Chapter 13: Substance Abuse Counseling

What are the five different stages in Prochaska's Model of Change?

Precontemplation, Contemplation, Preparation, Action, and Maintenance.

What occurs in the Precontemplation stage of behavior change?

No intention to change, not even aware of problem, seek TX only if pressured by others.

What occurs in the contemplation stage of behavior change?

Aware problem exists thinking about change, but not yet made commitment, still weighing pros and cons.

What occurs in the Preparation stage of behavior change?

Recognize costs outweigh benefits to drugs but yet to make change.

What occurs in the Action stage of behavior change?

Modify behavior.

What occurs in the Maintenance stage of behavior change?

Prevent relapse, (operational definition: 6 months free from problem behavior, in maintenance stage).

True or False: Often recycle through stages; many trying to change aren't ready

True

What is the best intervention for precontemplation of behavior change?

Provide information.

What is the best intervention for contemplation of behavior change?

Explore the benefits to change (pros/cons list, etc.)

What is the best intervention for preparation for behavior change?

Make explicit commitment (creating a contract, making a pledge in front of people, etc.)

What is the best intervention for action for behavior change?

Coping skills/therapy.

What is the best intervention for maintenance prevention for behavior change?

Problem-solve ways to deal with potential relapse (Consider social pressures, having a job is ideal, adequate living conditions, etc.)

What does it mean to be an enabler?

Behaviors that encourage another to persist in self-destructive behavior. Providing excuses for the addict, making it possible for the addict to avoid the consequences of a behavior, etc.

What does it mean to be co-dependent?

Type of relationship that encourages another to be reliant on you; relationship is one-sided, emotionally destructive, or physically abusive.

What are some signs of co-dependency?

- Excessive Caretaking: Feel responsible for others' actions, feelings, choices, thoughts.

- Low self-esteem: need to be needed.

- Denial: Codependents typically ignore, minimize or rationalize problems in the relationship

- Fear of anger

What is an intervention with family counseling?

- Family, friends confront client about effects substance abuse having on client & others, request client get help

- Family/friends decide in advance what response will be if client refuses help

- Research found this instrumental in starting the client to change

What AA?

Alcoholics Anonymous, spiritual based, acknowledge need power greater self to remain abstinent.

What is Al-Anon and Alateen?

Support groups for families of alcoholics.

What are the 12 steps for AA?

1. Admit that powerless over alcohol

2. Power greater than ourselves could restore us to sanity

3. Turn our will over to care of God

4. Make a fearless moral inventory

5. Admit to God, self, and another person our exact wrongs

6. Ready have God remove defects character

7. Ask God remove our shortcomings

8. Make list all persons we harmed, & willing make amends to all

9. Make direct amends wherever possible

10. Continue take personal moral inventory and promptly admit when wrong

11. Through prayer & meditation improve contact with God, praying only for His Will & power to carry that out

12. Try carry message to alcoholics

What are 2 major criticisms of AA?

- Spiritual component

- Focus on past & in recovery for life

What is SMART recovery?

Self-help for alcoholics that uses cognitive-behavioral model (practice cognitive restructuring, challenging irrational thoughts that lead to drinking or other behavioral problems).