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Substance Use Disorders
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Options for the evaluation of illicit substance use include interview, questionnaires, and chemical tests. Use of open-ended questions and motivational interviewing techniques may be helpful [10]. The “4 Ps” is a frequently recommended screening tool for pregnant patients (Table 23.3). SURP-P (specifically designed for pregnant patients), T-ACE, TWEAK (specific to alcohol), CAGE-AID, CRAFFT (for patients 26 years or younger), NIDA Quick Screen, and DAST are other available options. None of these have been proven to be both highly sensitive and specific [11].
Behavioral Change
Published in James M. Rippe, Manual of Lifestyle Medicine, 2021
A considerable amount of training is necessary to effectively deliver motivational interviewing. This can be learned and delivered by any health care provider as long as they have background training. A full depiction of motivational interviewing is beyond the scope of the current chapter; however, the classic book on this is entitled “Motivational Interviewing: Helping People Change Their Lives” and offers a wealth of information on this technique.
Obsessive-Compulsive Disorder (OCD)
Published in Judy Z. Koenigsberg, Anxiety Disorders, 2020
How has motivational interviewing (MI) been integrated with cognitive-behavioral therapy (CBT)? Motivational interviewing underscores the following principles: Showing empathy, pointing out discrepancy, moving with resistance, and facilitating self-effectiveness (Miller & Rollnick, 2002). Why integrate motivational interviewing with other treatments? Although research has shown that patients who are recipients of motivational interviewing at the inception of an intervention achieve a more effective outcome than patients who do not receive motivational interviewing, motivational interviewing can be used throughout the therapy process (Miller & Rollnick, 2002). Tolin and Maltby (2008) used motivational interviewing (MI) with patients with obsessive-compulsive disorder (OCD) who refused exposure and response prevention (ERP) interventions. They employed MI in order to engage the aforementioned patients in treatment.
Opportunities for social workers to mitigate unjust substance use policy
Published in Journal of Social Work Practice in the Addictions, 2023
Social workers have long embraced a client-centered, nonjudgmental approach to practice, as Rogers (1961) described. Rogers (1961) Client-Centered Approach highlights the importance of being an empathic, authentic clinician and ‘prizing’ and accepting clients wherever they are at. Rogers purported that if we truly accept a person for who they are, that creates the conditions for that person to accept and love themself, which, in turn, would be healing. The remnants of Rogers’ approach are evident in the stance of Motivational Interviewing (Miller et al., 2019). Even though Motivational Interviewing is one of the most widely used approaches by clinicians who work with people who use substances, consistent fidelity to the model is challenging to sustain, with limited training, supervision, and burnout being obstacles to overcome in often underfunded and overwhelmed programs. These are exactly the conditions Lipsky (2010) describes as contributing to shortcuts and routines in practice that reinforce negative stereotypes of clients and lead to practices like triage and creaming. For example, clients are described as resistant when the rigid structure of substance use treatment is not a good fit for where they are at. Workers do not often have the time or energy to elicit from the client their individualized view of recovery but rather make assumptions about them. The benefits are noteworthy of a consistent client-centered approach to working with people who use substances. Healing interactions that could mitigate the experience of a punitive policy and a system based too heavily on the notion of personal responsibility.
Substance Misuse among a Diverse Psychiatric Inpatient Sample: Suicidal Thoughts and Behaviors and Motivation to Change
Published in Behavioral Medicine, 2023
Julia D. Buckner, Raymond P. Tucker, Paige E. Morris, Caroline R. Scherzer, Kathleen A. Crapanzano, Sarah Pardue-Bougeois
Group MET-CBT sessions were administered in 60-minute sessions three (January–June 2020) or five (June 2020–August 2021) days per week. There was no limit to how many sessions patients could attend. Session topics were chosen from a MET-CBT for SUD manual10 and included goal setting, functional analysis, coping with cravings, managing thoughts about use, refusal skills, and seemingly irrelevant decisions (SIDs). Motivational interviewing techniques (e.g., discussing the pros and cons of substance use) were incorporated in all sessions. These topics were presented weekly. Half (51.4%) of patients attended more than 1 session (M = 2.0, SD = 1.3) with a range of 1–8 sessions. On average, there were 3 patients (range = 1–10 patients) per group. Each session was conducted by two trained clinical psychology graduate students under the supervision of the first author, a licensed clinical psychologist with over 10 years of experience with MET-CBT for SUD.
Perceived barriers to addiction treatment: an inductive qualitative content analysis
Published in Journal of Substance Use, 2022
Hamid Tavakoli Ghouchani, Mohammad Reza Armat, Hadi Akbari, Seyed Kaveh Hojjat, Hossein Lashkardoost, Dordane Asghari, Nazanin Gholizadeh, Hassan Saadati
Low self-efficacy is a personal trait and a major barrier to addiction treatment. Some studies have reported that most people cite low self-efficacy and inability to continue treatment as the most important cause of delaying the treatment (Tavakoli Ghouchani et al., 2016). In addition, the influence of addicted friends, and failing to manage the relations with them are barriers to seeking and continuing treatment which are signs of decision-making problems (ONDCP, 2007) Zvolensky’s study revealed that fears of increased withdrawal symptoms and low self-efficacy are barriers to addiction treatment (Zvolensky et al., 2018) Alexander’s study of 202 amphetamine users identified three major barriers to treatment: low self-efficacy, conflicting thoughts about methamphetamine use, and fear of withdrawal symptoms. (Alexander et al., 2018) On the other hand, the study by Tavakoli et al. showed that about 70% of drug users are not being able to stop drug use, because they found themselves incapable of stopping drug use (Tavakoli-Ghouchani et al., 2009). Therefore, motivational interviewing should be used in the treatment of substance users (Rimaz et al., 2013).