Treatment and Prevention Pt 1 Flashcards
What is treatment?
- planned activities designed to change patterns/lifestyle of an individual or their families
What is the most important thing for successful treatment?
- recognition that there is a problem
How can someone recognize they have a problem?
- from the individual or other sources (family/friends, legal system, employer)
What needs to happen for treatment to work?
individual needs to be convinced that there is a problem and is mortivated/committed to change
Why should someone try to be “ready” rather than motivated?
- motivation is essential, but not fruitful… there rare many ways to define/measure it
- so, better to try to real “ready”/commited to change
Who is the state of change model for?
- people who change on their own or use outside resources
State of change model steps in order
- pre-contemplation
- contemplation
- preparation
- action
- maintenance
What happens when maintenance is disrupted?
relapse, and then the cycle repeats
State of change model: precontemplation
complete denial, vast majority of people with SUDs (most common)
State of change model: contemplation
idea of questioning if there is a problem and if so, if the individual should make a change
State of change model: preparation
- verge of taking action
- can be very long with many attempts
- ex. talk to dr. and looking for resources
State of change model: action
actually actively changing, act on goals, specific activities
State of change model: maintenance
continual behavioral changes while individual is abstinent from the substance for a sustained time
Models of SUDs
Moral model
individual is personally responsible for problems from decisions/choices
Models of SUDs
American disease model
viewed as progressive disease that gets increasingly worse and is irreversible
Models of SUDs
Biological Model
there is some genetic/biological predisposition that leads to SUDs
Social learning model
- result of complex learning from enviornmental interaction… surroundings make it possible
- changing/re-arranging persons’ enviornment could get rid of SUD
Models of SUDs
Sociocultural Model
- subculures/societies shape use patterns and consequences (ex. legalization and acceptance)
- puts large groups/society as a whole at risk
What is the biopsychosocial model?
mix of all other models
What are the key questions in evaluating treatments?
- Does the treatment work better than no treatment?
- Does the treatment work better than a placebo?
- Does the treatment work better than standard treatments?
- Does the treatment work for the reasons that it claims it does?
What are the typical courses of behavioral treatment for SUD?
- quit on own
- self-help group
- professional treatment
Behavioral treatments
Quit on own
- attempted first
- usually takes multiple tries (spontneous remission)
- not very high success rate
How many americans participate in a self-help group?
around 1:200 (popular)
What is a self-help group?
- collection of individuals with unique, identifieable problem
- focused on therapeutic activity
Who leads self-help groups?
- individuals wihtout credentials/licensing who usually aslo have the same problem
- disadvantage and an advantage, depends
- professionals are also welcomed to participate and help
When/why was AA established and by who?
- 1935 by Dr. Bob and Bill W (surgeon and stock broker)
- to hold each other accountable to maintain sobriety
now an internation organization?
What other groups did AA spawn?
- Alateen-teens w alcoholic parents
- Al-anon- family members of alcoholics
What kind of program is AA?
- 12-step program w religious influence and group participation
- have to admit loss of self-control
American disease model and AA
- American disease model is the foundation for AA
- viewed as product of progressive, irreversible disease
What are the problems with outcome studies for AA?
- groups are heterogeneous
- length and nature of involvement varies
- drop out rate high
- participants have ongoing or prior professional treatment
likely attracts specific type of use (ex. personality)
What is the drop out rate for AA?
- 68% within 10 weeks
What are the benefits of AA- 1999 meta analysis results
- non-randomized study indicated AA is better than no treatmnet but only for those who stick with it
- those who attend more (longer) do better
What did project MATCH (Matching Alcohol Treatments to Client Heterogeneity) do and find?
- compared 3 types of therapy: 12-step facilitation therapy (not AA), cog-behavioral coping skills therapy, motivational enhancement therapy
- found comparable outcomes for all 3 treatments… while not direct test of AA, supports idea that only some users are attracted to conceptual and spritual underpinnings of AA
Women for Sobriety (1975)
- slight variant of AA
- similar in recognizing as progressive illness
- focuses on psychological/social concerns of women
SMART (self-management and recovery training) group
- scientifically validated, coordinater led
- 4 key areas: stoping motives for use, beliefs that can help/hinder individuals’s attempts, emotions, behavior
SOC (secular organizations for sobriety or save our selves)
- individuals are in charge of their own rational decisions
- growing rapidly
- uses peer support meetinfgs (like AA)
- one day at a time principle
Components of professional treatment
- individualizing treatment goals via assessment (formal testing and observation)
- and then makes personalized treatment
