Theories of addiction Flashcards
What makes a good theory?
> Unifies and gives explanation
> It is consistent with observations
> Not too many constructs
-> parsimonious and simple
> Testable
> Guides practice
Why interventions that seek to address motivation and/or self-control often do not increase the chances of recovery?
When someone with addiction attempts to recover, momentary risk of relapse is greatest in first few days, then fades
-> necessary natural process of recovery
What is the other name for the Trans-Theoretical Model (TTM) of addiction?
Stages of change theory
What does the Transtheoretical Model (TTM) of addiction (Prochaska and DiClemente, 1990s) propose?
People with addictive behaviour are in 1 of 5 stages:
- Precontemplation
- Contemplation
- Preparation
- Action
- Maintenance
- there is a momentum
What characterises the precontemplation stage in the TTM?
- Person is unwilling to change behaviour
- They don’t believe there’s a problem to address
What characterises the contemplation stage of the TTM?
- Person is considering changing behaviour in the next 6 months
- Dissonant state
What characterises the preparation stage of the TTM?
Person is getting ready to make a change within next month
What characterises the action stage of the TTM?
Person is actively changing a negative behaviour or adopting a new healthy behaviour
What characterises the maintenance stage of the TTM?
Person maintains behavioural change for up to 5 years
What characterises the termination/adoption stage of the TTM?
Person has eliminated undesirable behaviour
OR maintained positive behaviour for over 5 years
What characterises the relapse stage of the TTM?
Person slips/falls back into unhealthy behaviours or fails to maintain them
- can happen at any point
What are the 4 TTM principles?
- Motivation exists along continuum of readiness
- People progress through stages (not linear)
- cycle going through time
- it’s possible the person moves out and drops back in at any time - If clinicians use strategies in a stage other than the one the person is in, result usually negative
- If people are pushed at a faster pace than they are ready to take, ‘therapeutic alliance’ may break down
Which motivational strategies should the clinician adopt for a client in the precontemplation stage of the TTM?
- Establish rapport, ask permission, build trust
- Raise doubts/concerns about drug use
- Express concern, keep the door open
- > arguing and giving people advice might not be productive at this stage
Which motivational strategies should the clinician adopt for a client in the contemplation stage of the TTM?
- Normalize ambivalence
- Help tip the decisional balance scales toward change
- > self-motivated change
- Elicit and summarise self-motivational statements of intent, commitment from client
- Elicit ideas regarding client’s perceived self-efficacy and expectations regarding treatment
- > how confident are they? How to support this?
Which motivational strategies should the clinician adopt for a client in the preparation stage of the TTM?
- Explore treatment expectancies and client’s role
- Clarify client’s goals
- Negotiate a change/treatment plan, behaviour contract
(i. e. specific tasks, measurable goals) - Consider and lower barriers to change
- Help client enlist social support
Which motivational strategies should the clinician adopt for a client in the action stage of the TTM?
- Engage client in treatment, reinforce importance of remaining in recovery
- > focus on the value of change
- Acknowledge client’s difficulties in early stages of change
- Help client identify high risk situations
- > functional analysis, develop appropriate coping strategies
