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Contemplation

Pre- Contemplation. Lapse/Relapse. Contemplation. Preparation. Maintenance. Action. STAGES OF CHANGE. Relapsing back to problem use. Pre- Contemplation. Stages of Change. PRE-CONTEMPLATION Characteristics. “No problem” See no reason to change Lack of awareness. Pre-

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Contemplation

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  1. Pre- Contemplation Lapse/Relapse Contemplation Preparation Maintenance Action STAGES OF CHANGE Relapsing back to problem use

  2. Pre- Contemplation Stages of Change

  3. PRE-CONTEMPLATION Characteristics “No problem” See no reason to change Lack of awareness Pre- Contemplation

  4. PRE-CONTEMPLATION Tasks of Change: Information: Both factual and personal Consider circumstances which indicate a need for change Engagement of client, create positive relationship Pre- Contemplation

  5. Pre- Contemplation Contemplation Stages of Change

  6. CONTEMPLATIONCharacteristics Ambivalence Fear of change Wishful thinking Interest in “the problem”

  7. CONTEMPLATIONTasks of Change Examine the ambivalence Weigh and consider alternatives Examine “pros” and “cons” of particular actions

  8. Pre- Contemplation Contemplation Preparation Stages of Change

  9. PREPARATIONCharacteristics Readiness to consciously engage in change process Temporal imminence of change

  10. PREPARATIONTasks of Change Gather information about options Make initial contact

  11. Pre- Contemplation Contemplation Preparation Action Stages of Change

  12. ACTIONCharacteristic Change in behaviour

  13. ACTIONTasks of Change Understanding factors supporting the behaviour Strategies which will support behavioural change Communication with others

  14. Stages of Change Pre- Contemplation Contemplation Preparation Maintenance Action

  15. MAINTENANCECharacteristics Consolidation of changes Need for support Skills development

  16. MAINTENANCETasks of Change Establish support system Practice behavioural changes Act on relapse prevention plans

  17. Pre- Contemplation Lapse/Relapse Contemplation Preparation Maintenance Action Stages of Change Relapsing back to problem use

  18. LAPSE/RELAPSECharacteristics Initial return to use Re-establishing previous pattern

  19. LAPSE/RELAPSETasks of Change Reconnecting with supports Examining and learning from lapse experience Reviewing and modifying relapse prevention strategies

  20. EMPOWERMENT AND SELF CHANGE Understanding motivation Autonomy Motivational interventions FRAMES

  21. FRAMES F eedback R esponsibiltiy A dvice M enu of options E mpathic style S elf efficacy

  22. How does it balance?

  23. Case 1 Rod 19 year old Smokes cannabis 3 out of 7 days in a week. Takes Es on weekends. Drinks 5 units alcohol day Spends most of his spare cash on drugs and alcohols Impulsive and suffers with depression

  24. Case 2: Jane 45 year old restaurant manager Taking nitrazepam (prescribed by GP) for 2 years Anxious and depressed

  25. Case 3: Freddy 29 year old Crack cocaine user past 5 years Using heroin ‘to come down off the crack’ past 2 years Initially smoking, now injecting

  26. Addiction as: A biological (disease) model A psychological model A social model BIOPSYCHOSOCIAL MODEL

  27. Summary – Addiction Behaviour is no longer a matter of considered choice

  28. Summary – Addiction as a function of: THE DRUG Positive and negative re-inforcers THE PERSON Impulsive, sensation seeking THE SITUATION Opportunity, lack of alternatives, social influences

  29. The End Any questions ? bhagat.sharma@nepft.nhs.uk How do you detox a patient with opiod dependency syndrome? rehabilitation Blow to the head Straitjacket chocolate

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