| Course | PAC 110 Addiction Theories |
|---|---|
| Module | Module 4 |
| Paper type | Theory comparison paper |
| Length | About 1,015 words, 6 pages |
| Format | APA 7 student paper |
| School | Aspen University |
| Program | Psychology and Addiction Studies |
| Updated | October 2026 |
Free sample paper for PAC 110 Module 4
What the Wine Promises and What It Soothes: Cognitive and Psychodynamic Readings of One Client's Drinking
Student Name
Psychology and Addiction Studies Program, Aspen University
PAC 110: Addiction Theories
Instructor Name
Month Day, Year
What the Wine Promises and What It Soothes: Cognitive and Psychodynamic Readings of One Client's Drinking
Lena is thirty-three and works as a paralegal in a busy law firm. She came to Millbrook Counseling Center after her doctor noticed elevated liver enzymes and asked about her drinking. She drinks little on her own, but before almost every social event, a party, a work dinner, a first date, she finishes most of a bottle of wine. Without it, she says, she is stiff, boring and sure that everyone is judging her; with it, she is funny and relaxed. She grew up with a father who corrected everything she said at the dinner table. This paper reads Lena's drinking through two lenses, cognitive and psychodynamic, and asks what each explains and what each suggests for treatment. Lena is a composite drawn for this course and Millbrook does not exist; the cited research is real.
The Cognitive View: What She Expects
Cognitive approaches to addiction focus on the beliefs and thoughts that guide behavior. One of the best-studied is alcohol expectancy theory. Jones et al. (2001) reviewed research showing that people hold beliefs about what alcohol will do for them, such as making them more sociable, relaxed or confident, and that these expectancies predict how much and how often they drink. Expectancies begin forming in childhood, before people have tasted alcohol, through what they observe in families, peers and media. The review also examined expectancy challenge interventions, which show people that their expected effects come partly from belief rather than from alcohol itself, often by having them guess who received alcohol and who received a placebo. Some studies found that these interventions reduced drinking, though results were not consistent across groups.
Lena's account is full of expectancies: wine makes her funny, relaxed and likable. A cognitive approach would examine these beliefs, test them against experience and help her build confidence that she can manage social situations without alcohol.
The Psychodynamic View: What It Soothes
Psychodynamic approaches look beneath behavior to the feelings and conflicts that drive it. Khantzian (1997) proposed the self-medication hypothesis: people use substances to relieve painful feelings that they have difficulty regulating, and their choice of drug is not random but tends to match the distress they feel. In his account, people with addictions often struggle to recognize and manage feelings, to maintain self-esteem, to sustain relationships and to take care of themselves. Alcohol and sedatives, he suggested, can soften rigid defenses and relieve anxiety and isolation, allowing people to feel closer to others. The drug works, at first, which is why its use becomes compelling.
Read this way, Lena's wine relieves something older than her nerves before a party. Growing up with constant correction may have left her with deep shame and an expectation of criticism. Alcohol quiets that internal critic long enough for her to connect with others.
Comparing the Two Readings
| Question | Cognitive reading | Psychodynamic reading |
|---|---|---|
| Why does Lena drink? | She expects wine to make her relaxed and likable | Wine relieves shame and anxiety she cannot otherwise regulate |
| Where did it start? | Learned beliefs about alcohol and social success | A childhood of criticism that shaped how she feels about herself |
| What is the target of treatment? | Her expectancies and her confidence in coping | Her capacity to recognize and bear painful feelings |
| What does the helper do? | Examine and test beliefs, practice skills, plan exposures | Explore feelings, their origins and their link to drinking |
| What might it miss? | The depth and history of her shame | Practical skills for the next party |
Where the Approaches Agree
The two readings are not as opposed as they first appear. Both see Lena's drinking as purposeful rather than random; it does something for her. Both would also predict that simply telling her to stop will fail, because it removes the wine without replacing what the wine provides. And both would watch for the same warning sign in treatment, which is a stretch of sobriety that leaves her more isolated, since isolation would confirm her fear that without alcohol she has nothing to offer. Both locate the problem in her inner life, whether described as beliefs or as feelings. And both suggest that sobriety alone will not be enough unless she finds other ways to handle social situations and the feelings they bring.
The Evidence for Cognitive-Behavioral Treatment
Cognitive-behavioral treatment, which draws on cognitive and learning theories, has been studied extensively. Magill and Ray (2009) pooled randomized trials of cognitive-behavioral treatment for adults with alcohol or illicit drug use disorders. Pooling the trials, they found a small but statistically significant effect overall. The effect was larger when cognitive-behavioral treatment was compared with no treatment or minimal treatment and smaller when it was compared with other active treatments, and it tended to diminish over longer follow-up periods. The self-medication hypothesis has drawn mainly on clinical observation, and its predictions about drug choice have received mixed support in research.
A Plan That Uses Both
For Lena, a combined plan makes sense. Neither approach alone covers both the beliefs that send her to the wine before a party and the history that makes those parties feel so dangerous. Cognitive-behavioral work would examine her expectancies, teach her to notice and question thoughts about being judged and arrange graded exposures, starting with a short coffee with a friend and building toward a work dinner without wine. Alongside this, she and her counselor would explore the shame beneath her anxiety, its connection to her father and the ways it shapes her relationships now. If her social anxiety is severe, a referral for assessment and treatment of the anxiety itself would also be appropriate.
Conclusion
Cognitive and psychodynamic approaches read Lena's drinking differently: one through what she expects alcohol to do, the other through what it soothes. Jones, Corbin and Fromme show that expectancies predict drinking, Khantzian explains how substances relieve unbearable feelings and Magill and Ray provide evidence, modest but real, for cognitive-behavioral treatment. Used together, the approaches offer Lena both practical skills and a deeper understanding of why she reaches for the wine.
References
Jones, B. T., Corbin, W., & Fromme, K. (2001). A review of expectancy theory and alcohol consumption. Addiction, 96(1), 57-72. https://doi.org/10.1046/j.1360-0443.2001.961575.x
Khantzian, E. J. (1997). The self-medication hypothesis of substance use disorders: A reconsideration and recent applications. Harvard Review of Psychiatry, 4(5), 231-244. https://doi.org/10.3109/10673229709030550
Magill, M., & Ray, L. A. (2009). Cognitive-behavioral treatment with adult alcohol and illicit drug users: A meta-analysis of randomized controlled trials. Journal of Studies on Alcohol and Drugs, 70(4), 516-527. https://doi.org/10.15288/jsad.2009.70.516
PAC 110 Module 4 instructions, in plain terms
Comparing two schools of thought on one person is a frequent fourth-module task in PAC 110, and cognitive and psychodynamic approaches make a revealing pair because they look in different places. Work from the Module 4 directions your Aspen course provides; the client here is invented. Explain each approach's core constructs accurately. Apply both to the same client so the comparison is fair. Show where they agree, where they differ and what each misses. Review evidence for treatments that follow from each, being honest about its strength. Propose a plan that uses what each offers. Cite sources in APA 7, and keep psychodynamic ideas in language a reader outside the tradition can follow. Use the same case details for both readings.
How this PAC 110 Module 4 example is built
Lena drinks before parties, work dinners and dates, saying wine makes her funny and relaxed. The expectancy section draws on Jones, Corbin and Fromme's Addiction review: expectancies form before people drink, predict later use and can be challenged. Khantzian's Harvard Review of Psychiatry article supplies the self-medication hypothesis, linking her drinking to shame and anxiety rooted in a critical childhood home. A five-row table compares the readings on cause, target, technique and blind spot. Magill and Ray's Journal of Studies on Alcohol and Drugs meta-analysis reports a small overall effect for cognitive-behavioral treatment, larger against no treatment. The plan pairs expectancy work and graded exposure with attention to the shame beneath her drinking, plus an anxiety referral if needed.
Reading the PAC 110 Module 4 grading rubric
Comparison papers earn credit when both approaches are explained accurately, applied to the same material and evaluated on evidence. This example presents expectancy theory and the self-medication hypothesis in their own terms, then shows how each reads Lena's drinking. The table makes the comparison systematic, and the section on agreement shows that the approaches are not simply rivals. The evidence section reports Magill and Ray's effect sizes honestly rather than claiming cognitive-behavioral therapy simply works, and it notes that the self-medication hypothesis has more clinical than experimental support. The integrated plan demonstrates the reflective, theory-informed practice that the course is designed to build in social workers.
Common PAC 110 Module 4 mistakes, and how to avoid them
Students often explain one approach well and caricature the other, especially psychodynamic theory. Present each in its strongest form. Apply both to the same case details so differences are real rather than artifacts of different examples. Report evidence precisely, including effect sizes and comparison conditions. Note what kind of evidence supports each approach. Avoid jargon that a nonspecialist reader cannot follow. Show how the approaches might work together, since many clinicians combine them. End with a short reflection on which approach suits the way you think about people, because PAC 110 treats your own theoretical orientation as part of what you are studying.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Aspen University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
More PAC 110 and Psychology and Addiction Studies sample papers
- PAC 110 Module 1: Models of Addiction Across History
- PAC 110 Module 2: Biological and Genetic Theories
- PAC 110 Module 3: Learning and Behavioral Theories
- PAC 110 Module 5: Social and Environmental Theories
- PAC 110 Module 6: Theories of Change and Motivation
- PAC 110 Module 7: Systems of Psychotherapy in Addiction Practice
- PAC 110 Module 8: Integrating Theory Into Personal Practice
- SBS 105 Module 3: Sensation, Perception and Consciousness
- PAC 120 Module 6: Advocacy for Clients and Communities
- SBS 200 Module 4: Adolescence
- PAC 230 Module 3: Health Behavior and Behavior Change
PAC 110 Module 4 questions, answered
What does PAC 110 Module 4 usually ask for?
Aspen's PAC 110 turns to cognitive and psychodynamic approaches here, so comparing how each explains a client's use and what treatment follows is typical. Consult your Module 4 prompt.
What are alcohol expectancies?
Beliefs about what alcohol will do, such as make a person relaxed or sociable. Jones, Corbin and Fromme found that expectancies predict drinking and form before people start to drink.
What is the self-medication hypothesis?
Khantzian's idea that people use substances to relieve painful feelings they struggle to regulate, and that the drug chosen often matches the feeling.
Where can I find a free PAC 110 Module 4 sample paper?
Everything is on this page: cognitive and psychodynamic approaches compared through one client who drinks before social events, with a table and a plan.
How effective is cognitive-behavioral therapy for addiction?
Magill and Ray's meta-analysis found a small but significant overall effect, larger when compared with no treatment than with other therapies.