Most effective intervention in stopping people form using cocaine in the short term
Pay them to be abstinent with gift cards or vouchers: Contingency Management.
Learning theory utilized in contingency management
Operant conditioning: modifying behavior through consequences
Treatment that involves giving an unsavory stimulus every time a drug is used (usually by medication, can also be done by telling people to take an extra puff when smoking).
Aversion therapy: for alcohol an emetic is administered with pilocarpine (prevents alcohol absorption) and ephedrine (prevents hypotension). Prior to nausea/vomiting, the patient swishes and swallows favorite alcoholic beverage. Done multiple times during an inpatient stay. Good for cocaine and marijuana also.
Treatment that seeks to utilize extinction procedures
Cue Exposure Therapy: exposing people repeatedly to normal cues without drug use to extinct the normal cues for use. Opening alcohol over and over, smelling it, touching it etc without drinking it to extinct the craving. Virtual reality is now being used in this type of therapy.
Therapies that follow the animal learning theory
Contingency management, aversion and cue exposure therapy.
3 fundamental components of CBT
1) Cognitions affect behavior 2) Cognitions can be monitored and changed 3) Cognitive change can cause behavioral change
Mechanisms of CBT
Reduce negative emotional responses and target behavioral changes
Attentive awareness of the reality of things, especially the hear and now. How does this type of therapy work?
Mindfulness-based therapy. It attempts to improve your attention (able to control where your attention goes) and your attitude (development of detached perspective and decreased impulsivity).
Key target of motivational interviewing
Identification of ambivalence about drug use and motivation to overcome drug use
Techniques for motivational interviewing
Open ended questions, reflections, affirmations, summaries and rolling with resistance.
Non-professional groups of individuals with the same substance use problems providing mutual social, emotional, informational and instrumental support throughout the recovery process
Support groups, can be mutual support groups or peer recovery support groups (led be recovered addicts)
We have a primary need for connectedness and belonging to have self-esteem
Maslow’s Hierarchy of Needs
Learning through modeling
Social Learning Theory
Benefit from helping others
Helper Therapy Principle
Imparting expertise from someone who has been there before, not lay professional knowledge
Benefits from support groups
Being helped, helping others and learning from others
Technique that utilizes a higher power and replacing old friends with new friends
12-step programs (like AA)