Psycho-social interventions

Question 1

What are the best interventions for alcohol abuse? [5]

Answer 1

1. Motivational interviewing
2. Motivational enhancement therapy - four manualised session over 8-10 weeks.
3. CBT - mindfulness ‘buzz’
4. Social behaviour network therapy - lot of focus on social support, behaviour change is not an individual process, much more about the person in their social context. Uni Birmingham, see person with alcohol problem, they will invite in someone from their social network - friend, neighbour etc.
5. Behavioural couples therapy. 12 sessions, see the person with addiction and non-problematically using partner, the partner will help the addicted person to manage addiction with use of ‘antabuse - disulfram’.

Question 2

What is contingency management?

Answer 2

Rewarding people for working towards their goals - vouchers for opiate free urine schemes. vouchers for coming in for BBV screens, infectious disease screening.

Problem is that when patients stop getting rewards they stop engaging with the service.

Tends to be used much more with vaccinations, reward for getting this done.

Question 3

What is mindfulnes based relapse prevention? (Not NICE yet)

Answer 3

Mindfulness has been described as “paying attention in a particular way: on purpose, in the present moment, and non-judgmentally”

Not ignoring the cravings, acknowledging that the cravings are there but working through them.

Question 4

What are the normal human reactions to the righting reflex?

Answer 4

1. Feeling invalidated
2. Resisting
3. Withdrawing

Question 5

Does making people feel bad make them want to change?

Answer 5

Not really.

Question 6

What is a scaling question?

Answer 6

On a scale of 0 to 10, how important is it for you to make this change?

They say a 5: So why are you at a 5, not at 0?

A quick way to find out what is important to that person about stopping the behaviour etc.

Question 7

What are the normal human responses to a listen/evoke/empathic style of consultation?

Answer 7

1. Feeling Affirmed: understood, accepted, respected, heard, empowered.
2. Feeling accepted: open, undefensive etc.

3.

Question 8

What is the FRAMES model?

Answer 8

1. Feedback
2. Responsibility
3. Advice
4. Menu of options
5. Empathic interviewing
6. Self-efficacy