Stages of Change and Harm Reduction; Abstinence Models Psychotherapy

Question 1

When are people able to change?

Answer 1

Readiness, willingness, able!! (RAW)

Question 2

Structure of change, what are the stages?

Answer 2

1. Precontemplation (perhaps denial, just not contemplating)
2. Contemplation (uncomfortable stage where people are questioning what they’re doing)
3. Preparation (do I have th tools to make change, like making my house a cocaine-free zone?)
4. Action (tell people it’s hard to change but you can do it
5. Maintenance

Question 3

Structure of change, what are the processes?

Answer 3

1. Precontemplation to contemplation (consciousness raising, emotional arousal/dramatic release, social liberation/environmental reevaluation)
2. Contemplation to Preparation (self-evaluation: damned if you do, damned if you don’t)
3. Preparation to Action (self-liberation/commitment)
4. Action to Maintenance (Countering/counterconditioning, environmental control, rewards, helping relationships)

Question 4

Abstinence means

Answer 4

stop all drugs, not use them at all, EVER

Question 5

Example of Socratic teaching: when you take in nicotine, how do you die?

Answer 5

1. COPD (dirt over alveolar capillary membrane and “air trapping”)
2. Arterial damage (heart, brain, pudendal artery)
3. Cancer (irritation locally and hematogenous spread to pancreas, kidney, bladder, bone marrow)

Question 6

Ways of implementing Socratic teaching?

Answer 6

Clarification/reflexive listening (see example); confrontation/double-sided reflection (allow patient to educate you on why they do what they do)

Question 7

Harm reduction is

Answer 7

aim to reduce harmful consequences of certain human behaviors

Question 8

Ways to approach harm reduction?

Answer 8

1. Can tell them smoking is harmful to health
2. Could person find way to smoke healthier?
3. Tell patient to smoke certain amount/day and enjoy each puff!
4. If you ask them if they want to smoke healthier, they’ll probably be less resistant