theme 1 & 2 & overview relapse & recovery

7/29/2019 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.

theme 1 & 2 & overview relapse & recovery

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