Cognitive model of addictive behaviour

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Can I give up ?

What is CBT ?Why does it work?

Remember ….A=Activating event: The client records the event that led to the disordered thinking (e.g. exam failure)B= Beliefs: the client records the negative thoughts associated with the event (e.g. “I’m useless and stupid”)C= Consequence: client records negative thoughts or behaviour that follows D – Disputes- Therapist strongly disputes these thoughts

Utube clip

CBT

Utilizes ….. CBTCognitive Behavioural Therapy

The ‘Relapse Prevention’ (RP) Model

(Marlatt and Gordon 1985) • Although the RP Model concentrates mainly on the

factors that will influence success or failure of an addict who trys to become abstinent, there is considerable overlap with processes that may be involved in the initial development of an addiction (initiation)

• For addicts, there will be a range of discrimiative stimuli (a term borrowed from operant conditioning that refers to stimuli that indicate the appropriateness or ‘rewardingness’ of specific behaviour).

• For example: one addict may have learned that heroine use is more rewarding when they are ‘down’ rather than we they are ‘happy, while another may have learned that heroin is particularly exciting when they are with other users but less so when they are on their own (Powell 2000)

DSs = “Drug Using Friends” (e.g. for heroin use)

• If after becoming drug free, an addict meets one of these Dss, they will be at high risk of relapse.

For example: if a female addict meets one of her drug using friends. However, the addicts ability to survive any threat to abstinence is influenced by various other factors including:

• The strength of his/her motivation not to use• Knowledge of alternative strategies for coping with the

situation• Self-efficacy• A shortfall in any of these factors will increase

vulnerability to relapse..

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The ‘Relapse Prevention’ (RP) Model (Marlatt and Gordon 1985)

Activity: Using textbook page 402-3 use this model to explain; why an addict may relapse in a high-risk situation.

•Lacks coping response•Decreases self-efficacy which prevents a positive outcome - reverts to previous expectations of how substance can help•Reminder of initial use of substance•Stops person from abstaining from use due to perceived effects of substance •Result - increased Probability of relapse

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The role of Cognitive processes (destructive and productive) in the promotion or reduction of addictive behaviour

Activity: Use textbook page 402-404-take notes on the following

The abstinence violation effect (AVE)Drug use seen as incompatible with previous determination to remain abstinence

Cognitive dissonanceWhen two cognitive thoughts are psychologically inconsistent ‘I am a drug addict’ ‘I want to remain abstinent’. Festinger – creates a state of cognitive dissonance

Dissonance (personal/internal attribution)Negative drive state ‘psychological discomfort or tension’ motivating personto reduce it by achieving consonance (consistency or balance||)

Reduction of dissonance Attitude change a major way of reducing dissonanceInvolves changing one or more cognitions (things person knows about themselves, their behaviour and their surroundings

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Evaluation of the ‘Relapse Prevention’ model

Theoretically rich•Ideas common with other theories, i.e. Theory of Reasoned Action (TRA)/Theory of

Planned Behaviour TPB) – both have considerable empirical support.

•RPM and TRA - share the common idea of motivation to comply with other’s expectations.

•Link with Cognitive Dissonance Theory ( a major theory of attitude change) as it applies to health matters e.g. Smoking and drug taking

Substantial evidence in support of the general principles•Cummings et al (1980) - alcoholics, smokers, gamblers, overeaters relapse when experienced negative emotional state – addictive behaviour effective in escaping stress

•Stressful situations risky to recent ‘quitters’• Miller et al (1996) – progress of alcoholics – strongest predictor of relapse - Lack of coping skills

• Research is flourishing - see journal Addiction (1996)

Implications for treatment•No single treatment applicable to every client•Awareness of different factors influencing attitudes and expectations•Therapists - free from assumptions•Broad theoretical framework - principles to develop individual treatment

Timed exam question

• Explain how Classical Conditioning explains addictive behaviour (5 marks)

• Outline and evaluate two learning models as explanations of initiation and maintenance of smoking addiction in young people (10 marks)

• Explain two Cognitive processes (one destructive, one productive) involved in the promotion or reduction of addictive behaviour (4 + 5 marks)

Other sample exam questions

Explain how Classical Conditioning explains addictive behaviour (5 marks)

Outline and evaluate two learning models as explanations of initiation and maintenance of smoking addiction in young people  (10 marks)

Outline and Evaluate the Social Learning Theory of addictive behaviour

(10 marks)

 

Explain two Cognitive processes (one destructive, one productive) involved in the promotion or reduction of addictive behaviour (3 + 3 marks)

 

Outline and evaluate a Cognitive Model of Prevention as an explanation of addictive behaviour (10 marks)

Possible Question

“Outline and evaluate the cognitive model of addiction, including explanations for initiation, maintenance and relapse.”

(8+16 marks)

Exam question – Monday 4th March

a) Outline and evaluate two learning models as explanations of initiation and maintenance of smoking addiction in young people

(10 marks)

REVISION OF MODELS OF ADDICTION

Now a ..

1. Instructions

Divide into four groups or sit at 4 tablesLook through notes/textbook, etc

MODELS OF ADDICTIVE BEHAVIOUR

2. Then …Then make up 5 pub style questionsThey must be as difficult as possible-but

still be able to win. Write an answer sheet for all the

questions. When each team has 5 questions the pub

quiz beginsGroup 1-BiologicalGroup 2-BehaviouralGroup 3-CognitiveGroup 4 -All

3. Instructions You will be given a sheet with 1 – 15 on it

(answer sheet)Team 1 ask teams 2, 3 and 4 their questions Team 2 then asks teams 1, 3 and 4 their

questions etcAt the end the tables swap answers for

marking and each team reads the answers out.You can take questions from teams about the

answers you have in front of you..Winning team is the team with the most

points