Image For Activity Cover
Workshop: Conceptualizing Addiction in Clinical Practice: Choice, Compulsion, and Responsibility

There remains considerable debate about the nature of addiction, even among addiction psychiatrists. On one side stand those who see addiction as a chronic and relapsing brain disease characterized by intense cravings and compulsion to which the individual with addiction has no choice but to relinquish control. On the other side stand those who see addictive behavior as a choice – a constrained one perhaps, but fundamentally an intentional and conscious act subject to self-control. Both views carry intuitive appeal but also seem to conflict with one another and raise challenging questions. If addiction is a brain disease, how can we hold people responsible for addictive behavior? If addictive behavior reflects choice, how can we explain recurrent akrasia (acting against one’s best judgment) in the face of self-destruction? The practice of addiction psychiatry often benefits from educating patients and the public about addiction, and treatment decisions are often informed implicitly or explicitly by beliefs about the nature of addiction. Reflecting on how to conceptualize addiction is therefore of practical use to clinicians. In this interactive workshop, we use a series of clinical vignettes drawn from psychopharmacology, psychotherapy, trauma-informed treatment, and the Anglo-American law to examine and challenge our understandings of the nature of addiction. Participants will draw from their clinical experience, neuroscience and behavioral psychology knowledge, and philosophical/ethical reasoning to work through these cases. Throughout, participants will engage in a series of discussions with peers to attain a deeper and more sophisticated understanding of the nature of addiction.

Learning Objectives
  • Consider two different ways of conceptualizing addiction, the advantages and disadvantages of each, and how to reconcile them
  • Clarify one's own beliefs about the nature of addiction and reflect on how these beliefs influence one's clinical practice
  • Practice applying different ways of conceptualizing addiction to optimize clinical care through case discussions that bring together psychopharmacology, psychotherapy, trauma-informed treatment, and the law
Keywords / Topics
  • Choice
  • Compulsion
  • Responsibility
Jungjin Kim, MD, Chairperson


Dr. Kim is the Chief of Mental Health and Addiction Service Line and Assistant Professor of Psychiatry at the University of Minnesota Medical School. He is a triple board-certified general, addiction, and forensic psychiatrist. 

Reuben Hendler, MD, Presenter


Reuben Hendler, MD is an attending psychiatrist providing dual diagnosis care in inpatient, residential, and consult settings at McLean Hospital. On faculty at Harvard Medical School, he co-directs the MGH / McLean Clinician Educator Program, which trains residents in how to teach the practice of psychiatry. Dr. Hendler has obtained certification in motivational interviewing, coaches psychiatry residents in this therapeutic approach, and will be joining the Motivational Interviewing Network of Trainers in October, 2023. He has explored conceptual issues in psychiatry and addiction with the podcast Psychiatry & Society. 

Zoe Karavolis, PharmD, RPh, BCPP, Presenter


Zoe Karavolis, PharmD, RPh, BCPP is a clinical psychiatric pharmacist working at the McLean Alcohol and Drug Abuse Treatment Program (ADATP). 

Amanda Sedgewick, DO, Presenter


Amanda Sedgewick, DO is a psychiatrist at McLean Hospital’s Alcohol, Drug, and Addiction Treatment Program. She is fellowship trained in women’s mental health and board certified in addiction medicine. Dr. Sedgewick manages substance use disorders and co-occurring conditions such as trauma and personality disorders. Her area of interest is in treating women with substance use disorders and co-occurring exposure to intimate partner violence and directs the Recovering Safety outpatient women's program in the McLean Hospital outpatient clinic. 
Availability: On-Demand
Cost: FREE
Credit Offered:
No Credit Offered
American Academy of Addiction Psychiatry
The content on this site is intended solely to inform and educate medical professionals. This site shall not be used for medical advice and is not a substitute for the advice or treatment of a qualified medical professional.

400 Massasoit Avenue
Suite 307
East Providence, RI 02914

Education and Resources
Training Events

Powered By