Week 4: Chapter 8: Psychological Approaches to Addiction Flashcards
Psychoanalysis
(Freud) zowel een theorie als een behandeling die conflicterende elementen of delen probeert te begrijpen die vaak verborgen of ontoegankelijk (onbewust) blijven voor een individu zonder behandeling → Freud poneerde een structureel model dat het ‘ego’ (gebaseerd op de realiteit), een ‘superego’ (geweten) en een ‘id’ (onmiddellijk verlangen naar plezier, inclusief het libido)
→ het ideale resultaat van de behandeling wordt beschouwd als een versterking van het ego, zodat het minder macht heeft over het koppige id of het meer rigide superego
contingency management
uses the principle of positive reinforcement to change substance-using behaviour by reinforcing abstinence from a specified drug: done through the provision of a reward that has some meaning to a client
Social Learning Theory
suggests that social behavior is learned by observing and imitating the behavior of others. cognitive processes such as anticipation, planning, expectancies, attributions, self-e cacy and decision making have been shown to be an integral part of learning → all of these factors have been shown to be involved in the development of addictive behaviours
Cognitive Theory Therapy (mbt addiction)
cognitive theory of addiction proposes individuals develop addictive beliefs along their beliefs about self: may reflect social learning processes and become activated in response to life stressor.
Therapy: how an individual’s beliefs shape addiction and can then be worked to promote recovery → since many high risk situations are internal or inevitable, cognitive therapy focuses on how individuals can identify and modify their belief systems
What is Cognitive Behavioural Approach/Therapy ?
the role of thinking biases in maintaining specific problematic emotions and behaviour → it generally focuses on diffi culties that are manifest in the here and now: it is an explicit collaboration between therapist and client and aims to teach clients skills to self-manage their di culties as well as maintain improvements
As a therapist, what is important to know and to be able to share with clients four particularly important assumptions underlying the CBT approach to treating addictive behaviour?
- Addiction is a learned behaviour
- Addiction emerges in an environmental context
- Addiction is developed and maintained by particular thought patterns and processes
- CBT integrated well with other approaches as di fferences tend towards similar outcomes
Motivational Interviewing (MI)
a counselling style that focuses on the interplay of ambivalence (= being in ‘two minds’ or ‘feeling strongly towards two incompatible choices’) and motivation: as such, it is a normal and expected feature of addiction and recovery.
What are the three concepts of motivational interviewing?
- Client motivation is critical for change
- Motivation is a dynamic rather than a static trait
- Motivation is influenced by external factors, including therapists’ behaviour
Transtheoretical Model of Change = provides a simple heuristic model which suggests that most people move through five stages of change. What are those?
- Pre-Contemplation → there is no intention to change behaviour in the foreseeable future
- Contemplation → people are aware that a problem exists and are seriously thinking about
overcoming it but have not yet made a commitment to take action - Preparation → combines intention and behavioural criteria → intending to take action in the
next month and have unsuccessfully taken action in the past year - Action → individuals modify their behaviour, experiences, or environment in order to
overcome their problems: involves the most overt behavioural changes & requires energy - Maintenance → people work to prevent relapse and consolidate gains attained during action
What is PRIME Theory of Motivation?
proposes that the motivational system operates at di fferent levels of complexity from simple reflex responses to motives and evaluations
What is PRIME an acronym for?
- Plans → formulated when we cannot act upon an evaluation immediately → particular importance are plans for lifestyle change
- Responses → the way in which we initially show how we react to a particular situation
- Impulses/Inhibitory Forces → having a sudden strong and unreflective urge or desire to act:
motives can only exert influence on responding through impulses - Motives → allow us to consider the possible outcomes of our behaviour and manifest
themselves in our conscious awareness as feeling such as ‘want’, ‘desire’ or ‘need’
a. Past experiences will influence the generation of these motives - Evaluations → involve the world being represented in terms of ‘beliefs’, which through their influence on motives can indirectly a ect our behaviour → results in dissonance = an uncomfortable state that motivates us to suppress, change or add new beliefs1
Zimberg identifies three di fferent types of dual diagnosis. What are they?
- Type 1 = a primary mental health problem where substances are used as a means of
self-medication for that disorder → an adaptive attempt to heal, self-repair and self-care - Type 2 = a primary substance misuse problem with substance-induced mental health
problems. → ‘toxicity’ hypothesis: substance may (in)directly contribute to development of
mental health diffi culties, cognitive impairment & sometimes perceived personality disorder - Type 3 = a coexisting mental health problem and/or personality disorder together with
substance misuse → such comorbidity might reflect shared predisposing factors that may underlie both the mental health and addiction presentations
Type I is een primaire psychiatrische stoornis waarbij middelengebruik alleen psychisch symptomatisch is (zelfmedicatie). Type II is een primaire stoornis in het gebruik van middelen met door middelen veroorzaakte psychiatrische symptomen. Type III zijn psychiatrische en middelengebruiksstoornissen van lange duur die gelijktijdig voorkomen of op verschillende tijdstippen aanwezig zijn. Type III wordt beschouwd als de “echte” toestand van dubbele stoornis.
What do Pickard and Pearce suggest about addicts and what five areas for clinical intervention and targeting (mbt addiction) do they identify?
suggest that clients are able to regulate their consumption of drugs and that therefore the idea that drug use is a compulsive act should be questioned.
They identify five areas for clinical intervention and targeting:
1. Strength of Desire & Habit
2. Willpower
3. Motivation
4. Functional Role
5. Decision & Resolve
They argue that by targeting these five factors, enhanced choice, improved control and augmented agency should follow → ‘we cannot help addicts unless we treat them as agents, capable of choice and control, and responsible for their behaviour’
Executive Functioning
the mental processes that enable us to plan, focus attention, remember instructions, and juggle multiple tasks successfully → also supports other neuropsychological processes such as intellectual functioning, working and prospective memory
Relapse prevention is not effective enough for..
tobacco and cocaine treatments
