theme 1 & 2 & overview relapse & recovery
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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 of Addiction, Recovery and Relapse
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OVERVIEW
APA YANG ADA DALAM OTAKSEORANG PENAGIH DADAH /
SUBSTANS?
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OVERVIEW
ADDICTION VS RECOVERY
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THE BRAIN IS ABNORMAL
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THE BRAIN WAS CHANGE!
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KENAPA SUSAH NAK BERHENTI?
DOPAMINEBRAIN REWARD YG MERASA KELAZATAN / KESERONOKAN/KESEDAPAN/KEGEMBIRAN
PENGAMBILAN DADAH AKAN MERANGSANG SALURAN DOPAMINE DAN MENGUBAH
(MAKANAN TIDAK LAGI MENCUKUPI UTK MERASA KELAZATAN
KOMUNIKASI GAGAL!!
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TINDAKBALAS NEURON SEORANG YG
MENAGIH SUBSTANS
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LAST RESULT BRAIN DISEASE
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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.
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PENAGIHAN & KEPULIHAN??
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ANY ONE?
TEORI / MODEL
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TEORI / MODEL
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PROSES
PROSES
FENOMENA PENAGIHAN VS KEPULIHAN
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FENOMENA PENAGIHAN VS KEPULIHANADDICTION VS RECOVERY
BIOLOGICAL
PSYCHOLOGY
SOCIAL
PROCESS PROCESS
* This model adapted from Transtheoretical Model Behaviour of
Change (Prochaska and DiClemente (1983)
ADDICTION RECOVERY
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WHAT IS RECOVERY?
Recovery
?
?
?
?
?
?
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RECOVERY IS..
NO TIMELIMIT
ABSTINENS
CHANGE
LIFESTYLE
NOT USING
ANYSUBSTANCE
LIFE TIMEPROCESS
INDIVIDUALPROCESS
MANYCRISIS (ESP
1-2 YRS)
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RECOVERY PROCESS (Gorski & Miller)
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PROGESSION OF RECOVERY
Productiveliving
( learning howto build a
meaningfulsober life)
Comfortable
living(learning to
livecomfortably
whileabstinence)
Sobriety(learning tocope withlive w/out
drugs)
Abstinence(learning to
live w/otdrugs)
FROM BASIC TO MORE COMPLEX
To To To
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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 DARIPADAABSTINENS.KEKEKE.. DAN KE
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WHAT IS RELAPSE?
? ? ?
? ?
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RELAPSE IS
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RELAPSE RATE
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High-risk
situation
Copingresponse
Increased
self-efficacy
Decreased
probability of
relapse
No copingresponse
Decreased
self-efficacy
Positive
outcome
expectancy of
behaviour
Slip
Rule Violation
Effect
dissonance,
conflict &
self-
attributionguilt &
perceived loss
of control
Increased
probability
of relapse
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Marlatt & Gordon Model of Relapse Prevention
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Application to the model
Going to pub, friend
offers a cigarette
Thanks but I have
stopped smoking
Increased
self-efficacy
Decreased
probability of
relapse
Oh go onthen, Ive
had a bad
day
Decreased
self-efficacy- I
am too weak
to resist and
anyway, Im ina really bad
mood, this
will cheer me
up
Slip-
smokes
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
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Relapse process Gorski & Miller
1. denial2. Avoidance&defensive
3. Crisis building4.
immobilization
5.Confussion &overreaction
6.depression 7. Behavioralloss of control
8. Recognitionof loss ofcontrol
9. Option
reduction
10. The relapse
episode
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RELAPSE RATE..
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THANK YOU
!
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SUPER SPONTAN!..
Buat ayat :
RELAPSE ADALAH.
PROSES RELAPSE ADALAH..
RELAPSE BERLAKU KERANA..
GORSKI & MILLER MENYATAKAN PROSES RELAPSEMENGANDUNGI 10 FASA IAITU:
GORDON & MARLATT MENYATAKAN PROSES RELAPSEIALAH..
PADA PENDAPAT SAYA, PENAGIHAN BOLEH DIURUSKANDENGAN CARA.
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