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Assignment 1: The Five stages of Change

By Saturday, July 30, 2016, respond to the discussion in the Discussion Areabelow. Comment on your classmates’ submissions and continue the discussion untilWednesday, August 3, 2016.

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Discussion Question

Anthony is a 27 year old heterosexual Caucasian male. He was arrested 2 weeks ago for his second DWI and is facing a license suspension. He works as a delivery driver for a local store and after disclosing the arrest to his employer, as well as the consequences including loss of his license, he was terminated. Anthony lives with his girlfriend of 3 years and their 2 year old son. Anthony’s drinking behavior has increased to consumption of a case of beer on Saturday and Sunday evenings each week. He consumes several beers after work during the week “to maintain.” He has also been using methamphetamines, specifically “crystal meth” several times weekly. Anthony’s girlfriend ended their relationship as a result of his increasing substance use and ongoing difficulties. Anthony feels depressed and anxious about his current life situation, especially now that he realizes that he has no job and may be homeless because of his substance use. He is also feeling down about the loss of his relationship. He researched a few outpatient treatment programs to help him stop using both alcohol and methamphetamines, but is ambivalent about entering treatment. Anthony has considered the need to stop using substances to improve his life and relationships with significant others, though fears that he will lose his friends and miss partying with them if he stops. He also fears what life will be like without the comfort of getting high.

Consider and discuss the 5 stages of change. Based upon the information provided discuss what stage Anthony is in, and provide a rationale for your decision. Next, discuss the other stages of change and what indicators we might see as Anthony progresses on through these stages.  Your posting must be a minimum of 500 words.

Class, 

I have attached an interesting article regarding comparative treatment. Feel free to use this article as a source in your discussion.

 12 step and CBT for substance abuse.pdf
Class, 

I am attaching a clip regarding countertransference in treatment from an analyst point of view. 

http://www.youtube.com/watch?v=BAMS7QC3F-I
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One of the ways for intervention for substance abuse offenders is to follow the stages of change model. Developed by James Prochaska and Carlo Diclemente, the model propounds five stages in the potential behavioral change process of an addict or abuser. Based on the stage in which clients are situated, you can choose the appropriate treatment interventions and modalities for them. The choice of treatment or intervention to use in any stage depends on their appropriateness to a given client and situation. These five stages are:

  • Precontemplation: In this stage, substance abusers do not think they have a problem, regardless of the severity of their substance abuse. For example, Sam is a student. He takes cocaine daily, believing it helps him reduce stress. Despite the continuous deterioration of his performance in exams and problems with his parents, he doesn’t believe that his cocaine use is a problem. According to the study by Diclemente and Prochaska in 1998, at least 80 percent of persons with substance abuse problems at any time are in the precontemplation or contemplation stage. In this stage, a counselor should use the motivational interviewing technique to convince Sam that he has or may have a substance abuse problem, which may negatively affect his life. The motivational interviewing technique helps build a substance abuser’s readiness to change. Other approaches that may be used in this stage are unilateral family therapy and community reinforcement approach to family training. You will learn more about these techniques and approaches in the later weeks.
  • Contemplation: In this stage, the substance abusers are ambivalent about the change. They see the benefits of change but are reluctant to give up the abuse of substances. For example, Jack has problems with his wife and children. Due to the problems, his wife files for divorce. He feels that the problems may be because of his excessive drinking but says that he enjoys drinking. The counseling strategy in this stage should be to reflect the positive aspects of change to Jack.
  • Preparation: In this stage, the substance abusers begin considering change and different alternatives for the change. For example, Jack wants to stop drinking but doesn’t know if it is possible. The counseling strategy in this stage should be to prepare a change plan, which you will study in details in the later weeks, with the client.
  • Action: The change plan prepared in the preparation stage is implemented in this stage. For example, Jack knows it is difficult to give up drinking, but wants to give it up for his family. The counseling strategy in this stage should be to proceed from small to big goals.
  • Maintenance: This stage comes when a client does not abuse substances for at least six months. In this stage, steps are taken to prevent relapse. An example of a statement by a person in this stage is, “I am now completely free from substance abuse. Therefore, taking cocaine once or twice will not make much difference.”

please include 5 references.

references from material I have included can be labeled argosy and I will do the rest. Thank you

 
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