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Family Addictions > Prochaska Process of Change Model > Flashcards

Prochaska Process of Change Model Flashcards

1
Q

The counselor-client relationship is a _____.

A

Collaborative process

  • Bilateral, not unilateral
  • Adopting a collaborative stance can help discover new patterns, insights, behaviors, and experience
  • 2 person psychology
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2
Q

The therapist does not change people, but _____ change.

A

Facilitates

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3
Q

What are the common methods introduced by Prochaska?

A
  • Consciousness-raising
  • Social liberation
  • Emotional arousal
  • Self-Reevaluation
  • Commitment
  • Countering (counter conditioning)
  • Environmental control
  • Rewards
  • Helping relationships
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4
Q

Describe Consciousness-raising:

A

facilitate conversation, be curious, awareness increases on its own in the client

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5
Q

Describe social liberation:

A

what’s the external environment for the client, and does it support change?

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6
Q

Describe emotional arousal:

A

Usually directly related to the issue; usually has to deal with loss; connect client to the issue and get them to see how it effects them

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7
Q

Describe self-reevaluation:

A

Conversation that facilitates the client thinking about themselves in a different way; the client talking about the pros and cons instead of the counselor telling them

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8
Q

Describe commitment:

A

Can you get client to make a decision and accept responsibility to change?

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9
Q

Describe countering:

A

AKA counterconditioning. Help the client replace negative behavior with positive

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10
Q

Describe environmental control:

A

Changing parts of the environment that are controllable

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11
Q

Describe rewards:

A

Internal and external, find what’s meaningful to the client and allow them to create rewards for themselves

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12
Q

Describe helping relationships

A

Who can you get involved to help the client? AA sponsors, family, friends…

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13
Q

When the therapists approach doesn’t match the client’s stage of readiness for change, the client may feel forced into change, that he/she doesn’t want to make and as a result:

A
  • May feel the therapist doesn’t care/understand their need or struggle
  • May resist change and withdrawal
  • May resist change and leave therapy
  • May comply to please therapist (especially if this is similar to their past experience)
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14
Q

A therapist’s ability to match the client’s stage of readiness for change helps the client through it with _____.

A

Less trial and error and less distress

  • This collaborative awareness leads to a or many “a-ha” moments for clients
  • Ex: Discovery = longer lasting change
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15
Q

List the phases in Prochaska’s Changes of Phase Model

A 
Phase 1: Pre-contemplation
Phase 2: Contemplation
Phase 3: Preparation
Phase 4: Action
Phase 5: Maintenance/Relapse
Phase 6: Relapse/Termination
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16
Q

Describe Phase 1 of Prochaska’s Changes of Phase Model:

A

Clients usually don’t believe they have an issue; aren’t interested in help

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17
Q

Client Language in Phase 1 of Prochaska’s Changes of Phase Model:

A
  • I don’t have a problem.
  • They made me come.
  • I’ve tried this before and it didn’t work.
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18
Q

Client Characteristics in Phase 1 of Prochaska’s Changes of Phase Model:

A
  • Defensive, resistant, lack awareness, pressured, uncommitted
  • Denial, minimization
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19
Q

Therapist’s Strategy in Phase 1 of Prochaska’s Changes of Phase Model:

A
  • Demonstrate great attending skills
  • Engage in nonthreatening open discussion
  • U-turn, raise ambivalence
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20
Q

Therapist’s Questions in Phase 1 of Prochaska’s Changes of Phase Model:

A
  • Do you believe there is a problem?
  • Why do you think others believe there is a problem?
  • What would happen for you to know that there may be a problem?
  • Have you tried to change in the past? What happened?
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21
Q

Describe Phase 2 of Prochaska’s Changes of Phase Model:

A
  • Client is aware of a problem and has spent a lot of time thinking about it
  • Often present here and often stay here; at this point in the journey, they see the cost of change as being too high (AKA Chronic Contemplation-needs all the answers, to know exactly what will happen)
  • They’re so used to the problem, that to change is more problematic (in their mind) than the problem itself
  • Secondary Gains: the client may not want to give up certain things
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22
Q

Client Language in Phase 2 of Prochaska’s Changes of Phase Model:

A
  • I would like to change but…
  • I feel like I’m stuck
  • I’m just not sure I want to do that right now
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23
Q

Client Characteristics in Phase 2 of Prochaska’s Changes of Phase Model:

A
  • Seeking understanding
  • Distressed
  • Previous attempts with failure
24
Q

Therapist’s Strategy in Phase 2 of Prochaska’s Changes of Phase Model:

A
  • Empathy is key here - validate their struggles and offer hope
  • Get them thinking about the possibility of change and increase confidence
25
Q

Therapist’s Questions in Phase 2 of Prochaska’s Changes of Phase Model:

A
  • Why do you want to change at this time?
  • What keeps you from not changing?
  • What might help you overcome these barriers?
  • How have you overcome difficult things in the past?
26
Q

Describe Phase 3 of Prochaska’s Changes of Phase Model:

A
  • Clients making plans to take specific actions to chance
  • What resources does the client have available? Family, support groups…
  • Therapist should make plans for potential relapse with client
27
Q

Client Language in Phase 3 of Prochaska’s Changes of Phase Model:

A
  • It really has gotten out of control

- I need to do something about it

28
Q

Client Characteristics in Phase 3 of Prochaska’s Changes of Phase Model:

A
  • Intentionality/readiness
  • Engaged in the process
  • On the verge
29
Q

Therapist’s Strategy in Phase 3 of Prochaska’s Changes of Phase Model:

A
  • Help client gather info about what they need to change their behavior
  • Help client assess what it would take to change
  • Help devise a specific workable plan of action
30
Q

Therapist’s Questions in Phase 3 of Prochaska’s Changes of Phase Model:

A
  • What resources are available for you to change?
  • What support system do you have available?
  • What do you think you could do to begin to bring about change?
31
Q

Describe Phase 4 of Prochaska’s Changes of Phase Model:

A
  • Talked about it, thought about it, prepared for it

- Started abstaining, maybe gone to detox

32
Q

Client Language in Phase 4 of Prochaska’s Changes of Phase Model:

A
  • I think I’m ready to work on this now

- So what can I do to get started?

33
Q

Client Characteristics in Phase 4 of Prochaska’s Changes of Phase Model:

A
  • Solid decision
  • Motivated (internal/external)
  • Open to feedback
34
Q

Therapist’s Strategy in Phase 4 of Prochaska’s Changes of Phase Model:

A

Help client set realistic goals and develop practical methods

35
Q

Therapist’s Questions in Phase 4 of Prochaska’s Changes of Phase Model:

A
  • When things begin to change, how will you know?
  • How can you avoid a slip/relapse?
  • If you do slip, how can you get refocused again?
36
Q

What are some of the issues seen during the first 4 stages of Prochaska’s Changes of Phase Model?

A
  • Get through denial
  • Simplifying, minimizing, rationalizing, intellectualizing, diversion, hostility
  • Resistance - anything that prevents the client from tapping into unconscious
  • Roll with resistance, be aware of counter-transference
37
Q

What are clinical strategies during the first 4 stages of Prochaska’s Changes of Phase Model?

A
  • Maintain rapport
  • Support/present a realistic view of change through small, successive steps
  • Acknowledge the difficulty of change (especially early in process)
  • Help client identify triggers and high risk situations, then develop alternatives and explore coping strategies
  • Assess client support system
  • Offering insight
  • Empathic validation leads to therapeutic bond (especially necessary for challenge/discrepancy)
  • Removing barriers/decreasing desirability
  • Offering new perspective and providing choice
  • Clarify goals/active helping
  • Offer support and HOPE
38
Q

Describe Phase 5 of Prochaska’s Changes of Phase Model:

A
  • Clients are doing what they have prepared for and their new goal needs to shift toward maintaining the gains they’ve experienced thus far
39
Q

Client Language in Phase 5 of Prochaska’s Changes of Phase Model:

A
  • I can’t believe how far I’ve come.
  • Why did it take me so long to do this?
  • I’m still working, but I’m beginning to feel so much better
40
Q

Client Characteristics in Phase 5 of Prochaska’s Changes of Phase Model:

A
  • Actively working to sustain change

- Some fear/anxiety of failure

41
Q

Therapist’s Strategy in Phase 5 of Prochaska’s Changes of Phase Model:

A
  • Encourage, support
  • Remind them of the progress they’ve made
  • Be aware of relapse potential and help client navigate them
42
Q

Therapist’s Questions in Phase 5 of Prochaska’s Changes of Phase Model:

A
  • What could potentially throw you off track right now? How can you avoid that?
43
Q

Describe Phase 6 of Prochaska’s Changes of Phase Model:

A
  • Clients who’ve overcome their issue(s) also maintain their desired behavior on their own.
  • They have a clear direction and can distinguish between old and new life
  • Confidence/self-efficacy is usually evident and high
44
Q

Client Language in Phase 6 of Prochaska’s Changes of Phase Model:

A
  • I never want to go back there again.
  • I can’t see myself doing that anymore.
  • I feel so much better now.
45
Q

Client Characteristics in Phase 6 of Prochaska’s Changes of Phase Model:

A
  • Celebrate change with your clients
  • Remind them how far they’ve come and of progress made.
  • Re-discuss relapse
  • Begin termination discussion
  • Leave relationship open for future needs
46
Q

Therapist’s remarks in Phase 6 of Prochaska’s Changes of Phase Model:

A
  • I’m so proud of you!
  • So, let’s reflect on what this experience has been like for you.
  • I really think you’re doing well on your own and it’s time to discuss ending therapy for right now.
47
Q

Therapist’s input regarding relapse in Phase 6 of Prochaska’s Changes of Phase Model:

A
  • When clients relapse, they often feel a sense of failure, which undermines their confidence regarding overcoming the problem.
  • Remind them that relapse is not a final destination but an opportunity to examine why and how the slip occurred and a chance to reflect and learn new skills
  • The potential for relapse is high - they should prepare for it and expect it
48
Q

Describe loss of control:

A
  • Rotter - describes the degree to which individuals believe that reinforcements are contigent upon their behavior
  • Internal - what we do affects outcomes in our lives (easies to change)
  • External - believe that other evens and people control outcome (weakest determination of change)
49
Q

Learned helplessness & Learned Optimism are directly related to _____.

A

Locus of control

50
Q

People with learned helplessness believe that bad events are:

A
  • Global: it affects everything I do
  • Stable: happens all the time
  • Internal: It’s my fault, I’m flawed, defected, there’s no hope for me
51
Q

People with learned optimism believe that bad events are:

A
  • Specific: He/she didn’t like that comment I made
  • Temporary: only a problem right now
  • External: my parents are fighting because of their inability to get along, not because of me
52
Q

Define Secondary Gains:

A

All the elements for change are in place, but there is no change.
- Means they are gaining something from the addiction

53
Q

Define Unconscious Motivations:

A

Strong internal beliefs that affect outcome

54
Q

Define Tertiary Gains:

A

A desire to please the therapist; therapist becomes image of parent/role model they never had, client does not want to let you down

55
Q

Define Codependency:

A

Can only recover as long as a specific person is in their life

Family Addictions (4 decks)

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