Management of Drug and Substance Abuse

Detoxification Process

This is getting the drug out of the person’s system and seeing him/her through the withdraw system, where drugs dependency starts


Characteristics of clients who are motivated to change

  • Accept the diagnosis given
  • Uncomfortable about the behavior
  • Talk about change willingly
  • Agree with the counselor
  • Follow the course of action
  • They will start, continue and try to sustain change

NB: The counselor’s role is to motivate the client and affirm any small achievement

Effective Motivation Strategy

Motivation is a state of readiness or eagerness to change, which may fluctuate from one time situation to another. This stage is one that can be influenced. Prochaska & Diclemente developed a wheel of change model that shows the stages through which clients pass in course of changing a problem. These include:

i. Pre-contemplation

  1. A person is not considering change, has not contemplated having a problem or needing to make a change. People are very defensive here
  2. People seldom present themselves for treatment but they are made under coercion
  3. They need information and feedback to raise awareness about the problem and the possibility of change

ii. Contemplation

  1. Awareness is already raised but the client considers change and rejects it. They are ambivalent
  2. When they talk about self, they go back and forth between reasons for concern and justification for unconcern (caused by pathological personality traits or defense mechanisms)
  3. The counselor task at this stage is to help tip the balance in favor for change
  4. People come for consultation in the contemplation stage. As a counselor practice motivational interviewing

iii. Determination Stage 

This is a window of opportunity. The counselor helps the client to match i.e. helping client to find a change strategy that is acceptable, accessible, appropriate and effective

 iv. Action Stage

  1. This is what most people think is therapy
  2. The person engages in particular actions intended to bring about change
  3. These changes may or may not be assisted by formal counseling. the goal during this stage is to produce a change in the area

v. Maintenance Stage

  1. the challenge is to sustain the change accomplished by previous action to prevent relapse
  2. maintaining change may require a different set of skills and strategies e.g. quitting a drug, reducing drinking or loosing weight is an initial step followed by the challenge of maintaining assistance or moderation

 vi. Relapse

Help the client to renew the process of contemplation, determination and action stages without becoming stuck or demoralized because of the relapse

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