13. The Stages of Change are:
• Precontemplation (Not yet acknowledging that there
is a problem behavior that needs to be changed)
• Contemplation (Acknowledging that there is a
problem but not yet ready or sure of wanting to make
a change)
• Preparation/Determination (Getting ready to
change)
• Action/Willpower (Changing behavior)
• Maintenance (Maintaining the behavior change) and
• Relapse (Returning to older behaviors and
abandoning the new changes)
21. Key Themes in Relapse Prevention
1- identify risk relapse factors and develop
strategies to deal with.
2- understand relapse as a process and as an
event.
3- understand and deal with cues and cravings.
4- understand and deal with social pressures to
use substance.
5- develop and enhance a supportive social
network.
22. Key Themes in Relapse Prevention
6- develop methods of coping with negative
emotional states.
7- assess the pt. for co morbid psychiatric
disorder.
8- help and learn the pt. methods to cope
with cognitive distortions.
25. What is self Efficacy????
self-efficacy as our belief in our ability to
succeed in specific situations.
high risk factors internal, external( thoughts,
feelings, people, places, events and things )
26. Factors affecting self-efficacy
• Bandura points to four sources affecting self-efficacy;
• 1. Experience
– "Mastery experience" is the most important factor deciding a
person's self-efficacy. Simply put, success raises self-efficacy,
failure lowers it.
• 2. Modeling - a.k.a. "Vicarious Experience"
– “If they can do it, I can do it as well.” This is a process of
comparison between a person and someone else., modeling
27. Factors affecting self-efficacy
• 3. Social Persuasions
– Social persuasions relate to
encouragements/discouragements. These can have a strong
influence – most people remember times where something said
to them significantly altered their confidence. Where positive
persuasions increase self-efficacy, negative persuasions
decrease it. It is generally easier to decrease someone's self-
efficacy than it is to increase it.
• 4. Physiological Factors
– In unusual, stressful situations, people commonly exhibit signs of
distress; shakes, aches and pains, fatigue, fear, nausea, etc. A
person's perceptions of these responses can markedly alter a
person's self-efficacy.
28. Tools of managing self efficacy in
addict
- Individual psychotherapy .
- Group .
- Team work.
- Motivational skills.
- Ex addict .
- Family involvement.
- Relapse and lapse investigations.
29. Self efficacy and solve problem
- Psycho education
- Anticipation of risky situations .
- Discussion ??????
- Training , motivation.
- List of problems
- Prioritize the problems .
- Analysis of the problems.( cognitive errors
and other related psychosocial issues).
30. Problem solving
- Alternative solutions.
- Choose the suitable solution ( with,
against, and key persons).
- Test the solution .
- Approve the solution or choose other
alternative.
- Recycle and repeat.
31. Types of problems to be solved
- cues.
- Craving
- Psychiatric disorders.
- Medical disorders.
- Legal problem.
- Family .
- financial.
32. Self efficacy and problem solving
mean
Continuous motivation for change of
- Attitude .
- Thoughts .
- Mood .
- Behavior .
33. Cognitive behavioral model of the
relapse process
Decreased
Coping Increased
Probability
response Self efficacy
Of relapse
High risk
situations
AVE
disonance
No Initial use Increased
Decreased conflicts
Coping Of Probability
Self efficacy Of
response substance Self
relapse
attribution
34. Family intervention in addiction
treatment
- F Counseling
- Enabling, coping with relapse and craving.
- F therapy
35. The aims of counselling
Counselling can help people:
• discuss their problems honestly and
openly,
• deal with issues that are preventing them
from achieving their goals and ambitions,
and
• have a more positive outlook on life
36. Emphasizing issues in Family
Counselling in Addiction
• disease model of addiction.
• Motivational skills training.
• Signs of enabling.
• Main concepts of follow up .
• Lapse and relapse.
• Role of the family in each therapeutic step.
• Role of the key person.
• Trust vs. mistrust
• How to deal with patients cravings.
• More frequent questions from the family.
37. Emphasizing issues in Family
Counselling in Addiction
• disease model of addiction.
disease model
reward system
personality disorders and changes.
38. Emphasizing issues in Family
Counselling in Addiction
• Signs of enabling.
• Obsessively thinking or ruminating about what to
do to get others to change behaviors.
• Protecting someone from the consequences of
their addiction.
• Constantly cleaning up the chaos to keep the
status quo.
• Ignoring mood-altering substance abuse
patterns.
• Creating lies or excuses for other's drug using or
drinking patterns.
39. Emphasizing issues in Family
Counselling in Addiction
• Signs of enabling.
• Nagging or starting arguments then ignoring
drug use and drinking.
• Allowing the person in active addiction to live in
the same household when they are abusive or
continue with destructive behaviors.
• Tolerating individuals driving under the influence
of mood-altering substances
• Ignoring people's self destructive behaviors for
fear of starting arguments
40. Emphasizing issues in Family
Counselling in Addiction
Coping with Relapse
• Process.
• Handling crises and emergency situations.
• Indications for referral to family therapy.
41. Emphasizing issues in Family
Counselling in Addiction
Handling craving
• Encouraging the individual to express craving
• to them
• Not panicking, as craving can be handled in
ways
• other than using drugs
• Understanding that the process of craving is
• temporary.
42. Emphasizing issues in Family
Counselling in Addiction
Handling craving
• Giving him/her something to eat or drink. The
• craving is often reduced when a person’s hunger
• or thirst is quenched
• Talking it through when craving occurs
• Distracting the individual by playing a game,
• reading, going to a movie, listening to music or
• going out to visit some relatives, etc
43. Family Therapy
• confessions and confrontations.
• Parenting skills.
• Discussions skills.
• Solving problem skills.
• Anger management in the family.
• Family firmness.
• Therapeutic alliance ( patient , family and
therapists).
