Substance Abuse Flashcards
What is Motivational Interviewing?
Strategy for building client’s motivation to change so they are ready to work collaboratively.
- Collaborative
- Goal oriented
- Strengthen personal motivation
- Explore the person’s own reasons for change with acceptance and compassion.
How do you treat substance abuse?
With motivational interviewing
When would you use MI?
At the beginning of treatment
What are the six stages of change?
Pre-contemplation, contemplation, preparation, action, maintenance, relapse.
How would you engage and also strengthen/respond to change talk?
OARS [to understand perspective]
O - open ended Qs
A - affirm strengths
R - reflective listening
S - summarise
What are the FOUR PROCESSES in MI?
- Engagement
- Focusing (Identify change goal collaboratively)
- Evoking (What are their reasons? Pros and cons)
- Planning (What will help them move forward?)
What is DARN? and when would you use it?
Ask questions to evoke change talk [preparatory stage]
Desire [want, wish, like]
Ability [can, able, could]
Reason
Need [importance]
What is CAT? When would you use it?
To mobilise change talk
CAT
Commitment language
Activation
Taking steps
In summary, how would you evoke change talk in MI?
- open questions to elicit DARN and CAT
- importance ruler
- query extremes of their own concerns about use
- looking back and forward
- instil discrepancy
- if hear change talk, reflect it back
- goals and values
When screening for substance abuse disorder what sort of questions would you ask?
- Addictive cognitions, their beliefs about use
- Motivation to change
- Current use, dependence, withdrawal
- Consequence
- Current life problems
- History of use, prev treatment
- Early life
- Use a 5 part model
- Psychometrics DAST [drug screening tool] or AUDIT [alc screnning tool]
What maintains addictive behaviour?
Cognitions about addiction - e.g. I can’t stop, certain situations activates addictive beliefs.
What is Beck’s cognitive model of addiction?
Talk through an example using the model
High risk situation [int/ext cue] > addictive beliefs activated > automatic thought > craving/urge > Facilitating thought (permission) > Planning > Relapse
party environment [int talking is hard] > drinking makes me fun > Drink! > imagine tase > Just one! > get up and get drink > relapse
What is harm reduction?
Abstinence ideal but there are alternatives to reduce harm e.g. moderation goals. Meet them at their goal.
You have a client that is reluctant to discuss their substance use, how do you approach it? i.e. how do you respond to sustain talk.
- Come alongside
- Amplified reflection
- Straight reflection
- Reframe
- Emphasise autonomy
What are some of the behavioural treatments for substance abuse?
Activity monitoring Behaviour experiments Role play Relaxation training Problem solving Graded task assignment Exercise to help cravings
