OVERVIEW of Addiction, Recovery and Relapse

THEME 1 HELPING CLIENTS IDENTIFY HIGH-RISK RELAPSE FACTORS AND DEVELOP STRATEGIES TO DEAL WITH THEM

THEME 2 : HELPING CLIENTS UNDERSTAND RELAPSE IS A PROCESS AS WELL AS AN EVENT

OVERVIEW
APA YANG ADA DALAM OTAK SEORANG PENAGIH DADAH / SUBSTANS?

OVERVIEW ADDICTION VS RECOVERY

THE BRAIN IS ABNORMAL

THE BRAIN WAS CHANGE!

KENAPA SUSAH NAK BERHENTI?

DOPAMINE BRAIN REWARD YG MERASA KELAZATAN / KESERONOKAN/ KESEDAPAN/KEGEMBIRAN

PENGAMBILAN DADAH AKAN MERANGSANG SALURAN DOPAMINE DAN MENGUBAH (MAKANAN TIDAK LAGI MENCUKUPI UTK MERASA KELAZATAN KOMUNIKASI GAGAL!!

TINDAKBALAS NEURON SEORANG YG MENAGIH SUBSTANS

LAST RESULT BRAIN DISEASE

CRITERIA OF ADDICTIVE BEHAVIOUR Griffiths (1996)

Salience: The behaviour becomes the most important thing to the person and they have it on their minds for much of the time.

Mood modification The addict gets a rush or buzz when engaged in the behaviour. The addict is also able to use their behaviour to bring about a mood change. Interestingly, the same chemical or behaviour can alter mood in different directions depending on time or setting. Nicotine can stimulate in the morning or relax before sleep.
3. Tolerance Usually associated with chemical addiction such as alcohol or heroin, this one can also be applied to behaviours. Basically the addict needs bigger and bigger hits to get the same effect as they did initially with smaller amounts. Risk-taking behaviour, for example, tends to get more extreme over time. 4. Withdrawal symptoms Changes in mood, shakes, irritability etc. as a result of cessation. Applies to behavioural as well as chemical addiction. 5. Conflict The pursuit of short term pleasure can cause conflict with other; parents, spouse, friends and can also result in conflict within the person. 6. Relapse A tendency to return to the behaviour, months or even years after an apparent cure. Again this is just as common with behavioural addiction as it is with chemical.

PENAGIHAN & KEPULIHAN??

ANY ONE?

TEORI / MODEL

PROSES

PROSES

FENOMENA PENAGIHAN VS KEPULIHAN ADDICTION VS RECOVERY

BIOLOGICAL

PROCESS
ADDICTION

PSYCHOLOGY

PROCESS
RECOVERY

SOCIAL

* This model adapted from Transtheoretical Model Behaviour of

Change (Prochaska and DiClemente (1983)

WHAT IS RECOVERY?
?

? Recovery
? ?

RECOVERY IS..
ABSTINENS MANY CRISIS (ESP 1-2 YRS) NO TIME LIMIT INDIVIDUAL PROCESS NOT USING ANY SUBSTANCE

CHANGE LIFESTYLE

LIFE TIME PROCESS

RECOVERY PROCESS (Gorski & Miller)

PROGESSION OF RECOVERY
FROM BASIC TO MORE COMPLEX

Abstinence (learning to live w/ot drugs)

To

Sobriety (learning to cope with To live w/out drugs)

Comfortable living (learning to To live comfortably while abstinence)

Productive living
( learning how to build a meaningful sober life)

SUPER SPONTAN!..

Buat ayat : KEPULIHAN ADALAH. PENAGIHAN ADALAH.. OTAK SEORANG PENAGIH DADAH.. GORSKI & MILLER ADALAH PERINGKAT PERINGKAT KEPULIHAN ADALAH.. ABSTINENS IALAH.. SOBRIETY IALAH.. KEPULIHAN BUKAN HANYA TIDAK MENGGUNAKAN DADAH TETAPI.. PROSES KEPULIHAN MENGAMBIL MASA PERKEMBANGAN DALAM KEPULIHAN ADALAH DARIPADA ABSTINENS.KEKEKE.. DAN KE

WHAT IS RELAPSE?

RELAPSE IS

RELAPSE RATE

Coping response

Increased self-efficacy

Decreased probability of relapse

High-risk situation

Decreased self-efficacy No coping response Slip Positive outcome expectancy of behaviour

Rule Violation Effect dissonance, conflict & selfattribution guilt & perceived loss of control

Increased probability of relapse

Marlatt & Gordon Model of Relapse Prevention

Application to the model

Thanks but I have stopped smoking Increased self-efficacy Decreased probability of relapse

Going to pub, friend offers a cigarette Decreased self-efficacy- I am too weak to resist and anyway, Im in a really bad mood, this will cheer me up

Oh go on then, Ive had a bad day

Slipsmokes

Rule Violation Effect I am hopeless, I promised I would never smoke again. Might as well go an get a packet- Ill never be able to give up!

Increased probability of relapse

Relapse process Gorski & Miller

1. denial 2. Avoidance &defensive 3. Crisis building 4. immobilization

5.Confussion & overreaction

6.depression

7. Behavioral loss of control

8. Recognition of loss of control

9. Option reduction

10. The relapse episode

RELAPSE RATE..

THANK YOU

SUPER SPONTAN!..

Buat ayat : RELAPSE ADALAH. PROSES RELAPSE ADALAH.. RELAPSE BERLAKU KERANA.. GORSKI & MILLER MENYATAKAN PROSES RELAPSE MENGANDUNGI 10 FASA IAITU: GORDON & MARLATT MENYATAKAN PROSES RELAPSE IALAH.. PADA PENDAPAT SAYA, PENAGIHAN BOLEH DIURUSKAN DENGAN CARA.