Self efficacy Self efficacy and Problem solving and Problem solving in addiction disordersin addiction disorders

By By

Ahmed Albehairy, M.DAhmed Albehairy, M.D

Psychiatry ConsultantPsychiatry Consultant

IntroductionIntroduction

Possibility of relapse in addiction therapyPossibility of relapse in addiction therapy

Relapse preventionRelapse prevention

Key Themes in Relapse PreventionKey Themes in Relapse Prevention

1- identify risk relapse factors and develop 1- identify risk relapse factors and develop strategies to deal with.strategies to deal with.

2- understand relapse as a process and as an 2- understand relapse as a process and as an event.event.

3- understand and deal with cues and cravings.3- understand and deal with cues and cravings.

4- understand and deal with social pressures to 4- understand and deal with social pressures to use substance.use substance.

5- develop and enhance a supportive social 5- develop and enhance a supportive social network.network.

Key Themes in Relapse PreventionKey Themes in Relapse Prevention

6- develop methods of coping with negative 6- develop methods of coping with negative emotional states.emotional states.

7- assess the pt. for co morbid psychiatric 7- assess the pt. for co morbid psychiatric disorder.disorder.

8- help and learn the pt. methods to cope 8- help and learn the pt. methods to cope with cognitive distortions.with cognitive distortions.

Relapse warning signs!!!????Relapse warning signs!!!????

- Attitude changes.Attitude changes.

- Thoughts changes.Thoughts changes.

- Mood changes.Mood changes.

- Behavior changes.Behavior changes.

What is self What is self EfficacyEfficacy????????

self-efficacy as our belief in our ability to self-efficacy as our belief in our ability to

succeed in succeed in specific situationsspecific situations. .

high risk factors internal, external( thoughts, high risk factors internal, external( thoughts, feelings, people, places, events and things )feelings, people, places, events and things )

Factors affecting self-efficacyFactors affecting self-efficacy

BanduraBandura points to points to four four sources affecting self-efficacy;sources affecting self-efficacy;

1. 1. ExperienceExperience – "Mastery experience" is the most important factor deciding a "Mastery experience" is the most important factor deciding a

person's self-efficacy. Simply put, success raises self-efficacy, person's self-efficacy. Simply put, success raises self-efficacy, failure lowers it. failure lowers it.

2. 2. Modeling - a.k.a. "Modeling - a.k.a. "VicariousVicarious Experience Experience" " – ““If they can do it, I can do it as well.” This is a process of If they can do it, I can do it as well.” This is a process of

comparison between a person and someone else., comparison between a person and someone else., modelingmodeling

Factors affecting self-efficacyFactors affecting self-efficacy

3. 3. Social PersuasionsSocial Persuasions – Social persuasions relate to Social persuasions relate to

encouragements/discouragementsencouragements/discouragements. These can have a strong . These can have a strong influence – most people remember times where something said influence – most people remember times where something said to them significantly altered their confidence. Where positive to them significantly altered their confidence. Where positive persuasions increase self-efficacy, negative persuasions persuasions increase self-efficacy, negative persuasions decrease it. It is generally easier to decrease someone's self-decrease it. It is generally easier to decrease someone's self-efficacy than it is to increase it. efficacy than it is to increase it.

4. 4. Physiological FactorsPhysiological Factors – In unusual, stressful situations, people commonly exhibit signs of In unusual, stressful situations, people commonly exhibit signs of

distress; shakes, aches and pains, fatigue, fear, nausea, etc. A distress; shakes, aches and pains, fatigue, fear, nausea, etc. A person's perceptions of these responses can markedly alter a person's perceptions of these responses can markedly alter a person's self-efficacy. person's self-efficacy.

Cognitive behavioral model of the Cognitive behavioral model of the relapse processrelapse process

High risk situations

Coping response

IncreasedSelf efficacy

Decreased Probability Of relapse

NoCoping

response

Decreased Self efficacy

Initial use Of

substance

AVE

disonance conflicts

Self attribution

Increased Probability

Of relapse

Tools of managing self efficacy in Tools of managing self efficacy in addict addict

- Individual psychotherapy .Individual psychotherapy .- Group .Group .- Team work.Team work.- Motivational skills.Motivational skills.- Ex addict .Ex addict .- Family involvement.Family involvement.

- Relapse and lapse investigations.- Relapse and lapse investigations.

Self efficacy and solve problem Self efficacy and solve problem

- Psycho education Psycho education - Anticipation of risky situations .Anticipation of risky situations .- Discussion ??????Discussion ??????- Training , motivation.Training , motivation.- List of problems List of problems - Prioritize the problems .Prioritize the problems .- Analysis of the problems.( cognitive errors - Analysis of the problems.( cognitive errors

and other related psychosocial issues).and other related psychosocial issues).

Problem solving Problem solving

- Alternative solutions.Alternative solutions.

- Choose the suitable solution ( with, - Choose the suitable solution ( with, against, and key persons).against, and key persons).

- Test the solution .Test the solution .- Approve the solution or choose other Approve the solution or choose other

alternative.alternative.

- Recycle and repeat.- Recycle and repeat.

Types of problems to be solved Types of problems to be solved

- cues.cues.- Craving Craving - Psychiatric disorders.Psychiatric disorders.- Medical disorders.Medical disorders.- Legal problem.Legal problem.- Family .Family .

- financial.- financial.

Self efficacy and problem solving Self efficacy and problem solving meanmean

Continous motivation for change of Continous motivation for change of - Attitude .Attitude .

- Thoughts .Thoughts .

- Mood .Mood .

- Behavior .Behavior .

Thank youThank you