8. tratamentul Flashcards
(28 cards)
why does heroin addiction happen
it is not abt the chemicals, its abt your cage
the opposite of addiction is connection
what is psychological treatment concerned with
psychological treatments are concerned with meanings
understand what is valuable and meaningful to each client (idiosyncratic) including their connections to others
identify and understand what function the addictive behaviour serves for the client - what does it mean to them
what is comorbidity
high rates of comorbiditiy e.g. depression, social anxiety disorder, post-traumatic stress disoredr, pesonality disorder, psychosis
mental health services have separate pathways of care from addiction services
what is motivational interviewing
aim is to enhance motivation to change behaviour
client centred approach
what did Carl Rogers say
personality depends on self-concept
self-concept may not be consistent with actual experiences
incongruence undermines personal well-being
unconditional love fosters congruence
people go to great lengths to protect self-concept
what does it mean to be person-centred
empathetic understanding
unconditional positive regard
authenticity
create a non-judgemental environemnt in which the client can identify their own problems and their own solutions
how does MI work
open question - invite person to tell you about themselves - a series of open questions
not close ended questions
follow up with reflective listening
listen for the persons motivation for desire to change
what are the 4 central principles of motivational interviewing
express empathy
develop discrepancy
roll with resistance
support self-efficacy
the 4 principles of MI are foundational for guiding conversation with individuals who may be ambivalent or resistant to change, particularly in the context of substance use
what is empathy
practitioner demonstrates a deep understanding and acceptance of the individual;s feelings and perspective, without judgement or criticism
empathy creates a safe, non-confrontational environment where the individual feels heard and respected
this helps build trust and reduce defensiveness
e.g. Sounds like you are feeling…
what is develop discrepency
the practitioner helps the individual see the gap between their current behaviour and their personal goals
highlighting discrepency can increase motivation to change by showing hoe their behaviour may conflict with what they want for themselves
e.g. what do you want your life to look like in 5 years
what is roll with resistance
avoid direct confrontation or arguing with the individual
instead, acknolwdge and work with their resistance to change
resistance is a natural part of the change process
don’t try to convince them to change
what is support self-efficacy
foster the individual’s belief in their ability to make positive change and achieve their goals
ppl are more likely to attempt and sustain change when they feel confident in their own abilities
what is the success of MI
Rubak et al (2005) meta-analysis of MI outcomes for a range of problems (mainly drug/substance use)
MI outperformed traditional GP-style advice in around 75-80% of studies
what is the stage of change model
precontemplation
contemplation
preparation
action
maintenance
what is precontemplation
the individual is not considering change and may not recognise that a problem exists
lack of awareness or intention to change
resistance to discussing or acknowledging the issue
Intervention focus: raise awareness of the problem and its consequences
provide info w/o judgement
what is contemplatino
the individual is aware of the problem and thinking about change but is ambivalent or uncertain
they weigh the pros and cons of changing vs maintaining the behaviour
recognising the problem but no firm commitment to action
interventino focus: encourage self-reflection and build motivation
what is preparation
the individual intends to take action soon and may begin making small changes
intervention focus: provide resources and support for implementing the change
what is action
actively taking steps to modify their behaviour and achieve their goals
this stage requires significant effort and commitment
intervention focus: provide encouragement
what is maintenance
individual has successfully sustained the behaviour change for an extended period (6+ months)
they work to prevent relapse and integrate the new behaviour into their life
intervention focus: encourage reflection on progress and continued growth
what is disadvantage of stages of change model
very little convincing evidence that drug users progress through stages in linear fashion
in many cases the decision to stop is very sudden
what is cognitive behavioural therapy
to understand others; distress, we have to understand their cognitions, their individual ways of seeing the world
what is example of clinical work
working on relapse prevention of gambling behaviour
understand the function of the gambling (what did it mean to him)
MI technique alongside pro and cons
homework tasks to challenge assumptions
what is the relapse prevention model
high-risk situations - cirumstances that increase the likelihood or relapse such as negative emotional states (anxiety)
what is the abstinence violation effect
a lapse to substance use can lead to feelings of guilt, shame and failure which may cause individuals to believe they’ve blow it and abandon their change efforts entirely
