Psych 334 Addiction & Recovery

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Components of effective brief counseling

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FRAMES:

feedback to the client of personally relevant info

responsibility for change

advice from provider recommending behavior change

menu options from which to choose

self efficacy that the client could be successful

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brief interventions can be

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used as a preparation for addiction treatment, involve pharmacological or behavioral interventions

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attempts to pressure people into changing

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met with resistance and can jeopardize one's professional relationship with client

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maintaining contact and supportive relationship

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case management is vital component for treatment because it helps clients gain access to services that will support their change

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Clients at differing points of readiness

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need different kinds of help

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precontemplation (first stage of change)

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during which time the person is not even thinking about or considering change

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contemplation (second stage of change)

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where in the person is thinking about making a change within the next 6 months

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preparation (third stage of change)

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person is planning to change, but has not yet decided when and how to do it. people here need help developing a change

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action (fourth stage of change)

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the person implements the change plan, the person is actively trying to change

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maintenance (fifth stage of change)

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task here is to hold onto and continue gains made through action, this is sometimes called aftercare

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desire

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people talk about wanting to change wishing they could change

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ability

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the persons's perceived ability to change

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reason

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people express reasons to make (or not make) a change

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need

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people verbalize their level of need to change (or not to do so) example: I've got to do something or I don't have to quit

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commitment

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specific language that signals the level of commitment to change example: I will go to an AA meeting or I guess I will

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language of motivation

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natural language that people use to talk about their motivation

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ambivalence

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state of having mixed feelings or contradictory ideas about treatment

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CRAFT

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teaches family members that they can make a difference

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enabling

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make it easy for the client to do what he or she needs to do, refrain from doing things that make use easier

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primary focus on CRA

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positive reinforcement that when a behavior leads to rewarding consequences, it is likely to be repeated

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functional analysis

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figure out what function is the drive serving in the clients life what are the antecedents and consequences of substance use

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antecedent

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when is the person most likely to use?

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consequences

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interest is in the positive example what do they like about alcohol

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sobriety sampling

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when a client is unwilling to consider long term abstinence, the counselor and client negotiate a period of abstinence that the client is will to try

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successive approximation

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means taking baby steps, helps build self efficacy, as well as, remove the pressure from immediate change

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sobriety skills

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skills that are taught to the client to stay abstinent

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refusal skills

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prepare the client for when they come in contact with people who will offer them drugs

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coping skills

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find out what client is coping with and teach them how to cope without the drugs

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motivational incentives

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monetary incentive for people to abstain from using drugs. example program that pays clients for a clean drug test

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importance of employment

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stable employment is strong predictor of sobriety

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social skills

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teaching clients how to communicate in a manner that is more acceptable, being assertive but not aggressive

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I messages

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when expressing yourself use the I rather than you. example be specific, be clear, be respectful

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Assertiveness

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describe the behavior, your own feelings or reactions, what you want to happen

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STORC

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situation: the stimuli or antecedents in the persons environment

thoughts: how the person interprets and thinks about the situation

organism: what happens physically in the body

response: what the person does

consequences: what happens as a result, which in turn change the situation

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avoid

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avoid high risk situations is particularly useful early in the recovery process

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escape

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when encountering an urge, get out of the situation as soon as possible

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distract

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find an enjoyable distraction to surf through the urge

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endure

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strategies to get through until the urge subsides

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Relationship conflict & recovery

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once substance use is removed from a person they may find that there are other problems that linger or rise to the surface. Sometimes the main reasons why people resume substance use, interpersonal conflicts with an SO have been frequent precipitant. It is a destructive cycle.

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Disturbed Spouse Hypothesis

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people find spouses that fulfill their own unconscious needs ie. women who marry alcoholics that they can control and feel needed and they sabotaged their husbands recovery attempts by enabling their drinking

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Disturbed Family Hypothesis

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dysfunctional patterns of a family, where the family roles are important and as a family they sabotage recovery of the person who is an addict

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Codependence Hypothesis

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addiction is a “family disease” wherein both the addicted person and his or her family members are afflicted with complementary and interlocking illnesses.

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Stress-Coping Hypothesis

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What appears from the outside to be aberrant behaviors of a spouse or other family member represents a normal adjustive reaction to the addictive behavior of their loved one.

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Four Goals of Behavioral Couple Therapy

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engaging

supporting abstinence

improving the relationship

continuing recovery

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Common Myths about 12-step groups:

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believes traditional disease model and discourages people from receiving any other kind of treatment

pressured to discontinue their medications

only works for religious clients

told that only someone who is in recovery can be an effective therapist for them

pressuring clients to go to meetings can’t hurt, even if they don’t want to go

there is no scientific evidence that AA actually helps people

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Nicotine cessation and the use of other drugs

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Quitting smoking can reduce cravings for other drugs but not the other way around. Smoking sensation can facilitate abstinence from other drugs, but not the other way around

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Methadone

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prescribed medication to help heroin addicts

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Antabuse

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medication given to clients to take daily that induces discomfort and illness only if the person drinks alcohol

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Issues with treating drug use with drugs.

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Client can become addicted to the drug that is being used to treat the original drug they are trying to quit

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al-anon

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instructs members to focus on themselves and their own well being to reduce emotional distress and improve their coping skills