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Relapse Prevention: Maintenance Strategies in the Treatment of Addictive Behaviors
... Esta dimensión captura las respuestas, actitudes y estrategias empleadas para prevenir recaídas (Litman et al., 1983). Diferentes modelos teóricos han comprobado la influencia de estas estrategias, como los modelos de Litman et al. (1984), el Modelo de Prevención de Recaídas de Marlatt y Gordon (1985) o la Teoría del estrés y del afrontamiento (Folkman, 1984). Estos modelos proponen que la adquisición e implementación efectiva de estrategias de afrontamiento activas fomentan la autoeficacia, por lo que se constituyen como un componente relevante de la recuperación (Hasking y Oei, 2008;Larimer et al., 1999;Laudet, 2008;Laudet et al., 2002;Marlatt y Gordon, 1985;Marlatt, 1996;Monti y Rohsenow, 1999;Witkiewitz y Marlatt, 2007). ...
... Diferentes modelos teóricos han comprobado la influencia de estas estrategias, como los modelos de Litman et al. (1984), el Modelo de Prevención de Recaídas de Marlatt y Gordon (1985) o la Teoría del estrés y del afrontamiento (Folkman, 1984). Estos modelos proponen que la adquisición e implementación efectiva de estrategias de afrontamiento activas fomentan la autoeficacia, por lo que se constituyen como un componente relevante de la recuperación (Hasking y Oei, 2008;Larimer et al., 1999;Laudet, 2008;Laudet et al., 2002;Marlatt y Gordon, 1985;Marlatt, 1996;Monti y Rohsenow, 1999;Witkiewitz y Marlatt, 2007). Actualmente, la mayoría de los programas de tratamiento de los trastornos adictivos incluyen la prevención de recaídas, cuya eficacia ha sido ampliamente corroborada (Hasking y Oei, 2008;Larimer et al., 1999;Marlatt, 1996;Monti y Rohsenow, 1999;Witkiewitz y Marlatt, 2007). ...
... La literatura sobre trastornos adictivos y su recuperación ha resaltado la influencia del afecto negativo patológico y la gestión deficiente de la emocionalidad negativa en la predicción de recaídas como factores de riesgo, subrayando su papel en la recuperación clínica (Marlatt y Gordon, 1985;Pandina et al., 1992;Stasiewicz y Maisto, 1993). Por su parte, la medida del capital de recuperación (Groshkova et al., 2013;Sion et al., 2022) considera la disponibilidad de recursos para satisfacer necesidades básicas en distintos ámbitos vitales y los asocia con el curso clínico de la dependencia, así como con la probabilidad de inicio y mantenimiento de la recuperación. ...
El bienestar es un elemento clave de las definiciones actuales de recuperación en el trastorno por uso de alcohol (TUA). No obstante, es preciso desarrollar un marco unificado para conceptualizar la recuperación, caracterizar sus elementos y los mecanismos para lograrla. El objetivo del estudio fue proponer un modelo que relacionara las dimensiones psicológicas implicadas en la recuperación del TUA. Se evaluó a 348 participantes con diferentes períodos de abstinencia (rango:1 mes-28 años), mediante autoinformes de bienestar psicológico, calidad de vida, emocionalidad negativa y estrategias de afrontamiento. El análisis estadístico contó con un análisis factorial exploratorio (AFE) para identificar las dimensiones subyacentes a los indicadores evaluados y un modelo de ecuaciones estructurales (SEM) que las interrelacionó. El AFE identificó 3 factores que explicaron el 54,95% de la varianza: i) Afrontamiento; ii) Malestar Funcional (gestión emocional y capital de recuperación); iii) Salud Mental Positiva (bienestar y calidad de vida). El SEM mostró buenos índices de ajuste (GFI = 1,00, SRMR = ,137) y explicó el 85% de la varianza en Salud Mental Positiva (R2 = ,85). Los resultados muestran que el tiempo de abstinencia se asocia con el aumento del empleo de estrategias de afrontamiento, lo que contribuye a la mejora del malestar funcional, y esto favorece la salud mental positiva. Esta investigación representa la primera propuesta metodológicamente sólida realizada en España para un modelo clínico de recuperación centrado en el bienestar, que redefine la comprensión de la recuperación en el TUA y proporciona soporte para intervenciones clínicas y evaluaciones más efectivas.
... Avoidance strategies can be effective in the short term but may not be sustainable long-term. They are often used in conjunction with other coping strategies (Carroll & Onken, 2005;Marlatt & Gordon, 1985). ...
... Key techniques taught in therapy involve refusal skills, problem-solving, and stress management to help individuals better navigate challenges related to substance use. Cognitive-behavioral coping skills therapy is highly effective in reducing relapse rates and enhancing coping mechanisms (Carroll & Onken, 2005;Marlatt & Gordon, 1985). ...
... These strategies often involve identifying high-risk situations, developing coping strategies to manage cravings, and creating a plan for dealing with potential setbacks. Relapse prevention is highly effective in maintaining long-term recovery by equipping individuals with the skills and strategies needed to handle challenging situations and prevent relapse (Carroll & Onken, 2005;Marlatt & Gordon, 1985). ...
p dir="ltr"> Cognitive-behavioral therapy (CBT) encompasses a diverse range of techniques designed to facilitate behavior change. Evaluation of these techniques through the transtheoretical model (TTM) may provide insight into their effectiveness and the progressive nature of change in individuals with substance use disorders and the gradual nature of change in individuals with substance use disorders. This systematic review aims to identify and evaluate the methods and techniques used in CBT and examine their relationship to the stages of change as defined by the Transtheoretical Model (TTM). A comprehensive search of databases such as PubMed, PsycINFO, and the Cochrane Library was conducted, focusing on studies published between 2000 and 2023. The review focused on peer-reviewed articles that examined CBT (cognitive behavioral therapy) techniques and their alignment with stages of transformation. especially the transtheoretical model (TTM), in the context of substance use disorders. The review identified several CBT techniques, including cognitive restructuring, mindfulness, problem solving, and skills training. These techniques have been found to align with the various stages of the TTM and effectively promote progression through the stages of change, particularly in facilitating the transition from contemplation to preparation and from action to maintenance. The integration of CBT techniques with the TTM stages of change offers a structured approach to behavioral modification in substance use disorders. Understanding and applying these techniques within the TTM framework can enhance the efficacy of interventions.
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... Craving is believed to present itself during periods of drug abstinence elicited when experiencing drugrelated cues (e.g., environmental cues and drug exposure; Drummond et al., 1995), incentive salience (Berridge and Robinson, 2016), and due to drug expectancy (see Drummond, 2001). Thereby increasing the propensity for drug seeking behavior in individuals with compromised self-efficacy (Marlatt and Gordon, 1985), only satiated by drug use. ...
... To accurately identify and diagnose AAS craving and any existing sub-dimensions, a new measure should aim to represent the multidimensional nature of the construct (Tiffany and Wray, 2012). Researchers have characterized craving as eliciting several experiences upon an individual, these include cue-elicited craving (Drummond et al., 1995), outcome expectancy (Marlatt and Gordon, 1985), and associated positive and negative mood states Shiffman and Waters, 2004). Cue-elicited craving has been identified within alcohol research, whereby an individual associates their use of a substance (e.g., alcohol) with an environment (e.g., a bar), and elicits a desire or urge to administer the substance if immediate substance use does not take place (Anton, 1999). ...
... Cue-elicited craving has been identified within alcohol research, whereby an individual associates their use of a substance (e.g., alcohol) with an environment (e.g., a bar), and elicits a desire or urge to administer the substance if immediate substance use does not take place (Anton, 1999). Outcome expectancy is explained by the motivation and desire to administer a substance due to the positive outcome of its use, increasing the likelihood of drugseeking behaviors (Marlatt and Gordon, 1985). The effects of mood on craving have been identified within smoking research, whereby negative affect will increase craving and increase the risk of substance use in periods of abstinence (Shiffman and Waters, 2004). ...
Background
Anabolic-androgenic steroid (AAS) dependence affects approximately 30% of people who use AAS. Presently, measures to assess and diagnose AAS dependence are adapted from scales specific to other forms of drug misuse (e.g., alcohol), containing issues with internal consistency and breadth of construct capture. Additionally, there are no measures available to assess AAS craving, which represents a potentially important coeval factor to AAS dependence. Therefore, this study aimed to develop and provide evidence of validity for measures of AAS dependence and AAS craving.
Methods
Data were collected from male and female strength athletes who use AAS across two samples (nsample 1 = 206; nsample 2 = 224). Sample 1 completed the new measures alongside instruments assessing theoretically related constructs (Doping Moral Disengagement, Doping Self-Regulatory Efficacy Scale, craving items from the Wisconsin Smoking Withdrawal Scale, AAS adapted Diagnostic and Statistical Manual for Mental Disorder 4th Edition), whereas Sample 2 completed the new instruments.
Results
Exploratory and Confirmatory Factor Analyses (CFA) with Sample 1 data were used to finalize the item sets for both measures and determine the factorial structures of the AAS Dependence Scale (AASDS) and AAS Craving Scale (AASCS). The AASDS consists of 15-items across five first-order factors that are represented by one second-order factor. The AASCS consists of 16-items across four first-order factors that are represented by one second-order factor. Evidence supporting the concurrent, convergent and discriminant validity of scores obtained with both scales was provided through their associations with the theoretically related variables. CFA with the data from Sample 2 confirmed the factor structures for both scales.
Conclusion
The AASDS and AASCS represent valid and reliable measures of AAS dependence and AAS craving for use in research with strength athletes who use AAS.
... Lira-Mandujano, González-Betanzos, Carrascoza, Ayala, & Cruz-Morales (2009) demostraron que al utilizar una Intervención Breve Motivacional para Fumadores (IBMF), la cual se enfoca en el fortalecimiento de la autoeficacia y en el modelo de prevención de recaídas, se obtuvieron resultados positivos con respecto al mantenimiento de la abstinencia durante y después de la intervención. Este tratamiento se basa en la teoría cognitivo social de Bandura (1986), la entrevista motivacional (Miller, 1999;Miller & Rollnick, 1991), la teoría de etapas de cambio de Prochaska y DiClemente (1986), la teoría de prevención de recaídas (Marlatt & Gordon, 1985) y técnicas de autocontrol (Hester & Miller, 1989). Es un tratamiento que consta de nueve sesiones distribuidas en una sesión de admisión, una de evaluación, cuatro sesiones de tratamiento y tres sesiones de seguimiento. ...
... Este tratamiento tiene como sustentos teóricos y metodológicos a la teoría cognitivo social de Bandura (1986), la entrevista motivacional (Miller, 1999;Miller & Rollnick, 1991), la teoría de etapas de cambio de Prochaska y DiClemente (1986), la teoría de prevención de recaídas (Marlatt & Gordon, 1985) y técnicas de autocontrol (Hester & Miller, 1989), los cuales funcionaron como base para el diseño de cada una de las sesiones y la elección de las técnicas a utilizar en cada una de ellas. ...
El consumo de tabaco es un problema que va en aumento a nivel internacional relacionado con diferentes consecuencias de salud. Al identificar los predictores del éxito del tratamiento y trabajar sobre ellos, es posible aumentar la efectividad de estos tratamientos para dejar de fumar. La ansiedad, depresión y motivación al cambio ayudan a predecir el éxito de los tratamientos para dejar de fumar. El presente estudio tuvo como objetivo evaluar el alcance de factores como ansiedad, depresión y motivación al cambio para predecir el éxito en disminuir el consumo de tabaco después de un tratamiento cognitivo conductual para dejar de fumar. Se empleó un diseño pre experimental con seguimiento a seis meses, participaron 24 mujeres y 22 hombres con una edad media de 42.74 años, a los cuales se les realizó una evaluación pre-tratamiento, se les proporcionó un tratamiento para dejar de fumar, se hizo una evaluación post-tratamiento y un seguimiento a seis meses. Con respecto a los predictores de consumo, el nivel de depresión en el pre-tratamiento logra predecir el consumo en pre-tratamiento, el factor que logra predecir el consumo en evaluación post-tratamiento es la motivación al cambio en acción en post-tratamiento, por último, los factores que logran predecir el consumo en el seguimiento fueron el nivel de depresión en pre-tratamiento y la motivación al cambio en acción. Tomando en cuenta limitaciones como: el número de personas que participaron, el nivel inicial de ansiedad y depresión, el no tomar en cuenta otro tipo de variables y la forma de evaluar la motivación al cambio, se concluye que los principales predictores del consumo son el nivel de depresión y la motivación al cambio en acción.
... The explanation of the treatment program can be found in other publications (Rubio et al., 2018;Rubio et al., 2020), but in summary, it is a 24-months, multimodal, intensive, cognitive-behavioral treatment, divided into the following 5 phases: (a) Detoxification and motivation towards abstinence (2-3 months); (b) Relapse prevention, which was based on the cognitive-behavioral model of Marlatt and Gordon (1985); (c) Social skills program, which was based on the one developed in the MATCH Project (Kadden et al., 1992); (d) Consolidation of behavior and lifestyle changes (10-12 months). After completing the Therapeutic Intervention Program (TIP), patients were referred to the Continuing Care Program carried out by the Primary Care team (Rubio et al., 2020). ...
... These findings have led us to consider that maintaining or increasing MiL can be the thread through which recovery is achieved in severe alcohol dependent patients who request treatment. It is possible that, initially, recovery depends on the adherence to the treatment program, attendance and involvement in tasks of MH groups (Kaskutas et al., 2003;Pagano et al., 2004) or changes in lifestyle (learning to cope with risky situations and emotional management) (Marlatt & Gordon, 1985), but afterwards, MiL could be the guiding thread that drives the maintenance of recovery. It has been pointed out that purposeful individuals have a predisposition that guides their actions towards future achievements. ...
Several psychological variables have been associated with the prognosis during alcohol dependence treatment and after discharge. However, we still do not know the role that these variables play in the achievement of abstinence and if they modify throughout time. Method: Longitudinal survey data related to anxiety, depression, impulsivity, coping, meaning in life (MiL) and attendance to mutual-help groups were collected from outpatients with alcohol dependence (N= 159, 66% male, mean age=42.54 years). Assessment points were the following: baseline, at discharge (after 2-years of treatment), and 2-years and 4-years follow-up after discharge. Drinking outcomes were evaluated with the Timeline Followback Method Assessment. Results: At baseline, levels of avoidance coping and impulsivity were associated with months of accumulated abstinence at 4-years-follow-up. However, at discharge and at two-years follow-up, higher scores in MiL were consistently associated with months of accumulated abstinence at 4-years of follow-up. Mediation models showed that MiL increased accumulated abstinence at 4 years-follow-up by increasing avoidance coping and reducing levels of depression. Conclusions: MiL is a determining component in the long-term sustained abstinence. Our results support the key role of MiL and point to a new mechanism through which it influences the maintenance of sobriety. Because mutual-help groups have consistently demonstrated to promote MiL, they should be implemented and recommended as an essential part of an integrated treatment of alcohol dependence.
... Such lapses can contribute to reduced weight loss and/or weight gain, and are thus a potentially important target for interventions aiming to improve dietary and physical activity behavior. One theoretical model for understanding how social undermining may affect weight management behaviors is the relapse prevention model (Marlatt & Gordon, 1985). This model posits that high-risk situations (e.g., being offered a tempting, highcalorie food) can be threatening to one's self-efficacy and therefore may lead to relapse. ...
... The importance of employing theory in health behavior research is well documented, as it promotes understanding of health behaviors and provides guidelines for developing intervention targets (Michie & Abraham, 2004;Redding et al., 2000). One conceptual model that was only used in three of the included studies but may be particularly helpful for conceptualizing social undermining and its relation to lapse is the relapse prevention model (Marlatt & Gordon, 1985). Through the lens of this model, high-risk situations such as social undermining may be threatening to self-efficacy and lead to a lapse in healthy dietary and physical activity behaviors. ...
Objetivo: El debilitamiento social del comportamiento alimentario y de actividad física puede afectar la capacidad de una persona para perder o mantener peso. Esta revisión tiene como objetivo identificar cómo se ha conceptualizado y medido en la literatura existente el debilitamiento social del comportamiento dietético y de actividad física, y qué se sabe sobre sus efectos en el control del peso. Métodos: Los estudios se recuperaron de tres bases de datos electrónicas y se incluyeron si se centraban en examinar el debilitamiento social del comportamiento alimentario y de actividad física en adultos. Dos codificadores evaluaron de forma independiente los criterios de elegibilidad de cada estudio y extrajeron los datos. Resultados: Se identificaron treinta y tres estudios. Las poblaciones incluyeron personas inscritas en programas de pérdida de peso (k = 11) y poblaciones que no buscaban tratamiento (k = 22). Muchos participantes del estudio eran Blancos, pero once estudios tomaron muestras exclusivamente de poblaciones no Blancas. Se han utilizado múltiples medidas para evaluar el debilitamiento social del comportamiento dietético y de actividad física, y muchas de ellas tienen evidencia limitada de confiabilidad y validez. Aunque los estudios sobre prevalencia son limitados, se ha informado que el debilitamiento ocurre en el 28% de las personas, y se ha identificado a la familia como la principal fuente de debilitamiento. Los estudios que apuntan a vincular el debilitamiento con las conductas reales de alimentación y actividad física y los resultados de peso son limitados, y estos vínculos han sido respaldados en algunos estudios. Pocos estudios examinaron la intencionalidad del debilitamiento, definieron el debilitamiento o probaron las características individuales asociadas con el debilitamiento. Conclusiones: Las investigaciones futuras deberían buscar mejorar la medición del debilitamiento y utilizar una variedad de métodos de investigación adicionales para avanzar en el campo hacia una mejor comprensión y capacidad para abordar el debilitamiento social de los comportamientos relacionados con el peso.
... A basic idea is that abstinence can be maintained through thinking and acting in new ways. An important treatment goal is therefore improving the ability to identify triggers and high-risk situations, and to handle them (Dimeff & Marlatt, 1998;Marlatt & Gordon, 1985). The intervention is given as a course with several sessions led by professionals, and attendees are encouraged and helped through professional guidance to solve their own problems (Ortiz & Wirbing, 2017). ...
... Compared with AA, abstention is not the only possible treatment goal in RP. Although total abstinence in the RP literature is considered the best alternative for most people with substance use problems (Saxon & Wirbing, 2004), depending on personal preferences and preconditions, controlled drinking is also presented as a viable alternative (Marlatt & Gordon, 1985;Saxon & Wirbing, 2004). RP advocates have also challenged the disease model of addiction, including the notion that the individual cannot control substance use (Dimeff & Marlatt, 1998;Saxon & Wirbing, 2004). ...
Aim: This exploratory study analyses the interplay between the treatment philosophies of Alcoholics Anonymous (AA) and Relapse Prevention (RP) in personal stories of addiction. While the basic ideas of AA and RP are compatible in many ways, they also carry some fundamental differences. Methods: The data consisted of interviews with 12 individuals recovering from substance use problems, who had experience of both AA and RP. The analysis drew on a dialogical narrative perspective, and the concept polyphony was used to shed light on the interplay between different treatment philosophies in personal stories of relapse. Findings: Although sometimes resulting in incoherence, the treatment philosophies were combined idiosyncratically, in ways that appeared productive for the participants’ self-images and recovery journeys. Conclusion: The combination of AA and RP philosophies in narratives of relapse and recovery may reflect a new treatment discourse where individualisation and responsibilisation stand in a complicated relationship with collectivism and surrendering to so-called addicting processes.
... None of the covariates were significantly associated with tobacco lapse (gender: OR = 0. 73 1.08). Nonetheless, given their importance for tobacco lapse in previous work, these covariates were maintained in analyses. ...
... Results for negative affect states suggested that guilt, shame, nervousness, and for those with higher nicotine dependence, restlessness, were all associated with greater lapse likelihood. Findings for guilt and shame are consistent with theoretical models of relapse, particularly with the abstinence violation effect [66,67,73], which posits that lapse predicts increases in guilt and shame that, in turn, increase risk for subsequent lapse. Although our results cannot imply causal associations, together with previous work, these findings suggest that a renewed look at how interventions could best reduce trait-level feelings of guilt and event-level feelings of shame, or break the linkage between those affective states and lapse, is warranted. ...
Background:
Affect states are posited to play a pivotal role in addiction-related processes, including tobacco lapse (i.e., smoking during a quit attempt), and distinct affective states (e.g., joy vs. happiness) may differentially influence lapse likelihood. However, few studies have examined the influence of distinct affective states on tobacco lapse.
Purpose:
This study examines the influence of 23 distinct affect states on tobacco lapse among a sample of tobacco users attempting to quit.
Methods:
Participants were 220 adults who identified as African American (50% female, ages 18-74). Ecological momentary assessment was used to assess affect and lapse in real-time. Between and within-person associations testing links between distinct affect states and lapse were examined with multilevel modeling for binary outcomes.
Results:
After adjusting for previous time's lapse and for all other positive or negative affect items, results suggested that at the between-person level, joy was associated with lower odds of lapse, and at the within-person level, attentiveness was associated with lower odds of lapse. Results also suggested that at the between-person level, guilt and nervous were associated with higher odds of lapse, and at the within-person level, shame was associated with higher odds of lapse.
Conclusions:
The present study uses real-time, real-world data to demonstrate the role of distinct positive and negative affects on momentary tobacco lapse. This work helps elucidate specific affective experiences that facilitate or hinder the ability to abstain from tobacco use during a quit attempt.
... Програми соціальної адаптації допомагають реінтегрувати залежних осіб у суспільство та працевлаштувати їх.. Ефективне лікування залежностей неможливе без включення реабілітаційних програм, які допомагають пацієнтам інтегруватися в суспільство, відновлювати соціальні зв'язки та забезпечувати професійну адаптацію [7]. ...
... Estos resultados nos llevan a considerar que el mantenimiento o el incremento del SV podría ser el hilo conductor sobre el cual se va consolidando la abstinencia. Es posible que, inicialmente, el proceso de recuperación dependa de la adherencia al tratamiento, así como de la implicación de los pacientes con los grupos de AM y la asistencia a ellos (Kaskutas et al., 2003;Pagano et al., 2004) o los cambios en el estilo de vida (el aprendizaje de estrategias de afrontamiento ante situaciones de alto riesgo y regulación emocional) (Marlatt & Gordon, 1985), pero más adelante, es el SV el que conduce al mantenimiento de la abstinencia. Se ha señalado que los individuos con un propósito muestran una predisposición que guía sus acciones hacia futuros logros, lo que les permite limitar la percepción del valor de las recompensas a corto plazo (por ejemplo, volver a beber), a favor de otras recompensas de mayor valor (Burrow & Spreng, 2016). ...
Diversas variables psicológicas están implicadas en el pronóstico de los pacientes con dependencia de alcohol, durante el tratamiento y después del alta. Sin embargo, aún no conocemos el papel que juegan estas variables en la consecución y mantenimiento de la abstinencia y, si éstas, se modifican a lo largo del tiempo. Metodología: Se recogieron datos longitudinalmente relacionados con ansiedad, depresión, impulsividad, estrategias de afrontamiento, sentido de la vida (SV) y asistencia a las asociaciones de ayuda-mutua (AM) de pacientes ambulatorios con dependencia de alcohol (N=159, 66% varones, edad media=42.54 años). Se realizaron evaluaciones basalmente, al alta (después de 2 años de tratamiento), a los 2 y a los 4 años después del alta. Las variables relacionadas con el consumo de alcohol fueron evaluadas con el método Timeline Followback. Resultados: En la evaluación basal, el estilo de afrontamiento evitativo y la impulsividad se asociaron con los meses de abstinencia acumulada a los 4 años. Al alta, y a los 2 años de seguimiento, las puntuaciones altas en el SV se asociaron con los meses de abstinencia acumulada a los 4 años. Los modelos de mediación encontraron que el SV incrementaba los meses de abstinencia acumulada a los 4 años a través del estilo de afrontamiento evitativo y una reducción de los niveles de depresión. Conclusiones: El SV es un componente determinante en la abstinencia a largo plazo. Dado que las asociaciones de AM promueven el SV, éstas deberían ser recomendadas como una parte esencial de un tratamiento integrado de la dependencia de alcohol.
... Model ini sangat bergantung pada mengajar klien untuk mengenali pemicu dan rencana tanggapan terhadap pemicu yang meminimalkan kemungkinan kambuh melalui perubahan dalam pemikiran dan perilaku. Sedangkan pencegahan kambuh Model Cognitive-Social Learning (Marlatt & Gordon, 1995) memandang perilaku adiktif bukan sebagai penyakit, tetapi sebagai "kebiasaan dipelajari terus-menerus yang dapat dianalisis dan dimodifikasi dengan cara yang sama seperti kebiasaan lainnya" (Marlatt, 1985). ...
Berlatarbelakang optimisme bahwa teknik-teknik hipnoterapi memiliki potensi yang besar untuk peningkatan efektivitas penanganan korban penyalahgunaan narkoba di masa yang akan datang, Implementasi Model hipnoterapi ini secara khusus bertujuan untuk mengurangi gejala relapse korban penyalahgunaan Narkoba. Implementasi model diawali dengan penerapan kuisioner The AWARE dari Gorski untuk mengetahui berbagai gejala relapse, kemudian dilanjutkan dengan langkah (1) pre-induction yang mencakup membangun relasi dengan para calon klien, hypnotherapy training dan suggestibility test, dan membangun kontrak; (2) Induction yang mencakup eyelid fixation; flying hand; total body relaxation; progressive relaxation; dan rapid induction; (3) Deepening dengan cara hitungan dan imajinasi, serta depth level test dengan menggunakan ideo motor respon; (4) Sugestion therapy/therapeutic intervention berupa narasi yang dibuat khusus untuk menghasilkan efek penyembuhan terutama gejala-gejala relapse yang ditemukan; (5) Termination sebagai langkah teknis untuk mengembalikan Subyek ke kondisi normal. Implementasi model hipnoterapi dengan metoda eksperimen terbukti mampu mengurangi gejala relapse korban penyalahgunaan Narkoba. Kata kunci : Model hipnoterapi, Gejala Relapse, Korban Penyalahgunaan Narkoba.
... En cuanto a enfoques teóricos que expliquen el motivo de la dependencia a los videojuegos, el origen puede ser bioquímico; debido al placer que produce en una persona por ser una actividad atractiva y con desafío constante, lo cual puede satisfacer una necesidad (Ledo et al., 2016). El modelo biopsicosocial se enfoca en explicar la dependencia a los videojuegos como un patrón predeterminado de conducta de predisposición psicológica, como la regulación emocional y los rasgos de personalidad, biológica, social y conductual (Chang et al., 2023;Marlatt & Gordon, 1985). ...
La presente investigación pretende establecer la evidencia psicométrica del Test de Dependencia de Videojuegos (TDV) en jóvenes universitarios peruanos. Se trabajó con una muestra de 390 jóvenes universitarios de ambos sexos, de 17 a 35 años. Las evidencias del análisis factorial confirmatorio (AFC) indican un ajuste aceptable (CFI = .90 y TLI = .89; RMSEA = .091), con pesos factorialesestandarizados superiores a .50. Por otro lado, en el modelo donde se correlacionan errores y se elimina un reactivo, los índices de ajuste global mejoran (CFI y TLI > .90; RMSEA = .088 y .087; SRMR = .070 y .071); siendo sus valores: Ω de .77 a .88. Se concluye que la estructura factorial propuesta por el autor del TDV es confirmada en las puntuaciones derivadas de la aplicación del instrumento en universitarios peruanos.
... Interventions are important in preparing individuals for setbacks and avoiding the abstinence-violation effect. This effect occurs when lapses are seen as proof of incapability, leading to full relapse not because of actual incapability but the belief in not being able to quit (Marlatt & Gordon, 1985). Encouraging attribution of lapses to external causes preserves self-efficacy, fortifying individuals for future challenges. ...
Self-efficacy refers to an individual’s sense of control over novel or difficult situations or challenges by anticipating their own competent behavior. Individuals with higher self-efficacy are more inclined to select ambitious goals, exert additional effort to achieve them, and feel more competent than those with lower
self-efficacy. Self-efficacy beliefs, therefore, have a significant impact on people’s feelings, thoughts, and actions. As a result, the construct of self-efficacy has become an essential part of research on health and health behaviors. This chapter explains how self-efficacy beliefs can be differentiated from related constructs, and what types and dimensions self-efficacy encompasses. It suggests guiding principles and provides examples of how to measure self-efficacy. It also describes the sources of self-efficacy and behavior change techniques for enhancing each one in psychological interventions. Additionally, it summarizes the evidence for the effectiveness of interventions that target self-efficacy and subsequent health behavior. The dynamic relationships between self-efficacy and social resources are also explored. The chapter concludes with potential areas for future research.
... Participants were randomized to AE or LIM intermittent training interventions for 24 weeks. These interventions were designed based on theoretical frameworks, specifically the Social Cognitive Theory (Bandura, 1986), Problem Solving Theory (Perri et al., 2001), Relapse Prevention (Marlatt and Gordon, 1985), and Stages of Motivational Readiness for Change (Prochaska et al., 1994). Strategies employed in these interventions included self-monitoring, goal setting, problem solving, mastery skills, social support, and relapse prevention. ...
Background/objective
To examine the cognitive benefits of 6 months of prescribed intermittent exercise (10-min bouts totaling 150 weekly minutes) in community-dwelling older adults, comparing effects of low-intensity movement (LIM) and moderate-intensity aerobic exercise (aerobic exercise; AE) training; and exploring biological mechanisms of exercise-related cognitive improvement.
Method
Twenty-five adults (>60 years old) participated in a 6-month controlled trial and were randomized into LIM or AE intermittent training. Cognition was assessed using a neuropsychological test battery including the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), California Verbal Learning Test, 2nd Edition (CVLT-II), and Delis-Kaplan Executive Function System (D-KEFS). Neuroimaging measures were collected using a 7 T human MRI scanner. Serologic neurotrophic and inflammatory factors were analyzed using Luminex multiplex assays [brain derived neurotrophic factor (BDNF); vascular endothelial growth factor (VEGF)]; interleukin-6 (IL-6), C-reactive protein (CRP), plasminogen activator inhibitor (PAI-1).
Results
LIM and AE intermittent training had dissociable effects on cognition, with LIM resulting in improved learning and memory and AE resulting in improved executive functioning. Intervention groups differed on change in cognitive performance on CVLT-II learning and D-KEFS trail making test. Increase in right dorsolateral prefrontal cortex (DLPFC) surface area was linked to executive improvement (i.e., phonemic fluency) regardless of intervention group. A decline in circulating PAI-1 was linked to learning and memory improvement in response to LIM over 6 months.
Conclusion
Moderate-intensity AE and LIM intermittent training likely have distinct cognitive benefits, though low-intensity activity is often included as a control group in exercise trials in aging.
... Cravings, stress, and negative affect are some of the psychological variables that greatly increase the likelihood of post-hospitalization relapse in SUD patients (Sinha, 2008).He continues, adding that emotional dysregulation and coping skills are made worse by stressful life events, trauma, and mental health comorbidities, which raises the risk of relapse. Furthermore, unhelpful thought patterns and attitudes regarding substance abuse might support addictive behaviors and thwart attempts at recovery (Marlatt & Gordon, 1985). In SUD patients, social and environmental factors also influence substance use patterns and the likelihood of relapsing (Laudet, 2011). ...
This qualitative case study explored patient perceptions on the efficacy of relapse prevention support systems available for individuals institutionalized for Substance Use Disorders(SUD)s at Chikurubi psychiatric hospital in Harare Zimbabwe.Focused Group Discussions and Individual In-depth Narrative Interviews(IIDNI) were used to collect data and analyze emerging themes. Participants underscored the essence of prescribed antipsychotic medication in facilitating recovery and mitigating the risk of relapse. Concerns about the infiltration of triggering substances such as cigarettes into the hospital environment underscored the need for stringent institutional controls and effective monitoring. While most of the participants were generally satisfied with hospital services, they expressed desire for more resources. Overcrowding concerns also resonated with local research findings highlighting the strain imposed on mental health facilities, and the implication of such on patient care and treatment outcomes. A myriad of factors were identified to be responsible for precipitating relapse, these include peer influence, environmental stressors and familial dynamics. Family dysfunction and stigmatization emergent as salient risk factors for SUD relapse, highlighting the need for multipronged interventions that address psychosocial stressors. Personal factors such as mental health comorbidities and social isolation emerged as prominent risk factors for relapse. Participants advocated for the provision of continuous after-care support, emphasizing the role played by familial and community networks.
... Par ailleurs, plusieurs facteurs de risque sont communs à la détresse psychologique et à la consommation abusive d'alcool. Les travaux des dix dernières années mettent l'accent sur le sentiment d'incompétence personnelle, sur la difficulté à composer avec les situations stressantes et sur l'adaptation (coping) (Wilson, 1992 ;Marlatt et Gordon, 1985) ; ils insistent aussi sur le stress, les événements critiques (Rhodes et Jason, 1990 ;Nadeau, 1990 ;Timmer et al., 1985) et la solitude (Akerlind et Hornquist, 1992 ;Sadave et Thompson, 1986) comme facteurs de risque. La consommation abusive a aussi un effet direct et très varié sur le système nerveux central. ...
... To date, understanding the impact of negative affect on alcohol use has been limited to the study of mean levels of affect (Kang et al., 2019). Many studies have demonstrated that intensity (i.e., mean level) of negative affect is associated with alcohol consumption (Marlatt & Gordon, 1985;Witkiewitz & Villarroel, 2009). However, a recent meta-analysis found no relationship between mean levels of negative affect and drinking (Dora et al., 2023). ...
Objective: Negative affect and affect variability figure prominently in models of addictive behaviors but are not without controversy. Negative affect variability may better capture a mechanism of behavior change in alcohol use disorder (AUD) treatment because it contains information about affect regulation, a common clinical target. The aims of this study are to examine the change in: (a) trajectory of negative affect variability, (b) association of negative affect variability and abstinence, and (c) association of negative affect variability and heavy drinking during AUD treatment. Method: This article is a secondary analysis of data drawn from a randomized clinical trial. N = 181 participants diagnosed with Diagnostic and Statistical Manual of Mental Disorders, fifth edition AUD (Mage = 50.8, SDage = 10.6; 51.4% female) received 12 sessions of Cognitive Behavioral Coping Skills Therapy for AUD. Participants completed one daily diary prompt per day for 84 consecutive days. Each day, participants reported on negative affect and number of alcoholic drinks consumed the previous day. Time-varying effect models examined changes in negative affect variability and its associations with abstinence and heavy drinking. Results: Negative affect variability decreased throughout treatment. The positive association between negative affect variability and heavy drinking became nonsignificant (decoupled) midway through treatment. The inverse association between negative affect variability and daily abstinence became nonsignificant (decoupled) at approximately day 75 of 84. When mean levels of NA were added as a covariate, the effects were in the same direction but no longer statistically significant. Conclusion: Reductions in negative affect variability may capture an important change mechanism of behavioral treatments for AUD because it contains information about affect regulation as compared with mean levels of negative affect. Negative affect variability warrants further consideration as a mechanism of behavior change.
... Ultimately, the schemas of negativity/pessimism (negative expectation that things will go wrong by focusing on the negative aspects of life) and imperfection/shame (feeling that one is inferior or that one would cease to be liked if one shows oneself as one is) (Young, 2003), refer to the difficulties widely described in the literature in relation to the management of negative emotionality in this type of pathology (González-Yubero et al., 2021). Relapse processes in addictive disorders are usually associated with the same three high-risk situations: Negative emotional states, interpersonal conflicts and social pressure (Marlatt & Gordon, 1985). ...
Early maladaptive schemas (EMS), dysfunctional patterns of thought and emotions originated during childhood, latent in most mental disorders, might play a role in the onset of alcohol use disorder (AUD), although their impact on prognosis remains unknown. Our aim is to determine the presence of EMS in patients with AUD and their role in the psychopathology and course of addiction (relapse and withdrawal time). The sample included 104 patients and 100 controls. The diagnosis of AUD was made according to the Diagnostic and Statistical Manual of Mental Disorders (DSM–5) criteria, EMS were determined with the Young Schema Questionnaire in its Spanish version (YSQ–S3) and psychopathology with Symptom Checklist–27 (SCL–27). AUD group showed significantly higher scores in emotional deprivation, confused attachment, emotional inhibition and failure schemas. In addition, vulnerability schema correlated (> 0.500) with all subscales of SCL–27. Whereas social isolation, insufficient self-control and grandiosity schemas correlated with a higher number of relapses. But it was the grandiosity and punishment schemas that correlated with shorter abstinence time. These findings suggest that EMS are overrepresented in the AUD population and some correlate with psychopathology and worse AUD outcomes.
... Möglicherweise lassen sich die Vorhersagemodelle in zukünftigen Studien verbessern, wenn Bewältigungsstrategien und Selbstwirksamkeitserleben als Variablen mit einbezogen werden. Zum einen stellen sie nach dem sozialkognitiven Rückfallmodell (Marlatt & Gordon, 1985) wichtige psychologische Einflussfaktoren bei der Vermeidung von erneutem Konsum dar, zum anderen wurden sie in Studien auch als Prädiktoren langfristiger Abstinenz gefunden (Ludwig et al., 2013;Maisto, Zywiak & Connors, 2006 Anmerkungen. B = Betakoeffizient, SE = Standardfehler, p = P-Wert der Z-Statistik, OR = Odds Ratio, KI = 95 % Konfidenzintervall von OR, NFI = Normed Fit Index, LRT = Likelihood-Ratio Test für die Modelle mit versus ohne Alkoholkonsum während der Behandlung (P-Wert), Signifikanz: *p < 0.05, **p < 0.01, ***p < .001. ...
Zusammenfassung: Fragestellung: Es wurde untersucht, ob Alkoholkonsum während einer abstinenzorientierten Entwöhnungsbehandlung einen Zusammenhang mit dem Abstinenzstatus und der beruflichen Teilhabe ein Jahr nach Behandlungsende aufweist. Außerdem wurde untersucht, ob der Zusammenhang durch andere bekannte Prädiktoren langfristiger Abstinenz beeinflusst wird und welche Merkmale von Patient_innen mit dem Alkoholkonsum während der Behandlung zusammenhängen. Methoden: In einer Stichprobe von 1.262 Patient_innen mit der Hauptdiagnose Alkoholabhängigkeit wurden Zusammenhänge zwischen Aufnahme-, Behandlungs- und Ein-Jahres-Katamnese-Daten einer stationärewn medizinischen Rehabilitationsbehandlung mittels logistischer Regression untersucht. Es wurden modifizierte Completers-only und Intention-to-treat Analysen entsprechend den Katamnesestandards DGSS1 und DGSS4 der Deutschen Gesellschaft für Suchtforschung und Suchttherapie durchgeführt. Ergebnisse: Es zeigte sich in beiden Berechnungsformen ein signifikanter Zusammenhang zwischen Alkoholkonsum während der Behandlung und Rückfall im Katamnesezeitraum, der auch bei Hinzunahme weiterer Variablen im Regressionsmodell bestehen blieb. Dagegen konnte zwischen Alkoholkonsum während der Behandlung und dem Erwerbsstatus ein Jahr später kein signifikanter Zusammenhang gefunden werden. Alkoholkonsum während der Behandlung trat umso häufiger auf je jünger die Patient_innen waren und je mehr Entzugsbehandlungen sie hatten. Schlussfolgerungen: Patient_innen mit Alkoholabhängigkeit, die bereits während einer stationären Entwöhnungsbehandlung Alkohol konsumieren, sind trotz Weiterbehandlung mit höherer Wahrscheinlichkeit im 1-Jahreskatamnesezeitraum rückfällig. Dagegen scheint der langfristige Erwerbsstatus der Patient_innen eher mit anderen Faktoren zusammenzuhängen als mit dem Alkoholkonsum während der Behandlung. Die Ergebnisse sprechen dafür, dass weiterer Forschungsbedarf zum Alkoholkonsum während einer stationären Entwöhnungsbehandlung besteht. Genauere Erkenntnisse könnten dazu beitragen, den Betroffenen langfristig eine erfolgreichere Bewältigung ihrer substanzbezogenen Störung zu ermöglichen.
... Developed by Marlatt and Gordon, this cognitive-behavioural approach is designed to help individuals identify and manage relapse risks (Marlatt & Gordon, 1985). RPT equips patients with strategies to cope with high-risk situations, such as stress, social pressure, and environmental cues, which are common triggers for relapse. ...
This paper explores the critical role of psychosocial interventions in treating alcohol and substance use disorders (AUDs and SUDs) which are¬¬¬ conditions with significant health and societal impacts. Psychosocial interventions, including Cognitive-Behavioural Therapy (CBT), Motivational Interviewing (MI), family-based therapies, and various group psychotherapies, are examined for their effectiveness in addressing the multifaceted nature of these disorders. The integration of these psychosocial interventions in holistic treatment plans is emphasized, acknowledging the necessity of a multidimensional approach that combines individual, group, and family therapies, complemented by pharmacotherapy. Contemporary trends point towards personalized care and the integration of digital counselling, reflecting the evolving landscape of addiction treatment. The importance of ongoing research and adaptation of these interventions to enhance their accessibility and effectiveness is highlighted, underscoring their significant contribution to sustained recovery and improved quality of life.
... Ahora bien, es posible que tras la caída inicial se sienta una recaída rápida debido a que el locus de control se encuentra vulnerable ante la primera caída, además, las personas tienden a retornar ligeramente a las etapas iniciales de la violencia. A este fenómeno se lo conoce como "efecto de violación de la abstinencia" y que consta de dos elementos cognoscitivos elementales (Marlatt y Gordon, 1985): a. La discrepancia cognoscitiva. El comportamiento resultante se atribuye a una reorganización de la autoimagen para que coincida con la recaída, como por ejemplo pensar "soy un desastre sin él", "ya esto es un caso perdido", "no tenemos solución, debemos continuar". ...
El estudio de los procedimientos que posibilitan la salida de las víctimas de la violencia sigue siendo de actualidad. Por lo tanto, en este documento, se analizan los procesos involucrados para poner fin a la violencia. Ya en la década de 1970, tanto la violencia hacia las mujeres como la violencia practicada por la pareja íntima se reconocieron a modo de problemas sociales reales y se convirtieron en temas centrales de la agenda política europea, situación que fue tomada como prioritaria gra-cias a los movimientos feministas. Desde entonces, estudiar la violencia ha sido todo un desafío. En 1997, la violencia doméstica se convirtió en tema de atención pública en Bélgica cuando la ley introdujo la noción de delito grave en el caso de agresiones intencionales contra un cónyuge o excónyuge. En 2006, la posición de Bélgica contra la violencia doméstica se fortaleció con la adopción de la política de cero tolerancias (Melan, 2017). A partir de estas leyes, las investigaciones acerca de las víctimas que abandonan relaciones violentas han ido en aumento (Hendy et al., 2003; Offermans y Kacenekenbogen, 2010; Catallo et al., 2013) y es noto-rio que los estudios se enfocan casi exclusivamente en mujeres víctimas. Los estudios sobre hombres maltratados y sus trayectorias siguen siendo escasos (Jaillet y Vanneste, 2017).
... Ahora bien, es posible que tras la caída inicial se sienta una recaída rápida debido a que el locus de control se encuentra vulnerable ante la primera caída, además, las personas tienden a retornar ligeramente a las etapas iniciales de la violencia. A este fenómeno se lo conoce como "efecto de violación de la abstinencia" y que consta de dos elementos cognoscitivos elementales (Marlatt y Gordon, 1985): a. La discrepancia cognoscitiva. El comportamiento resultante se atribuye a una reorganización de la autoimagen para que coincida con la recaída, como por ejemplo pensar "soy un desastre sin él", "ya esto es un caso perdido", "no tenemos solución, debemos continuar". ...
La violencia incide en todas las esferas sociales, culturales, económicas, académicas, psicológicas, emocionales, cognitivo-biológicas, políticas, de género, educativas, infantiles, carcelarias, sanitarias, entre otras múltiples. Comprender la violencia representa un ejercicio cognitivo y sociocultural importante. Un verdadero reto contrahegemónico, pues se trata de desnaturalizar lo que hemos naturalizado desde nuestras esferas más interiores hasta las estructuras y dinámicas socioculturales sistémicas. El estudio de la violencia es un proceso que día a día requiere un enfoque transdisciplinario, para que se comprendan todas las aristas de esta problemática profundamente arraigada en la cultura humana, así como las implicaciones que tiene en la vida de los seres humanos y otras especies vivas. Esta obra aborda su compleja dinámica, sus implicaciones y dimensiones.
... According to the ACT approach, humans learn to avoid thoughts, emotions, images, and physical sensations that they judge to be aversive, and this experiential avoidance is posited to underlie emotional dysregulation (Blackledge & Hayes, 2001;Clark, Ball, & Pape, 1991), serve as a barrier for the person's pursuit of valued outcomes, and generate drug use or mood disturbances. For example, substance-use behaviors, like smoking, are frequently motivated by attempts to regulate and control uncomfortable internal experiences, such as negative affect or craving, and become negatively reinforced, thereby making it difficult to quit (Marlatt & Gordon, 1985). An ACT-aligned therapeutic goal is the reduction of experiential avoidance and the development of what is known as "psychological flexibility", which refers to a person's willingness to identify and remain in the presence of unpleasant internal events and still commit to behaviors that are aligned with their life values. ...
... This is in line with previous results (Yeh et al., 2017) showing that motivation-focused psychoeducation increases awareness about sAUD (i.e., promotes the evolution from precontemplation to contemplation) but has no incentive impact on actual behaviors to quit drinking (i.e., do not make patients switch from contemplation to action). Such result might appear surprising when conceptualizing, as proposed in most classical cognitive-behavioral models (e.g., Hendershot et al., 2011;Marlatt & Gordon, 1985;Prochaska & DiClemente, 1983), addictive disorders as being anchored in a lack of motivation towards abstinence combined with a reduced understanding of the ways to achieve it. Such approach is at the heart of psychoeducation, with the hypothesis that increasing patients' awareness and knowledge of their addictive state will help them realize the severity of the disorder, will increase their motivation to change and will finally give them cognitive or behavioral action tools to initiate this change. ...
Background
Psychoeducation constitutes a routine therapeutic practice in most treatment settings for severe alcohol use disorder (sAUD). This technique is considered an efficient way to help patients to learn more about their disease and achieve therapeutic objectives. However, this approach capitalizes on three untested assumptions: namely, that (1) patients with sAUD possess insufficient knowledge about sAUD at treatment entry; (2) patients with sAUD have the cognitive resources to learn new information and benefit from psychoeducation; and (3) psychoeducation positively impacts clinical outcomes.
Methods
We tested these assumptions in two experimental studies. In the first experiment in 66 recently detoxified patients with sAUD and 102 matched healthy controls, we measured baseline knowledge on sAUD through self‐reported questionnaires, determined whether an up‐to‐date psychoeducation program can improve this knowledge, explored the role of cognitive abilities in such learning, and established the impact of psychoeducation on relapse rates. In a second experiment in 23 patients and 17 healthy controls, we examined whether the increased knowledge following psychoeducation is alcohol specific, and whether the motivation to change influences the relation between psychoeducation and clinical outcomes.
Results
At treatment entry, patients with sAUD presented with more sAUD‐related knowledge than healthy controls, and were able to increase this knowledge following psychoeducation, independently of their cognitive status. However, psychoeducation did not impact either the motivation to change or relapse rates.
Conclusions
Psychoeducation can increase patients' knowledge about sAUD, but it does not increase the likelihood of abstinence or controlled low consumption after discharge. Thus, clinicians should question whether psychoeducation should occupy a central position in the therapeutic programs and reconsider what can be expected from psychoeducation in terms of achieving therapeutic objectives.
... Attribution Theory: Attribution refers to the "inferred causality individuals engage in while attempting to 'explain' reasons" [12] for their own behavior or the behavior of others. The theory "describes the processes that operate as if the individual were motivated to attain a cognitive mastery of the causal structure of the environment" [13]. ...
Aim: This is the first of a two part paper that illustrates how cognitive-behavioral factors, the disregard of prior epidemiological data, and misfortunate timing contributed to the failure of National Prohibition in the United States. Methods: This first paper gives a detailed historical and cultural review of the early colonial, the post-revolutionary war, pre-civil war, and post-Civil-War, drinking patterns in the United States. It addresses the origins of the temperance movement, its evolution into a prohibition movement, and the post–civil war, prohibition in Kansas. Findings: Attribution theory shows a cognitive bias in the early 19th century temperance and late 19th century prohibition thinking. Scapegoat theory pointed out that the 19th century reformers targeted alcohol itself as the main source of social suffering and, by and large, neglected the context in which it was consumed. Conclusion: Nineteenth century attribution bias, cognitive errors, and failure to evaluate prior experience set the stage for 20th century, National Prohibition, a disastrous, preventive intervention.
... MSC provides tools for better and proactive self-care, allowing for relief from suffering, including CP [35][36][37][38]. MBRP is an intervention to reduce the probability and intensity of relapse by identifying its risk factors and increasing awareness, exposure, and behavioral flexibility in daily cognitive and emotional experiences [39][40][41]. MORE uses social-behavioral learning theory to enhance participant motivation and engagement, and, by combining CBT, psychological concepts, and mindfulness in a group program, it uniquely addresses and improves psychiatric symptoms, physical pain, and addictive behavior [42][43][44][45][46]. Spiritualized Mindfulness (SPM) is a combined mindfulness and spiritualization technique which aims to cultivate a spiritual feeling through framing and explaining the technique, followed by guided meditation focused on the spirituality-breath connection [47]. In spite of the benefits, mindfulness can lead to increased false-memory recall, temporary increases in pain, and agitation or anxiety derived from the increased awareness of bodily sensations in certain patients [48] and, herein, specific features need to be considered, such as individual characteristics, preferences, and medical history. ...
Background and Objectives: There has been an increasing interest in the use of non-pharmacological approaches for the multidimensional treatment of chronic pain. The aim of this systematic review was to assess the effectiveness of mindfulness-based therapies and Guided Imagery (GI) interventions in managing chronic non-cancer pain and related outcomes. Materials and Methods: Searching three electronic databases (Web of Science, PubMed, and Scopus) and following the PRISMA guidelines, a systematic review was performed on Randomized Controlled Trials (RCTs) and pilot RCTs investigating mindfulness or GI interventions in adult patients with chronic non-cancer pain. The Cochrane Risk of Bias Tool was utilized to assess the quality of the evidence, with outcomes encompassing pain intensity, opioid consumption, and non-sensorial dimensions of pain. Results: Twenty-six trials met the inclusion criteria, with most of them exhibiting a moderate to high risk of bias. A wide diversity of chronic pain types were under analysis. Amongst the mindfulness interventions, and besides the classical programs, Mindfulness-Oriented Recovery Enhancement (MORE) emerges as an approach that improves interoception. Six trials demonstrated that mindfulness techniques resulted in a significant reduction in pain intensity, and three trials also reported significant outcomes with GI. Evidence supports a significant improvement in non-sensory dimensions of pain in ten trials using mindfulness and in two trials involving GI. Significant effects on opioid consumption were reported in four mindfulness-based trials, whereas one study involving GI found a small effect with that variable. Conclusions: This study supports the evidence of benefits of both mindfulness techniques and GI interventions in the management of chronic non-cancer pain. Regarding the various mindfulness interventions, a specific emphasis on the positive results of MORE should be highlighted. Future studies should focus on specific pain types, explore different durations of the mindfulness and GI interventions, and evaluate emotion-related outcomes.
This study thus explores and identified the social support to drug surrenderers of the community-based rehabilitation program at the Municipality of Baungon, Province of Bukidnon. Using a mixed-methods research design, data was collected through a survey-questionnaire, in-depth interviews, and focus group discussions from 142 drug surrenderers. The drug-surrenderers are mostly between 30 and 39 years old, married, with three to four children and low-skilled workers. Majority are high school graduates, thirteen of them were degree holders, and Roman Catholics. Data shows that the drug-surrenderers reports high level of emotional support from friends, significant other, and family. This strengthens the facts that friends, significant other, and family play a critical role in the recovery process of drug surrenderers. The study also found that age, civil status, educational attainment, and gender have a significant impact on perceived social support that shows that people have different attitude and treatment given to drug surrenderers according to their age bracket, civil status and educational attainment. While membership in organization did not show any significant difference on perceived social support. Thus, it is recommended that Community-based rehabilitation program in Baungon should continue to provide services to drug surrenderers. The government and non-government organizations may also work hand-in-hand to fight drug addiction in the country.
La adicción al cannabis es un problema de salud pública creciente asociado a múltiples consecuencias negativas. En respuesta a la necesidad de nuevas modalidades de intervención psicoterapéutica accesibles y eficientes, este estudio evalúa la efectividad de un asistente virtual basado en inteligencia artificial (IA) entrenado en técnicas cognitivo-conductuales. Para ello, se utilizó un diseño pre-experimental con un caso simulado, en el cual dos expertos en adicciones evaluaron la capacidad de dicha intervención. La evaluación se realizó mediante un cuestionario elaborado ad hoc con 9 ítems, con opciones de respuesta en una escala Likert de 10 puntos.Teniendo en cuenta que las puntuaciones máximas admisibles eran de 9 puntos, los resultados mostraron que el asistente virtual tuvo un desempeño positivo, con puntuacionesmedias de 8.22 y 7.56 por parte de los expertos. Las áreas de mayor fortaleza incluyeron Ajuste ético, Formación actualizada, Identificación de creencias subyacentes y Orientación asoluciones. Sin embargo, se identificaron discrepancias en Capacidad analítica, Autoconciencia, Reflexión y Cambio, lo que indica áreas de posible mejora.Se concluye que el asistente virtual mostró potencial en la intervención de adicciones al cannabis, ofreciendo intervenciones basadas en evidencia y éticamente sólidas. Aunque los resultados son prometedores, las limitaciones del diseño pre-experimental sugieren la necesidad de estudios adicionales con metodologías más robustas para confirmar estos hallazgos.
The evidence-based literature included in this chapter provides an in-depth understanding of various aspects related to clinical social work practice and education. The content in the chapter includes but is not limited to topics such as a historical overview of the development of clinical social work, the skills required for clinical social work in the twenty-first century, harm reduction guidelines for clinical social work practitioners, the state of clinical social work in South Africa, COVID-19 and clinical social work and social work education and clinical learning.
Community development through the strength of an esprit de corps shared by members of the community is the main key to ensure a society is free from social ills. However, it is undeniable that the prosperity currently enjoyed has taught society to become apathetic to their surroundings, and even have a negative stigma towards members with a dark past. Therefore, this chapter focuses on the importance of an esprit de corps as a significant mechanism to provide support for community members involved in drug addiction to prevent their relapse. This esprit de corps is based on Ibnu Khaldun’s Theory of Asabiyyah. Issues of drug addiction in rural areas are also discussed. Next, emphasis is given to discussion on the social support factor through community esprit de corps that further encourages more strategic and sustainable community development programmes.
As it does throughout an individual’s personal history of alcohol use, stigma plays a significant role in one’s experience of recovery. Exploring aspects of stigma can help identify the role and meaning that alcohol has taken in an individual’s life and, thus, what is at stake to be both gained and lost for that person in moving toward recovery. In addition to the practical criteria of symptom remission and heavy drinking cessation, we view recovery as a holistic process of behavioral change and psychological growth toward greater health, wellness, and meaning. This understanding can help guide an effective aftercare plan and the employment of relapse prevention strategies that address the affective, cognitive, behavioral, and physiologic/psychiatric dimensions of recovery over time.
ademic stress is an inevitable experience that profoundly disorganizes and declines student’s wellbeing as a result of its devastating and debilitating effects. This study thus, investigated the impact of emotional intelligence and academic self-efficacy training in reducing academic stress of secondary school students. The relative merits of the therapeutic approaches were evaluated in terms of their efficacy. The influence of gender on the treatment packages was also considered.
The study adopted a quasi experimental study with 4 x 2 factorial matrices comprising experimental and the control groups by the row and gender vary at two levels-male and female in the column. A conceptual model was designed to illustrate the treatment package for the eight-week programme on emotional intelligence and academic self-efficacy. A multistage sampling technique was used to select 160 participants into the experimental and control groups. The participants responded to an adapted instrument, Academic Stress Scale (ASS) after establishing its psychometric properties. Analysis of Covariance, Duncan Multiple Range Test and t-test (using the standard error of the mean) where applicable, were the main inferential statistical analyses employed to determine the differential effectiveness of the treatment packages at 0.05 level of significance.
The result obtained revealed that both emotional intelligence training and academic self-efficacy training were effective in reducing academic stress of students. However, emotional intelligence training was found to be more effective while the combination of the therapeutic approaches (emotional intelligence and academic self-efficacy) was found to be the most effective. It was also found that the treatments were not significantly affected by gender. The findings showed that the needed proficiencies for students should require a counselling programme that constitutes emotional intelligence and academic self-efficacy. It is, therefore, recommended that counselling services should be intensified to organize lectures, bookshops, seminars and trainings on emotional intelligence and academic self-efficacy for better enlightenment.
The purpose of this study is to explore the effects of imago psychotherapy on Abstinence Likelihood Inventory, Anxiety and Depression of alcoholics who are hospitalized.The period of this research was from November 30, 1998 to August 2, 1999.The subjects were male alcoholics who were hospitalized and those who were appropriate to the standard of this study in T mental hospital located in Taegu City.There were 60 subjects : 24 were placed in the experimental group and 36 in the control group.The research design was a nonequivalent control group with a non-synchronized design and the theoretical framework was psychodynamic theory. The experimental group was treated by the researcher who leads imago psychotherapy, and the program consisted of six sessions, 90 minutes per session,twice a week.Collected data was analyzed using the chi -square test, paired t-test, ANCOVA with SAS program and the analysis of image process was done. The result of this research was as follows:1. Mean score of trait anxiety was 48.47 and mean score of state anxiety was 45.40.Mean score of depression was very high with 20.63 compared with degree of depression (13.01) in normal group.2. There were no significant differences of abstinence likelihood inventory scores between the experimental and the control group, but the score of the experimental group was greater than that of the control group.3. There were significant differences of trait anxiety scores between the experimental and the control group. Trait anxiety score showed increases in the experimental group, but decreases in control group.4. There were no significant differences of state anxiety scores between the experimental and the control group.5. There were no significant differences of depression scores between the experimental and the control group.Results of this study show the differences of the existing research result.It is a novel attempt to try individual imago psychotherapy with alcoholics.In the beginning of imago psychotheraphy, distinctive feature of image is that patients could not concentrate on one theme, were not systematically organized and did not have pure feeling. But as time passed by, patients could concentrate on one theme and experience his candid anger, sorrow, anxiety, and feeling.Patients would gradually realized the real causes of why he could not control himself.I would like to make following suggestions with the results of this study.
Cigarette smoking is highly prevalent in the United States and associated with a host of negative outcomes. Individuals with elevated mental health conditions who smoke cigarettes are among the most vulnerable in terms of difficulty quitting smoking. Anxiety sensitivity (AS) is one targetable transdiagnostic factor that has consistently been implicated as a prominent and unique individual difference factor relevant to both mental health conditions and smoking behavior. Thus, the present chapter presents an integrated intervention program (Anxiety Sensitivity Reduction Program for Smoking; ASRP-S) developed to target AS in the context of smoking cessation. ASRP-S consists of four in-person treatment sessions focusing on multiple treatment techniques (i.e., cognitive behavioral, motivational interviewing, pharmacotherapy, etc.) and psychoeducation to target AS reduction and smoking cessation. The chapter provides empirical support for the implementation of ASRP-S and suggestions for personalized treatment approaches as well as a practical guide to assist clinicians in utilizing the treatment.
Introduction:
Substance use disorder (SUD) poses a significant public health challenge globally, with substantial impacts on physical and social well-being. This study investigates the interplay between abstinence self-efficacy (ASE), locus of control (LOC), perceived social support (PSS), and various socio-demographic and psychosocial factors among individuals undergoing SUD rehabilitation.
Methods:
Researchers obtained permission from drug rehabilitation centers in Assam, India, and conducted orientation programs for prospective participants. A total of 144 participants, aged 18-65 years, predominantly from rural areas participated in the study. Data was collected through one-to-one interviews, covering socio-demographic history, drug abuse, and administering scales for ASE, LOC and PSS. Collected data underwent digitization and subsequent descriptive and inferential statistical analyses.
Results:
Significant associations were found between ASE and socio-demographic variables, family dynamics, and drug use history, highlighting the importance of considering these factors in SUD rehabilitation. Disturbed family relationships were linked to diminished ASE and higher risk of relapse, emphasizing the role of family support in recovery. Additionally, a negative correlation was observed between ASE and LOC, suggesting that individuals with higher ASE tend to have a more internal locus of control, which positively influences recovery outcomes. Moreover, positive correlations were found between ASE and PSS, particularly from family members, underscoring the importance of social support in fostering recovery. Regression analysis further elucidated the relationships between ASE, LOC, and PSS, emphasizing the predictive value of LOC and the impact of family support on ASE.
Conclusion:
Findings of this study have several implications for developing targeted interventions aimed at strengthening ASE, promoting internal locus of control, and enhancing social support systems.
Relapse prevention therapy is found to be effective in the process of preventing or delaying relapse by persons with alcohol use disorder. It is based on the cognitive-behavioral approach and employs strategies to identify high-risk situations. The study aims to identify high-risk situations and provide relapse prevention therapy to a client with alcohol dependence to maintain abstinence. The study is based on a single-case study design. The case in this context is an individual diagnosed with alcohol dependence syndrome as per the international classification of diseases-10 (ICD-10). A qualitative assessment was conducted to assess the psychosocial background of the client. Following the assessment, psychosocial interventions were provided in the form of relapse prevention therapy sessions at the individual and family psychoeducation. During the follow-ups at 3 months, 6 months, and 1 year after the psychosocial treatment, the individual was found to be abstinent with an improvement in work functioning. Relapse prevention therapy techniques have been effective in helping the client maintain abstinence. The client was also able to develop alternative ways of coping with stressful situations.
Substance Use Disorder is a condition that generally presents comorbidity with other mental health problems, in addition to representing one of the most important health problems with high costs. However, despite social and health efforts, the data show an increase in the incidence and prevalence of this problem and traditional treatments have high dropout and relapse rates. Therefore, it is necessary to contribute to the study of the phenomenon of substance consumption and generate more effective intervention proposals. One of the therapies that has shown effectiveness over traditional interventions aimed at substance use is the Dialectical Behavioral Therapy (DBT). This may be because this therapy offers a multimodal, comprehensive and flexible treatment that can be used transdiagnostically in both adults and adolescents. and because it addresses problematic emotions and behaviors, such as the abuse of psychotropic substances. The present theoretical review aims to show the bases of DBT dialectical behavioral therapy, the adaptations made for cases with substance abuse and the evidence, so far available, of the effectiveness of interventions based on DBT for the management of problems related to consumption. of substances.
Este estudio aborda la prevención de las recaídas del consumo problemático de drogas, concepto propuesto por Marlatt y Gordon en 1985. La última revisión sistemática de este tema, fue elaborada por Ramadas et al. en el 2021. El objetivo de este trabajo ha sido conocer las intervenciones aplicadas para la prevención de recaídas, para ello se realizó una revisión sistemática empleando el método PRISMA con búsquedas en 10 bases de datos. El criterio de selección fue la pertinencia temática, artículos publicados 2017-2023, el título, el resumen con el método IMRD y acceso abierto en idioma inglés. Resultados: Se incluyen 9 artículos que portan ensayos clínicos aleatorios y grupos de control. Cuatro estudios aplicaron mindfulness, cuatro técnicas cognitivo conductuales y uno de farmacología. Discusión: Se declaró alcanzar diferencias significativas entre el grupo de mindfulness con el grupo de control y reportan cambios cualitativos en la reducción de las recaídas de drogas, a partir de un empleo focalizado de técnicas con la mirada en la efectividad clínica. Conclusiones: Las técnicas de mindfulness, terapias cognitivas conductuales, la combinación de fármacos y la aplicación de dispositivos móviles desarrollan autoeficacia, disminución de síntomas y abstinencia permitiendo la prevención de las recaídas.
Objectives. Cognitive-Behaviorally Based Interventions (CBIs) are evidence-based treatments for alcohol and other drug (AOD) use with potential variable effectiveness by population sub-groups. This study used evidence synthesis to examine treatment effect by demographic and study context factors in clinical trials of CBI for AOD. Methods. Studies were systematically identified, and their characteristics and outcome data were extracted and summarized. Standardized mean differences were calculated for within- and between-condition effects on substance use outcomes. Demographic and study context moderators were identified during data acquisition and several sensitivity analyses were conducted. Results. The sample included K = 29 trials and a total of 15 study-level moderators were examined. Information on participants' age, biological sex, and race were reported in at least 26 trials, but information on gender identity, sexual orientation, and ethnicity were reported infrequently or in non-inclusive ways. The mean between-condition effect size was small and moderately heterogenous (d = 0.158, 95% CI = 0.079, 0.238, I2 = 46%) and the mean within-condition effect size was large and showed high heterogeneity (dz = 1.147, 95% CI = 0.811, 1.482, - I2 = 96%). The specific drug targeted in the study and whether biological assay-based outcomes were used moderated between-condition CBI efficacy and the inclusion of co-occurring mental health conditions and study publication date moderated within-condition CBI effects. Conclusions. Results provide preliminary data on study context factors associated with effect estimates in United States based clinical trials of CBI for AOD.
Individuals and teams in the journalism community cover stories relating to death, destruction, and tragedy in society, exposing themselves to potentially traumatic events (PTEs). The aim of this review was to explore: (1) the impact trauma exposure may have on substance use, (2) substance use as a method of coping, and (3) personality profiles that are predictive of substance use. Findings indicate that journalists are exposed to a wide variety of PTEs. Despite substance use being considered a trauma reaction in the broader literature, this connection has not been adequately addressed within journalist samples. The most common substance researched in journalists is alcohol consumption, with few studies considering other substances (e.g., nicotine, caffeine, or illicit substances). Future research with journalist samples could evaluate substance use as a method of coping and incorporate broader theory relating to substance use risk personality profiles. There is a need to bridge the gap that exists between broader trauma and substance use literature and a focus on journalist samples, with the intention of: (1) providing a more holistic understanding of psychosocial issues associated with trauma exposure and substance use to inform diagnosis and treatment, (2) assessing risk and protective factors for this community, (3) informing the development of health promotion and education programs specific to practising journalists and journalistic organisations, and (4) highlighting opportunities for trauma specific education targeted at those training to become a journalist, including protective coping strategies.
To study the structure of beliefs about condom use outcomes, the authors derived and tested 4 psychosocial hypothetical models: (a) a 2-factor model of the personal and social outcomes of condom use; (b) a 2-factor model of the pros and cons of the behavior; (c) a 3-factor model (i.e., physical, self-evaluative, and social) of outcome expectancies; and (d) a thematic 4-factor model of the protection, self-concept, pleasure, and interaction implications of the behavior. All 4 models were studied with a confirmatory factor analysis approach in a multisite study of 4,638 participants, and the thematic solution was consistently the most plausible. Self-concept and pleasure were most strongly associated with attitudes toward using condoms, intentions to use condoms, and actual condom use, whereas protection and interaction generally had little influence. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
This paper examined the relationship of three aspects of personality to sexual risk-taking in gay men: (1). sexual arousability, as propensity for sexual excitation, and propensity for inhibition of sexual arousal in the face of threat (measured by the Sexual Excitation, SES, and Sexual Inhibition, SIS1, SIS2, scales); (2). the relation between negative mood and sexuality; and (3). sensation seeking. Risk-taking was assessed for the past 6 months in relation to unprotected anal intercourse (UAI), oral sex, number of casual partners, and patterns of cruising behavior. A combination of number of partners and use of condoms was used to derive a "longer-term risk" grouping. Two patterns of association were identified. UAI and high risk oral sex were more likely in those with low inhibition of sexual response due to "threat of performance consequences" (i.e., low SIS2) and low trait anxiety (low STAI). High numbers of casual partners and frequent cruising were associated with increased sexual interest in states of depression and high propensity for sexual excitation (SES). Higher "long-term risk" was also associated with low SIS2. Unexpectedly, high SIS1, which is strongly related to vulnerability to erectile failure, was also predictive of higher long-term risk. Possible reasons for this are discussed. Disinhibition from the Sensation Seeking Scales was a positive predictor of all types of sexual risk assessed. All three aspects of personality are of potential relevance to designing better interventions to reduce high risk sexual behavior and in evaluating their effectiveness.
Uganda provides the clearest example that human immunodeficiency virus (HIV) is preventable if populations are mobilized to avoid risk. Despite limited resources, Uganda has shown a 70% decline in HIV prevalence since the early 1990s, linked to a 60% reduction in casual sex. The response in Uganda appears to be distinctively associated with communication about acquired immunodeficiency syndrome (AIDS) through social networks. Despite substantial condom use and promotion of biomedical approaches, other African countries have shown neither similar behavioral responses nor HIV prevalence declines of the same scale. The Ugandan success is equivalent to a vaccine of 80% effectiveness. Its replication will require changes in global HIV/AIDS intervention policies and their evaluation.