200 words response
Substance related disorders are classified into 10 distinct categories representing different kinds of drugs. Each producing their own feelings of pleasure for the user, they highly activate a reward system that can inhibit a person’s self-control and cause them to neglect normal activities (
DSM-5). According to Prochaska and DiClemente’s motivational model, clients are encouraged to identify the problems that are caused by their drinking and weigh the costs against the benefits of stopping (Barlow, 2021).
One of the therapy session videos depicted a man named Larry who was in recovery for 7 years (APA, 2006). Larry spoke with Dr. Marlatt about his substance use disorder and the things that he tried that did and did not work for him to learn to abstain. At the time of the taping, Larry was in the maintenance stage according to the motivational model continuum (Barlow, 2021). Larry asserted that he maintained his sobriety by remaining humble, learning to trust others, building a strong support network of friends in recovery, being honest with himself and others, and by praying. According to Barlow (2021), having a social support network is crucial to successful recovery. Dr. Marlatt was encouraging with Larry’s progress and praised his accomplishments, especially those concerned with helping others recover from addiction. During the session, they discussed how much better Larry’s life was with out using harmful substances and focused on all he had gained by giving them up. Larry was sensitive to the needs of others struggling with substance use disorders and desired to give back to others because of those who helped him during his struggle to recover.
In his interview with Larry, Dr. Marlatt used a few of the FRAMES elements as described by Miller and Rollnick (Barlow, 2021). He demonstrated empathy when Larry was describing what life before recovery was like and also how hard the road to recovery was to him. He also empathized with the plight of those that Larry was coaching. Dr. Marlatt applauded Larry’s self-efficacy throughout the session by encouraging each step he mentioned in the process.
The other therapy session video depicted a client named Pat and Dr. William R. Miller (APA, 2011). Unlike Larry, Pat was not in recovery, but was open to the idea. He mentioned that he tried a few times on his own with varying degrees of success, but found the allure of the drugs, particularly heroin to be too powerful for him to resist. Pat was most likely between the contemplation and determination stages of Prochaska and DiClemente’s continuum (Barlow, 2021). Pat acknowledged that what he was doing was wrong but was also hesitant to move forward to plan for recovery that involved getting outside help. Dr. Miller used the motivational interviewing approach by asking him to weigh the pros and cons of his current lifestyle against the possibilities of life without a substance abuse disorder. The cons for Pat included financial issues of drug use and he did not like disappointing his family and girlfriend. With Dr. Miller’s guidance, he imagined a life without drugs where he was married with children and had a successful business as an electrician. Dr. Miller also used elements of FRAMES when talking to Pat. He began with feedback, gave advice, offered a menu of options, and empathized with Pat’s inability to recover without help. He was most interested in a pharmacological option called naltrexone that Dr. Miller described as blocking the effects of heroin so that it would lose its attractiveness. According to research, the efficacy of this treatment for substance use disorders is strongly correlated to the desired outcome of the individual (Bardwell, 2021). The study of 22 HIV positive participants recorded their belief in the outcomes of taking the naltrexone before beginning and then the results they each experienced after using it for a while. Those who were most positive about the final outcome showed far better results than those who were more apprehensive. Hopefully this treatment helped Pat with his recovery and to get to a point where he would be willing to work on building a support system like Larry had to reduce the likelihood of relapse.
References
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). American Psychiatric Publishing.
American Psychological Association (2006, June 14). Preventing Relapse in a Twelve Step Program of Recovery (Part 1 of 2) [Video]. APA PsycTherapy.
to an external site.
American Psychological Association (2011, September 6). Treatment for Drug Abuse Using Motivational Interviewing [Video]. APA PsychTherapy.
Barlow, D. H. (2021). Clinical Handbook of Psychological Disorders A Step-by-Step Treatment Manual (5th ed.). Guilford Press.
Bardwell, G., Jaffe, K., Korthuis, P. T., & Richardson, L. (2021). Participants’ treatment perspectives on a clinical trial on the use of extended-release naltrexone for substance use disorders: Considerations for future clinical research. Journal of Addiction Medicine,
Regarding Prochaska and DiClemente’s Stages of Change Model and the videos provided in this week’s lesson, the first video, titled “Preventing Relapse in a Twelve-Step Program of Recovery (Part 1 of 2),” features a client who is cross-addicted to alcohol and drugs and is about to celebrate seven years of sobriety. The client shares his recovery journey with Dr. Marlatt, focusing almost entirely on his history of working the 12 Steps of recovery in Alcoholics Anonymous. The client has maintained sobriety for seven years and now assists others in their recovery. His motivation level for change can best be described as “Action” because he has initiated and maintained behaviors to address his problems, and “Maintenance,” as his behavior change is considered successful (Barlow, 2021, p. 560). The therapeutic techniques I observed, outlined by Miller and Rollnick in their FRAMES elements of therapeutic techniques, included Dr. Marlatt’s use of Feedback by discussing the client’s seven years of sobriety and its positive impacts, Empathy by understanding the challenges faced during recovery, and Self-Efficacy by acknowledging the client’s success in maintaining sobriety and helping others.
In the second video, titled “Treatment for Drug Abuse Using Motivational Interviewing,” Dr. Miller engages with an adult male who has a history of drug abuse. This client exhibits ambivalent feelings about changing his drug-using lifestyle. The motivation level for change that best describes this scenario is “Relapse” due to the client’s repeated pattern of drug-use behavior. However, at the beginning of the video, the “Contemplation” stage is evident as the client acknowledges the significant costs of his drug use and its negative impact on those around him, despite continuing to use drugs. Additionally, a motivational level of “Preparation” is observed as the client expresses a desire to stop using drugs altogether in pursuit of a happier, healthier life. Dr. Miller effectively uses motivational interviewing to identify the client’s goals, motivations, and values, and to explore a course of action that could potentially lead to an “Action” stage of change. In this video, Dr. Miller emphasized responsibility by allowing the client to acknowledge the need for change. Advice and Menu of Options could be offered by exploring different strategies for quitting drug use, and Empathy is shown by understanding the client’s ambivalence towards change. Differences noted in the text included useful tools such as a Goal Choice Questionnaire, which was identified (Barlow, 2021, p. 570). This would have been useful in the second video. This reminds me of Philippians 4:13: “I can do all things through Christ who strengthens me.” This verse encapsulates the essence of overcoming challenges and making transformative life changes. It also resonates with the therapeutic techniques of Feedback, Empathy, and supports the concepts of Responsibility and Self-Efficacy in the context of seeking a healthier, substance-free life, reflecting the motivational interviewing techniques aimed at facilitating change.
Reference
Barlow, D. H. (2021). Clinical handbook of psychological disorders: A step-by-step treatment manual, 6th ed. New York, NY: The Guilford Press. ISBN: 9781462547043.
New International Bible. (2011). The NIV Bible. work published 1978)
