiction and compulsive spending. Sixty-four percent of the counselors surveyed acknowledged they treated clients with PAs, but where lacking the training to assess and screen for addictions. Regarding comfort level in assessing, diagnosing and treating PAs, 25% of respondents reported feeling very comfortable, 42% reported feeling comfortable, 22% reported feeling ambivalent, 6% reported not feeling comfortable, and 6% selected not applicable. Counselors reported being trained to assess, diagnose and treat eating disorders more than the other PAs listed on the survey. Eating disorders, relationships and sex were the three PAs that counselors reported having the most learning experiences. Approximately 24% of the respondents had been trained to assess and screen for eating disorders. However, 36% of the participants were trained to diagnose eating disorders and only 19% had been trained to treat eating disorders. From the responses of the participants in this pilot study, it can be gathered that counselors are treating PAs without adequate training and continued education. On average, a third of the participants had been trained to diagnose eating disorders, but most had little to no training in diagnosing the various other forms of PA. Yet, they knowingly are treating clients with addictions. With this admittance, the 89% of counselors who participated in the survey identified the importance of training counselors to assess, screen, diagnose and treat PAs, and 94% expressed interest in taking a process addictions seminar or course. Regarding theoretical orientation, 69% of the participants identified as cognitive behavioral, 8 % as humanistic, and 6% as psychodynamic. Participants also were given the opportunity to provide qualitative responses to some questions. Overall, participants shared that they believed learning about PAs was important. Many were not prepared to provide treatment for clients with PAs, and many were not trained to adequately provide therapeutic services for clients with PAs. One participant stated, “I have never considered the term process addiction , and I could easily see myself changing that answer upon further thought and education. I find the ignorance in the counseling world regarding process addictions terrifying.” Another wrote, “I think graduate programs are very deficient in chemical and behavioral education/training. I was never taught anything in graduate school about addictions.” Overall, the majority of participants expressed their opinions about the importance of continued education and knowledge of PAs, shared that they had not been educated on PAs, or shared that their education on addictions was mainly focused on substance abuse treatment. Discussion “Counselors practice only within the boundaries of their competence, based on their education, training, supervised experience, state and national professional credentials, and appropriate professional experience” (ACA, 2005, p. 9) is an integral aspect of the counseling profession. By adhering to this section of the ACA Code of Ethics (ACA, 2005), all licensed professionals vow to accept responsibility to ‘do no harm’ to the physical, mental and emotional well-being of self, clients, and associates. Although most counselors intend to do no harm and strictly follow ethical guidelines, it is important to understand that by not providing comprehensive treatment for all addictive or problematic behaviors, some counselors may be unintentionally harming clients. Moreover, when the counselors’ only focus for treatment is the first behavior presented by the client, there is a danger of overlooking co-addictions. “Once the initial neural pathway is laid down, other addictions become overlays using some of the same circuitry” (Carnes, 2009, p.13). These co-addictions are often referred to as addiction interactions. Unfortunately, many factors of co-addictions can be found in PAs, which are often compounded by nature such as eating, sex and exercise, making the need or craving acceptable in society. PA can be defined as any compulsive-like behavior that interferes with normal living and causes significant negative consequences, and the physiological responses in the brain are similar to chemical dependency (Grant, 2008). As aforementioned, the difficulties in recognizing PAs lie within the realm of society. For example, many of the associated behaviors are socially accepted, such as sex, spending, eating and work, all of which are an intricate part of our hierarchy of The Professional Counselor \Volume 3, Issue 1