Prevention Flashcards
What do prevention programs involve?
one or more intervention to reduce or deter specific or predictable problems, protect the current state of well-being, or promote desired outcomes or behaviours
What can be influential in helping to prevent addiction and reduce substance abuse?
Messages that parents, doctors, teachers, the media and others in the community send to children and teens about the dangers of tobacco/nicotine, alcohol and other drug abuse
What is the preventure program?
Examined how children’s temperament drives their risk for drug use, indicating different pathways to addiction. Since most teenagers who try addictive substances (e.g., alcohol, opioids or methamphetamine) dont become addicted, the program focuses on what’s different about the minority who do. Personality testing can help identify most of the highest risk children before their risky traits cause problems
What 4 personality traits may lead to or foster the development of addiction?
impulsivity, sensation seeking, hopelessness, anxiety sensitivity
How does the preventure program work?
- An intensive two- to three-day training is given for teachers—a crash course in therapy techniques proven to fight psychological problems.
- When the school year starts, middle schoolers take a personality test to identify the outliers. Months later, two 90-minute workshops—framed as a way to channel students’ personalities toward success—are offered to the whole school, with only a limited number of slots.
- The workshops teach students cognitive behavioral techniques to address specific emotional and behavioral problems.
What components of the preventurre programme intervention are incorporated using manuals?
psycho-educational
motivational enhancement therapy (MET)
cognitive–behavioural therapy (CBT)
and include real-life ‘scenarios’ shared by local youth with similar personality profiles.
What is the goal of the preventure programme?
Goal is to provide participants with the tools to moderate the cognitive and behavioural tendencies stemming form their personality that contribute to their difficulties in life
Is the preventure programme effective?
The evidence is promising
Two RCT’s show reduced alcohol consumption and initiation among at risk adolescents
What is the goal of prevention in general?
The goal of prevention is to identify and help those at high risk to not develop behavioural addictions
What Is motivational interviewing?
Among people engaging in addictive behaviours, motivational interviewing (MI) can be used to help them think about and pursue behaviour change
The goal of MI is to evoke the client’s own reasons for change (and his/her ideas bout how change should happen)
What are the five principles of MI?
- Express empathy for the client
- Develop discrepancy between the client’s goals and values and their current behaviour (i.e., behavioural addiction)
- Avoid argumentation and direct confrontation
- Roll with client resistance, instead of fighting it
- Support the client’s self efficacy, or their belief that they can change
What is an understudied element of MI?
People become more ready to change and actually attempt to change through nostalgia (gambling, alcohol and cannabis)
Longing for the past is an understudied aspect of MI
Finding that it actually has utility in trying to motivate change
What is the spirit of MI?
The MI spirit represents an egalitarian relationship characterized by:
- Unconditional acceptance and positive regard
- Compassionate and empathetic understanding (no confronting)
- A stance of evoking (versus installing) ideas, goals and deep wisdom
What are the Do’s of MI?
MI Do’s: Emphasize and respect client’s autonomy, actively collaborate with them, elicit their perspective, ideas, concerns, and demonstrate non-judgmental acceptance while conveying empathy
What are the Dont’s of MI?
Asserts authority about what is best for the client, pursues own agenda in the session, mandates specific goals, provides unsolicited feedback, confronts or threatens client with negative consequences if change does not occur
What are the four processes of MI?
Engaging, focusing, evoking, planning
What is the nature of addictive behaviours and changing them?
Addiction has been conceptualized as a chronic relapsing disorder or chronic disease. Although changing an addictive behavior is difficult, maintaining change is even more challenging. Relapse means failure to maintain behavioral change
What was treatment outcome once believed to be?
once thought to be binary: “Either you have it or you don’t, and there is nothing in between”. Categorizes treatment outcomes as either abstinent or non-abstinent. Then means that relapse Implies failure, weakens, and shame, which are unhelpful value judgments and barriers to change
What are some factors that should be considered when assessing relapse?
Threshold (the amount of substance use)
Window (the period of time judged)
Reset (the period of abstinence required before a person can be considered to have relapsed)
Polydrugs (the types of substance use that constitute a relapse)
Consequences (behaviors and consequences associated with substance use required before a person can be considered to have relapsed)
Verification (self-report or collateral reports).
What is a relapse versus a prolapse?
Lapse – an initial setback (a slip)/Relapse – a return to pre-treatment use
Prolapse – recovering from a relapse by making positive behavior changes
Others use quantitative cut-offs to distinguish between lapse and relapse. These terms may not equally apply to all addictive behaviors (e.g., having 1 beer vs. injecting heroin)
What is the client centered definition of relapse?
Severity of problem not quantity of consumption
- the person’s progress toward treatment goals, including substance use, psychosocial or other goals
- The personal and social consequences related to alcohol or other drug use (e.g., fight with partner)
- The person’s return to the addictive behaviour
What is Marlatt’s relapse prevention model?
Cognitive-behavioral model of relapse
Two-stage process, where the precipitants of substance use are distinct from the factors that prolong or sustain such use over time. Relapse occurs as a result of a person’s lack of coping skills to successfully avoid drinking or using drugs in certain challenging situations
What 8 risk situations or relapse determinants did Marlatt propose?
Unpleasant emotions Physical discomfort Pleasant emotions tests of personal control Urges and temptations Conflict with others Social pressure to use Pleasant times with others
Marlatt’s approach focuses on Providing coping skills training for the risk situations that are particular to each client
What are some limitations of Marlett’s prevention model?
Relapse determinants are multidimensional and can interact in complex ways. Does not account for structural factors (e.g., living n substandard housing, poor access to health care) which can affect behaviour change. As can motivation and ambivalence. The negative experience of relapse may solidify the motivation to change for some people
Does not take into account the powerful role of neurobiology and craving on relapse risk.