Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Week 10 Lecture 371
Substance Use and Motivational Interviewing
| Question | Answer |
|---|---|
| Treatment Concerns | -No gold standard -Anyone can run a treatment centre w/o credentials or scientific research -Can be pricey; usually not covered through insurance -Few programs report success rates |
| Treatment Components | -Assessment -Treatment Planning -Detoxification -Residential Treatment -Outpatient counseling -Psychiatric services -Social services -Medical services -Community Treatment (look in notes for specifics) |
| Motivational Interviewing | Based on Carl Rogers' humanistic techniques -Therapist be: --Genuine --Accepting --unconditional positive regard (hold client in high esteem regardless of behaviours) |
| Stages of Change | 1. Precontemplation 2. Contemplation 3. Preparation 4. Action 5. Maintenance 6. Relapse and recycle |
| Precontemplation Stage | Not considering change and do not intend to change |
| Contemplation Stage | beginning of the perception that their may be cause for concern and reason to change |
| Preparation Stage | user perceives pros of change outweighs costs |
| Action stage | user chooses a strategy for change and begin to pursue it |
| Maintenance Stage | efforts are made to sustain gains in action stage |
| Relapse and Recycle Stage | user learns that certain goals are unrealistic, certain strategies are ineffective, or certain environments are not conducive to change |
| Stages of Change: Intervention Strategies | Motivational Enhancement Strategies: in Precontemplation &/or contemplation Assessment and Treatment Matching: Contemplation, Preparation, Action Relapse Prevention & Relapse Management: Action, maintenance, relapse |
| MI Techniques | -Open ended Qs -Active listening -Summarize & highlight ambivalence -Elicit client's own motivational statements (change talk) -Develop discrepancy between goals/values & current behaviour -Roll with resistance ->no power struggles |
| MI Techniques (Ruler Questions) | Ruler questions to assess readiness for change and confidence for making change Ex. "On a scale of 1-10, how ready do you feel to make changes?" "What would it take to get you to a 9?" |
| Relapse in Substance Use Disorders | 2/3 relapse rate -Those who quit, don't stay sober for long (relapse around 3 months) |
| Symptoms Before Relapse | -Post-Acute Withdrawal Syndrome -Return to denial -"everything's alright" -Avoidance & defensive behav -Starting to crisis build-work,relationships -Feeling stuck -Becoming depressed -Compulsive &/or impulsive behavs -Urges & cravings (for drugs/al |
| The Black and White Model of Relapse | Thin line between being abstinent and relapsing again. That once you have even only one drink, you are considered to have relapsed |
| A Better Model (Lapse vs Relapse) | Distinguish between lapse and relapse. Lapse = temporary blip (used after one month clean, but continue to be clean after that one time use) Relapse = return to previous state of use or functioning |
| Two Processes of Relapse | Abstinence Violation Effect Apparently Irrelevant Behaviours |
| Abstinence Violation Effect | The "What the Hell" effect -once you start (have had one drink), you might as well keep going (keep using) |
| Apparently Irrelevant Behaviours | behaviour doesn't seem related, but significantly increases chance of relapse. Ex. substance use problems, drove past dealer's house as an alternate route home due to heavy traffic |
| Relapse Prevention: Coping with lapses (initial use of a substance) | -Relapse plan with emergency procedures (who you can call, activities you can do) -Relapse Contract to limit extent of use (lapse ->stop at this # of uses) -Relapse Reminder Card - especially if intoxicated (lists what to do in case of lapse) |
| Relapse Prevention: What to do if lapse occurs | -Stop, look, and listen (notice, describe situation) -Keep calm (don't beat self up) -Renew your commitment to your goal -Implement your Relapse Prevention Plan -Ask for help -Review the situation leading up to the lapse |
| After a Lapse | 1) Identify stimuli that trigger cravings (ex. being around drug-using friends) 2) Problem solve on how to modify/avoid/resist 3)Identify alternative behaviour options when drug cravings are likely to hit |
| Evidence for Relapse Prevention (Review of 24 RCTs) | -doesn't prevent a lapse better than other active tx -more effective at delaying first relapse, reducing duration, & intensity of lapses -effective at maintaining tx effects over 1-2 yrs -May be most effective for more severe users -May be delayed effect |
| Evidence for Substance Use Tx(Irvin, Bowers, Dunn, & Wang 1999) | -group format more effective than individual therapy -more effective as "stand alone" than as aftercare -inpatient settings yielded better outcomes than outpatient -stronger tx effects on self-reported use than on physiological measure |
| 12-Step Programs | -90-day induction period (daily meeting attendance) -Sponsors as mentors (same-sex) -Meeting attendance in which a leader & 2-3 speakers share their experiences of how 12-steps relates to their recovery |
| Pharmacological Models | -admit to residential/semi-residential tx -little emphasis on psychological or social interventions (target physical aspects of addiction) -drug replacement to ameliorate withdrawal --sometimes will involve sedating |
| Project Match Study (Background) | -Participants assigned to: -Cognitive Behavioural Coping Skills Therapy (like relapse prevention) -Motivational Enhancement Therapy (like MI) -12-step facilitation therapy |
| Project Match Findings | -participants got better with any one of the three tx -Exception with low psychiatric severity patients that had more abstinent days with 12-step -ISSUE: no control group. Only compared tx against each other |
| Key things to study for this chapter | -MI: ruler questions, rolling with resistance, amplifying ambivalence, open ended questions, elicit change talk -Stages of Change (MC Q) -Relapse prevention (apparently irrelevant behavs, abstinence violation effect, lapse vs relapse, relapse plan) |
Created by:
lbord313
Popular Psychology sets