addiction

Question 1

What is an addiction

Answer 1

Addiction is a disorder in which an individual consumes a substance i.e. nicotine, or engages in a particular behaviour i.e. gambling, that is pleasurable but eventually becomes compulsive with harmful consequences.

Addiction is more than simply doing something a lot. Key features are dependence (physical and psychological, tolerance and withdrawal syndrome.

Question 2

What is meant by psychological dependence in relation to addiction (2)

Answer 2

This is the mental and emotional compulsion to keep taking a substance as the individual believes that they cannot cope with work and social life without a particular drug e.g. alcohol, nicotine or behaviour e.g. gambling

Absence of the drug/behaviour causes the individual to feel anxious or irritable and this leads to a craving for the substance.

Question 3

What is meant by the term physical dependence in relation to addiction (2)

Answer 3

Physical dependence is a state of the body that occurs when withdrawal syndrome is produced

from stopping the substance use/behavior e.g. Nausea, headaches and shaking.

Question 4

Explain what is meant by the term withdrawal symptoms (4)

Answer 4

Withdrawal syndrome is the collection of psychological and physical symptoms an individual will experience when they no longer have a substance in their system/engage in a particular behaviour.

Withdrawal syndrome includes low mood, feeling nauseous, achy, in pain or experiencing tremors.

The seriousness of the withdrawal syndrome can depend on a variety of factors:

1. The substance used/type of behaviour – What type of substance is being taken/behaviour is being engaged?
2. The amount of substance consumed – How much of a substance does an individual take at once?
3. Drug-use/behaviour pattern – How often does the substance use/behaviour occur?

Question 5

Explain what is meant by the term tolerance, provide examples (2-4)

Answer 5

Tolerance arises when you have taken a drug/maintained a certain behaviour for some time, and due to the repeat exposure the response is reduced. When tolerance occurs an individual will need more of it in order to feel the same physical and psychological effects.

Examples include the following :

Cellular tolerance - CT takes place when brain neurons adapt their responsiveness to higher levels of a substance.

Metabolic tolerance - MT takes place when a substance has been metabolised quicker and therefore leaves the body

Behavioural tolerance - When individuals learn through experience to adjust their behaviour to compensate for the effects of the drug e.g. walking more slowly to avoid falling over when drunk.

Question 6

What are the 3 types of tolerance

Answer 6

Cellular
Metabolic
Behavioural

Question 7

What is cellular tolerance

Answer 7

CT takes place when brain neurons adapt their responsiveness to higher levels of a substance.

Question 8

What is metabolic tolerance

Answer 8

MT takes place when a substance has been metabolised quicker and therefore leaves the body

Question 9

What is behavioural tolerance

Answer 9

When individuals learn through experience to adjust their behaviour to compensate for the effects of the drug e.g. walking more slowly to avoid falling over when drunk.

Question 10

What is a risk factor

Answer 10

A risk factor is anything internal or external that increases the likelihood of an individual starting to use drugs or engage in addictive behaviour.

Question 11

What are the five risk factors

Answer 11

Genetic vulnerability
Stress
Personality
Family influence
Peers

Question 12

Genetic vulnerability introduction (what is genetic vulnerability)

Answer 12

It is a possibility that we may inherit a predisposition/vulnerability that increases the risk of this disorder (addiction).

Genetic vulnerability can explain why some individuals become dependent and others do not.

Genetic Vulnerability is explained as an interaction between genes and environmental factors as individual will not become addicted unless they are exposed to the substance or an opportunity.

Question 13

What are the two reasons genetic vulnerability can occur

Answer 13

D2 receptors
Metabolism

Question 14

Describe D2 receptors as a reason for why genetic vulnerability occurs

Answer 14

Within the brain we have a number of receptors that communicate with neurotransmitters.

The D2 receptor is responsible for communicating with Dopamine (neurotransmitter). The number of D2 receptors an individual has is determined by genetics.

Having FEWER of these receptors is associated with addiction as this leads to problems with experiencing pleasure from everyday activities e.g. chocolate therefore, they turn to more addictive substances such as nicotine to experience the same feeling of pleasure and compensate for this
deficiencv.

Question 15

Describe metabolism as a reason for why genetic vulnerability to occur

Answer 15

Some individuals are able to metabolise (break down hertain addictive substances a lot faster than others, therefore making it easier for them to become addicted as they may need more to have the same effects. An individual’s rate of metabolism is inherited through their genes.

For example, Pianezza (1998) found that some people lack a fully functioning enzyme (CYP2A6) which metabolises nicotine, they were less likely to smoke than those with the fully functioning version.
Expression of the CYP2A6 gene is genetically determined.

Question 16

What is stress

Answer 16

Stress is where an individual experiences a state of arousal (physical and psychological state) that occurs when they believe they do not have the ability to cope with the perceived threat.

Question 17

Describe stress as a risk factor in the development of addiction

Answer 17

Stress is where an individual experiences a state of arousal (physical and psychological state) that occurs when they believe they do not have the ability to cope with the perceived threat.

People who experience stress may turn to addictive substances or behaviours as a form of self-medication for stress (to avoid pain or to cope).

Periods of chronic, long lasting stress and traumatic life events in childhood have been linked with increased risk of developing an addiction.

Anderso and Teicher (2008) found that early experiences of severe stress have damaging effects on a young brain in a sensitive period of development and can create a vulnerability to later stress. Further stressful experiences in later life could trigger the vulnerability and make it more likely that a person may self-medicate with substances or behavioural addictions.

Question 18

Describe personality as a risk factor in the development of addiction

Answer 18

Psychologists have proposed an addictive personality suggesting a correlation between certain traits and addiction.

It is suggested that anti-social personality disorder leads to a high vulnerabity to addiction; which can include neurotic and psychotic personality traits (Evsenck).

High levels of neuroticism = High levels of anxiety, irritability, and low self-efficacy.
High levels of psychoticism = aggressive, impulsive and sometimes emotionally detached - leading to risk tasking and sensation seeking behaviour.

Individuals who have these pathological personalities are more likely to become addicts as the behaviour/substance helps them and offers relief.

Question 19

What are high levels of neuroticism

Answer 19

High levels of anxiety, irritability, and low self-efficacy.

Question 20

What are high levels of psychoticism

Answer 20

aggressive, impulsive and sometimes emotionally detached - leading to risk tasking and sensation seeking behaviour.

Question 21

Describe family influences as a risk factor in the development of an addiction

Answer 21

Family members can have an effect on an individual’s thoughts, feelings and behaviour’s over the course of their development.

One family influence which can create vulnerability to addiction is perceived parental approval. If an adolescent believes their parents show positive attitudes towards a particular addictive substance/behaviour, then they will be more vulnerable to developing the addiction themselves.

Livingstone et al found that final year high school students who were allowed by their parents to drink alcohol at home were significantly more likely to drink excessively at college (uni) the following year.

Also, adolescents who believe that their parents have little interest in monitoring their behaviour (e.g. internet use, peer relations) are significantly more likely to develop an addiction.

Also, exposure within family life to a substance/behaviour creates risk of developing an addiction. Social Learning Theory could play a role. An individual could observe a family member (role model) engaging in addictive behaviour and imitate this behaviour as they identify with them and want to be like them.

Question 22

Describe peers as a risk factor in the development of addiction

Answer 22

An individual’s peers are people who share their interests, age, similar backgrounds and social status.

Peers can influence an individual’s development during adolescence as they spend more time with them and less with their family.

Some psychologists may argue that peers may act as gateways to addictive behaviour.

O’Connell et al (2009) suggests that adolescents are at risk of developing alcohol addiction due to the influence of their peers because of three major elements:

1. Attitudes and norms to drinking alcohol - the at risk individuals attitudes and norms to drinking alcohol can be influence by associating with groups of peers who drink alcohol (NSI and ISI)
2. Opportunities to drink alcohol - The experienced peers provide more opportunities for the at risk individual to drink alcohol.
3. Individual’s perception - The individual may over-estimate how much their peers drink, and therefore drink more to ‘keep up with them’.

Question 23

What are the two explanations for nicotine addiction

Answer 23

1. Brain neurochemistry including the role of dopamine
2. Learning theory as applied to smoking behaviour including reference to cue activity

Question 24

Introduction for brain neurochemistry including the role of dopamine

Answer 24

Brah neurochemistry is an internal (biological) explanation for nicotine addiction, that relates to the chemicals inside the brain that regulate psychological functioning: It states that a nicotine addiction is formed due to the repeated activation of the brain’s reward pathway. Here is what happens inside the brain when an individual smokes a cigarette:

Question 25

Describe neurochemistry, including the role of dopamine as an explanation of nicotine addiction

Answer 25

1. Individual smokes a cigarette and inhales nicotine, and reaches the blood stream and activates nicotinic acetvIcholine receptors (nACh) in the ventral tegmental area (VTA) of the brain in less than 10 seconds. 2. Dopamine is released from the VTA down the mesolimbic pathway to the D2 receptors on the nucleus accumbens (NAc) responsible for the feeling of pleasure, euphoria and relaxation. 3. When dopamine hits to NAc this triggers release of more dopamine from the NAc down the mesocortical pathway to the PRE-FRONTAL CORTEX, responsible for what we pay attention to and decision making, the person then makes the decision to smoke again (in order to experience to the same pleasurable feelings, reduced anxiety). 4. Therefore, explaining why people repeatedly smoke and become addicted to nicotine

Question 26

Describe the learning theory an an explanation for nicotine addiction

Answer 26

One plausible explanation is that smoking is a learnt behaviour through operant conditioning. Forming the addiction - Smoking behavidur could be explained by positive reinforcement. The individual is rewarded with the feeling of euphoria when they inhale nicotine, due to it's impact on the dopamine system in the brain's reward pathway. Therefore the person will smoke again to get the same reward of euphoria. Maintaining the addiction - can explain why an individual would continue to smoke. Cessation of nicotine (stopping smoking) leads to the appearance of withdrawal syndrome which has unpleasant symptoms such as disturbed sleep, agitation and poor concentration. These symptoms make it difficult for a smoker to abstain for long and therefore an individual would continue to smoke to avoid the unpleasant symptoms (negative symptoms) Nicotine addiction can also be explained by classical conditioning as a person may associate their nicotine addiction with pleasure.

Question 27

Describe cue reactivity as a learning explanation for nicotine addiction

Answer 27

The pleasurable effect of smoking (nicotine) is known is known as the primary reinforcer because of it's rewarding effect on the dopamine reward system (euphoria), this is not learnt. Any other stimuli that are repeatedly present at the same time as the nicotine, or just before, (such as a lighter, certain friends, places), over time, become associated with this pleasurable feeling. These stimuli are called the secondary reinforcers, because they have taken on the properties of the primary reinforcer (nicotine), and become rewarding in their own right. These secondary reinforcers (certain friends, places and smells) also act as cues, because their presence produces a similar psychological (craving) and physiological (increased heart rate reaction to the nicotine itself- this is cue reactivity. These reactions makes a person want to smoke again (seek primary reinforcement. This can explain why individuals sometimes relapse and/or maintain their addiction to nicotine.

Question 28

What are the explanations of gambling addiction

Answer 28

Learning theory as applied to gambling (partial and variable reinforcement) Cognitive theory including reference to cognitive bias

Question 29

How do you form the addiction as part of the learning theory as applied to gambling

Answer 29

Social learning theory

Question 30

How do you maintaining addiction as part of the learning theory as applied to gambling

Answer 30

Operant conditioning

Question 31

Describe forming addiction, the social learning theory

Answer 31

A gambling addiction can form due to the experience ofobserving a role model being rewarded for their gambling behaviour (vicarious reinforcement). The reward could be their enioyment in gambling or the occasional wins and financial returns they gain. This observation doesn't have to be direct it can be through newspapers, magazine or the media. For example, hearing about someone winning big on the lottery could make a person more likely to gamble to gain the same reward.

Question 32

Describe maintaining the addiction, the operant conditioning

Answer 32

Both positive and negative reinforcement can explain an addiction to gambling. Gambling can provide two kinds of positive reinforcements; the reward of winning money and the 'buzz' excitement from gambling. Therefore, the gambling behaviour is likely to be repeated to gain the same reward. Gambling can also be seen as a distraction for some from anxieties of everyday life. Gambling can act as negative reinforcement to distract the individual from their unpleasant feelings and anxiety. Therefore, they will continue to engage in gambling behaviour to avoid the negative consequence of anxiety.

Question 33

Define the term partial reinforcement

Answer 33

Partial reinforcement is where a behaviour is reinforced only some of the time. If a person is rewarded every time they may become bored, therefore partial reinforcement enables a person to develop an addiction due to reinforcements being limited to only some of the time, and not consistently, therefore making the gambling more exciting (rewarding) as the individual is unsure when they will next win, so the behaviour does not extinguish, even when the wins stop.

Question 34

Define the term variable reinforcement

Answer 34

This is a type of partial reinforcement where behaviour is reinforced an unpredictable amount of times (at variable intervals) e.g. you win at black jack on the 15th time, then on the 2nd time, the on th 7th etc. This highly more reinforcing (rewarding) as it is highly unpredictable and exciting and therefore leads to stronger, more persistent gambling behaviour.

Question 35

Cognitive theory introduction - what is cognitive bias

Answer 35

The cognitive approach sees addictive behaviour as a result of cognitive distortions and/or faulty thought processes. Cognitive bias is where a person's thinking, memory and attentional processes are faulty leading an individual to make irrational judgements and poor decisions. These biases influence how gamblers think about their behaviour, what they pay attention to, what they remember and what they forget

Question 36

Who classified cognitive bias into categories and how many categories

Answer 36

Rick wood et al (2010) 4

Question 37

What are the four cognitive biases

Answer 37

Faulty beliefs or skills and judgement Engaging in personal traits/ ritual behaviours Selective recall (expectancy theory) Faulty perceptions

Question 38

Explain faulty beliefs of skills and judgement and provide an example

Answer 38

Gambling addicts have an illusion of control, which means they overestimate their ability to influence a random event E.g they believe they are skilled at choosing lottery numbers, making them more likely to gamble

Question 39

Explain engaging in personal traits/ ritual behaviours and provide an example

Answer 39

Addicted gamblers believe they have a greater probability of winning over other people because they are lucky or have engaged in superstitious behaviour E.g touching a certain item of clothing before placing a bet makes them more likely to win

Question 40

Explain selective recall and provide an example

Answer 40

Addicted gamblers remember certain types of information/memories/events better than others E.g they are more likely to recall their wins but forget their loses describing them as unexplainable mysteries , leading them to be more likely to gamble

Question 41

Explain faulty perceptions and provide an example

Answer 41

Addicted gamblers have distorted views about the operation of chance (gamblers fallacy) E.g believe that losing a streak cannot last and will always be ended with a win, making them more likely to gamble

Question 42

Outline self-efficacy

Answer 42

Self-efficacy refers to an individual's perceived ability to control their own with behaviour, which can explain why some people relapse into gambling again after abstaining. Addicts with low self-efficacy believe they cannot give up gambling and it will always be a part of them'. In turn, this leads to a self-fulfilling prophecy in which the individual continues to gamble because their belief is they cannot stop themselves. This causes their gambling addiction to be reinforced due to the gamblers belief that they lack control over this aspect of their life.

Question 43

What are the ways of reducing addiction

Answer 43

Drug therapy Behavioural interventions - aversion & covert Cognitive behaviour therapy

Question 44

What are the two types of drug therapy

Answer 44

Nicotine replacement therapy (NRT) - agonist substitution Drug therapy for gambling addiction - opioid antagonist

Question 45

What is the aim of Nicotine replacement therapy (NRT) - agonist substitution

Answer 45

Provide nicotine from a less harmful source e.g. patches, gum, nasal spray, rather. than a cigarette

Question 46

How does Nicotine replacement therapy (NRT) - agonist substitution work

Answer 46

NRT stimulates the nicotine receptors and activates the brain's reward pathway, releasing dopamine into the limbic system, stimulating the nucleus accumbens and creating the same pleasurable feeling as smoking a cigarette does. This can lead to a reduction in the nicotine withdrawal symptoms and stops the cravings. The reduction in the withdrawal symptoms is an example of negative reinforcement as the NRT removes the unpleasant circumstances of quitting smoking. NRT also desensitises the nicotine receptors in the brain by releasing small amounts of nicotine so that only some receptors are full with nicotine, but not all. Therefore, over time the number of nicotine receptors reduce meaning that cigarettes become less rewarding to smoke, therefore relapse is less likely to occur. The addict can gradually reduce the dosage of nicotine as their tolerance to nicotine is reduced.

Question 47

What is the aim of Drug therapy for gambling addiction - opioid antagonist

Answer 47

Reduce the pleasurable feeling associated with gambling.

Question 48

How does opioid antagonist (naltrexone) work

Answer 48

Enhance the the release of the neurotransmitter GABA in the mesolimbic pathway. The increased GABA activity reduces the release of dopamine in the nucleus accumbens (and ultimately pre-frontal cortex). Some research (e.g. Kim et al) has linked this with reductions in gambling behaviour.

Question 49

Behavioural interventions introduction

Answer 49

Behavioural interventions include aversion therapy and covert sensitisation. Both work on the principles of classical conditioning and aim to replace the pleasurable association with the addictive substance/behaviour with an unpleasant association. (Counterconditioning)

Question 50

What are the types of behavioural interventions

Answer 50

Aversion therapy -> For nicotine addiction For gambling For alcohol Covert sensitisation

Question 51

What is the aim of aversion therapy

Answer 51

The idea of the therapy is to use the principles of classical conditioning in order to change the pleasurable association with the addictive substance/behaviour and replace it with an unpleasant association in a vivo experience.

Question 52

How does aversion therapy work for nicotine addiction

Answer 52

One specific technique used is 'Rapid Smoking." Individuals will sit alone in a room taking a puff of a cigarette every 6 seconds. They will begin to feel nauseous and sick and start to associate this feeling to smoking (principles of CC). This is repeated until the individual develops an aversion to smoking, thus reducing their addiction. UCS - Unpleasant stimulus (rapid smoking) UCR - Nausea NS - Cigarettes CS - Cigarettes CR - Nausea

Question 53

How does aversion therapy work for gambling addiction

Answer 53

Electric shocks have been used for some behavioural addictions such as gambling. The shocks used do not cause permanent damage, but they are meant to avert people, neer from gambling and therefore do cause pain (they are pre-selected by participants at U the start of treatment). The addicted gambler thinks of phrases that relate to his or her gambling behaviour and write them down on cards, for example lottery', 'casino'. Some non-gambling behaviours are also included e.g. 'went straight home'. The participant is asked to read out each card and when they get to a gambling related phrase they are given a two second electric shock. The participant should then associate (classical conditioning) gambling with the painful shock, rather than pleasure and develop an aversion to gambling, reducing their addiction.

Question 54

How does aversion therapy work for alcohol addiction

Answer 54

A client is given an aversive drug such as disulfiram (Antabuse) . This interferes with the bodily process of metabolising alcohol into harmless chemicals. This means a person who drinks alcohol whilst taking disulfiram will experience severe nausea and vomiting. The aim of this is for the individual to associate the alcohol with the nausea and develop an aversion to drinking alcohol as it would cause a conditioned response of nausea, reducing their addiction.

Question 55

What is the aim for aversion therapy, on alcohol addiction

Answer 55

The aim of this is for the individual to associate the alcohol with the nausea and develop an aversion to drinking alcohol as it would cause a conditioned response of nausea, reducing their addiction.

Question 56

What is the aim for covert sensitisation

Answer 56

The idea of the therapy is that the pleasurable association with the addictive substance/behaviour has to be broken down and replaced with an unpleasant association in a vitro experience.

Question 57

How does covert sensitisation work

Answer 57

Client is encouraged to relax. Therapist then reads from a script asking the client to imagine an aversive situation. For example, the client may imagine himself or herself smoking a cigarette followed by the most unpleasant consequences e.g. the experience of vomiting, or imagine themselves smoking a cigarette covered in faces. The more vivid the imaginary scene is the better the treatment works. Therefore, the therapist will go into graphic detail about certain elements of the scene (smells, sounds, physical movements). Towards the end of the session, the client imagines turning their back on the addiction and experience the resulting feelings of relief. The participant should then associate the addiction with the unpleasant scenario, rather than pleasure, reducing their addiction.

Question 58

What is the aim of cognitive behaviour therapy

Answer 58

To identify and fallenge cognitive distortions that are causing an addiction as a way of coping and replace with more adaptive ways of thinking via cognitive restructuring

Question 59

What are the four stages of cognitive behaviour therapy

Answer 59

1. Functional analysis 2. Cognitive restructuring 3. Social skills 4. Homework

Question 60

What are the cognitive stages within cognitive behaviour therapy

Answer 60

Functional analysis Cognitive restructuring

Question 61

What are the behavioural stages within cognitive behaviour therapy

Answer 61

Social skills Homework

Question 62

What is functional analysis

Answer 62

A therapist will ask the client identify the high-risk situations/triggers to their addiction erg. walking past a betting shop, and ask them to report what they are thinking before, during and after the addiction. The relationship between the client-therapist is critical, it should be warm and responsive, but not cosy. This is because the therapist must challenge the client's biased cognitions and not merely accept them.

Question 63

What is cognitive restructuring

Answer 63

After analysis, cognitive restructuring (disputing) is used to change irrational/maladaptive thoughts to rational/adaptive ones. For example, if a person had an addiction to gambling, they may have irrational beliefs that they win more than they lose (selective recall), this could be challenged via empirical disputing for example, the therapist could ask where is the evidence that you win more than you lose?'

Question 64

What are social skills

Answer 64

Moreover, the addicted person will be taught social sklls, for example an fridual will learn how to refuse the addictive behaviour (gambling) or substance without embarrassment and fuss in social situations. This is done by the therapist teaching the patient how to act within a social situation, for example making eye contact and being firm in the refusal to gamble, in a safe and secure environment (role play). Moreover, the client would be taught avoidance strategies, where the client would learn to avoid situations that are likely to produce addictive behaviours (high risk situations identifted in functional analysis) le. driving a diferent way home to avoid driving past a betting shop.

Question 65

What is homework

Answer 65

The patient practices these social skills within the real world on their own and reports back to their therapist until they feel confident within social situations, where their addictive behaviour/substance is available. This leads to relapse prevention

Question 66

The theory of planned behaviour introduction

Answer 66

The theory of planned behaviour (Ajzen) describes how a set of 3 interacting beliefs can influence a person”s intention to change and therefore whether the therapy will be effective or not

Question 67

The theory of planned behaviour

Answer 67

Attitudes, subjective norms, control -> intention -> behaviour change

Question 68

Describe attitudes

Answer 68

If any individual has more negative attitudes towards their addiction than positive then they therefore more likely to change their addictive behaviour. E.g gamble, less likely to gamble therefore more likely to change their addictive behaviour

Question 69

Describe subjective norms

Answer 69

If an addicted person believes that the people who matters most to them disapprove of the addictive behaviour and therefore less likely to actually gamble/smoke and more likely to change their addictive behaviour

Question 70

Describe control

Answer 70

How much control (self efficacy) a person feels they have over their own behaviour and ability to change influences their intention. This is based on: • Internal factors e.g. how determined they are • External factors e.g. support and time • Past experience e.g. if they have successfully given up before This is the most important part of the model as without the control (will-power) a person is still vulnerable to addiction. All 3 interacting components need to be present to influence a person's intentions to stop their addiction. If one component is missing they will not have an intention to stop so therapy will not be offered.

Question 71

What is prochaska’s six stage model on behaviour change

Answer 71

The model explains the process involved in behavioural change that can be used to explain how individuals overcome an addiction. This model has a cyclical nature, and takes a positive and dynamic approach, to changing addictive behaviour as opposed to an all or nothing approach The model recognises that people differ in how ready they are to give up their addiction and how usef a treatment intervention will be depends on which stage the individual is at.

Question 72

What are the six stages of prochaska’s model

Answer 72

Pre-contemplation Contemplation Preparation Action Maintenance Termination

Question 73

What is the pre- contemplation stage

Answer 73

Individual does not consider themselves as having a problem and isn't thinking about changing their behavior even though they know it is not healthy. This could be due to denial or demotivation.

Question 74

What is a potential quote for pre- contemplation

Answer 74

'Ignorance is bliss' "I am ok right now'

Question 75

Useful intervention ao2 for pre-contemplation

Answer 75

Focuses on helping the addict to consider the need for change.

Question 76

What is contemplation

Answer 76

Individual is now thinking about changing their behavior and have an awareness that they need to take action. They are aware of the costs (e.g. less enjoyment) and benefits (e.g. health) to changing.

Question 77

Potential quote for contemplation

Answer 77

I will change tomorrow'

Question 78

Useful intervention ao2 for contemplation

Answer 78

Drug treatment at this stage would not be helpful. Wavs of helping the individual understand the pros of overcoming the addiction outweighs the costs.

Question 79

What is preparation

Answer 79

This stage where the person belives the benefits of changing behaviour are outweighing the costs. They decide to change within the next month but maybe not exactly what they will do to change,

Question 80

Potential quote for preparation

Answer 80

Ok I'm ready for this' I'm changing next month so I need to plan how I will do it'

Question 81

Useful intervention ao2 for preparation

Answer 81

The most useful form of intervention is support in constructing a plan e.g. making a GP appointment, calling a helpline etc. Or presenting them with options.

Question 82

What is action

Answer 82

This is when the plan is put into action. Usually at this stage, the individual has done something to change their behavior in the last six months e.g. behavioural or cognitive therapies or pour away alcohol and is continuing with their behavior change.

Question 83

Potential quote for action

Answer 83

'I have stopped Let's do this'

Question 84

Useful intervention ao2 for action

Answer 84

Developing coping strategies the individual will need to quit and maintain their change of behavior.

Question 85

What is maintenance

Answer 85

The individual has maintained some change of behavior for more strategiest hey have stopped' than six months. The focus is on relapse prevention such as sources of support avoiding situations where cues might trigger the addiction. This stage can be lengthy and the individual needs to keep focused on the long-term goal of termination.

Question 86

Potential quote for maintenance

Answer 86

‘I have still stopped’ ‘Stay on track’

Question 87

Useful intervention ao2 for maintenance

Answer 87

Applying the coping strategies they have learned and use the sources of support available to them to prevent relapse

Question 88

What is termination

Answer 88

Newly acquired behaviours such as abstinence become automatic. The individuals. no longer turns to addictive behaviours to cope with stress, anxiety etc. They are confident in their ability to resist the behaviour. The final stage may not be possible for all people to achieve. It may be that more appropriate goal for some is to prolong maintenance for as long as they can, accepting that relapse might be inevitable and providing them with skills to work through the earlier stages of the process quickly

Question 89

Useful intervention ao2 for termination

Answer 89

No intervention is required

Question 90

Potential quote for termination

Answer 90

‘I will never do it again’