9 Motivation in substance abuse

Motivation in substance abuse

10 broad principles of druguse

• Drug use is a chosen behavior

• Drug problems emerge gradually & occur along a continuum of severity

• Once well-established, drug problems tend to become self-perpetuating

• Motivation is central to prevention andintervention

• Drug use responds to reinforcement

• Drug problems do not occur in isolation, butas part of behavior clusters

• There are identifiable and modifiable risk & protective factors for problem druguse

• Drug problems occur within a family context

• Drug problems are affected by a larger socialcontext

• Relationship matters

preconetemplation

• not seeing advantages in quiting

contemplation

• seeing advantages in quitting

preparation

• taking first steps, but still drinking

action

• quitted & modified the behaviour

maintenance

• maintenance of behaviour

Transtheoretical model

• Model of behavioural change

• Describes how people modify a problem behavior or acquire a positive behavior.

• Stages of Change

Self-efficacy construct represents

• the situation specific confidence that people have that they can cope with high-risk situations without relapsing to their unhealthy or high-risk habit.

The Situational Temptation Measure 

• reflects the intensity of urges to engage in a specific behavior when in the midst of difficult situations.

• Motivational interviewing

• evidence-based intervention designed to enhance client motivation for change

• Tested in a variety of clinical intervention modalities (substance abuse treatment, chronic disease managment, behavioral health interventions)

Motivational interviewing types

• Traditional approach

• Motivational Interviewing approach

Traditional approach

• Increased patient knowledge will translate into behaviour change

• Increases clinician & patient frustration due to poor outcomes

• ‘You should quit smoking because it will preventdisease’

Motivational Interviewing approach

• Based on the assumption that individuals are motivated to change when change is connected to something they value

• Source is then internal

MI begins with 

• exploration of the patients’view of the potential benefits of changing

• “Tell me about any benefitsyou see in quitting smoking”

A client-centered directive method for 

• Enhancing intrinsic motivation to change by exploring an resolving ambivalence

• work from the client’s perspective

• Elicit from the patient whatever reasons he or she has for engaging in that health behaviour

Intrinsic (internal) reasons for change tend to be associated with

• greater adherence to medical recommendation, persistence, & long-term behaviour change

Three major elements of spirit

• Collaboration

• Evocation

• Autonomy

Collaboration

• Style of working with the patient

• Fostering a partnership with the patient rather than assuming an expert role

• Working together toward a common goal

Autonomy

• Patients have the freedom to make their own choices

• The role of the clinician is to facilitate the change, not to impose it

• Final decision rests with the patient

Express empathy

• patient’s perspective

• Need to avoid judgment although there may be

  conflicts with our own beliefs

MI - MajorPrinciples

• Express empathy

• Develop discrepancy

• Roll with resistance

• Support self-efficacy & optimism

Being non-judgmental helps to

• reduce self-defend

Develop discrepancy

• Between the patient’s current behaviour & his or her important goals or values

Roll with resistance

• Essential to avoid arguing

Support self-efficacy & optimism

• If the clinician expresses doubt regarding the ability or likelihood or a patient to succeed with making a change, that will undermine the patient’s self-efficacy

Fields of application emotion

• Emotional intelligence

• Association with Psychological well-being

Authors in emotional intelligence

Mayer & Salovey

According to Mayer and Salovey, emotional intelligence refers to the

• involved in:

• recognizing

• using

• understanding

• manage

other & owns emotional states to solve problems & regulate behaviour.

ABILITY MODEL

• components such as sociability, self-control, & emotionality

illustration of emotional intelligence components

two ways of measuring emotional intelligence

• EXPERIENTIAL emotional intelligence

• STRATEGIC emotional intelligence

two components of experiential emotional intelligence

• Perceiving emotions

• Emotions to facilitate thought

two components of Strategy emotional intelligence

• Understanding emotions

• Managing emotions

Perceiving emotions

• Faces

• Pictures

Emotions to facilitate thought

• Sensations 

• Facilitation

Understanding emotions

• Blends

• Changes

Managing emotions

• Emotion management 

• Emotional relations

Measurement of emotional intelligence: MSCEIT

What does emotional intelligence predict?

• Physical & psychological well-being.

• Link between emotional intelligence & education.

• Emotional intelligence & organizations.

 Physical & psychological well-being

• MSCEIT scores correlate positively

• MSCEIT scores correlate negatively 

The MSCEIT scores correlate positively with 

• Ryff Scale of Psychological Well-Being

• In areas related to growth & social relationships.

MSCEIT scores correlate negatively with

• depression & anxiety scales, such as the BDI & STAI.

• less vulnerable to negative affect & depression

EMOTIONAL INTELLIGENCE & EDUCATION

• Relationship between academic achievement & emotional intelligence

• Emotional regulation have impact on academic performance

• emotional intelligence associated with social skills in the classroom

EMOTIONAL INTELLIGENCE & ORGANIZATIONS

• Emotional intelligence & goal achievement & organizational behaviour assessed by a supervisor.

• important skill for supervisors

• influencing organizational commitment &  emotional regulation