Relapse in Addictions
Since we know that relapse in Additions is closely linked to substance dependency or behavioural addictions, training in preventing relapse is a highly relevant element once the previous phases have been overcome.
The Marlatt and Gordon (1985) model offers effective techniques so that the person does not relapse. Relapse prevention has become one more component of treatment. We can get the person to remain abstinent; if he relapses, he can return to abstinence.
If the person changes their previous lifestyle to a healthy one, they are more likely to stay abstinent long-term. Reality shows us that a lifestyle change is not always easy, especially for opioid addicts. It will depend on multiple circumstances, both the subject and the family and social environment, opportunities, maturity, etc.
When we achieve an abstinence-related lifestyle change, it is more likely and easier to achieve abstinence. The analysis of comorbidity related to the change in lifestyle is of great relevance. Keeping track of it and intervening in the problems associated with addiction is one factor that facilitates the maintenance of abstinence.
Treatment of Addictions. overall model
Next, we present a general model for treating addiction and then continue with a specific technique for specific addictions.
The phases of treatment for a person with an addiction consist of the phases of demand for treatment, evaluation, treatment and follow-up. In turn, within the treatment, six phases are distinguished: detoxification or maintenance; psychological withdrawal or achievement of withdrawal from the substance or cessation of the behaviour; normalization, change of previous lifestyle and search for new alternative goals to addiction; relapse prevention; maintenance program or support program in the short, medium and long term; and, where necessary, controlled gambling or harm reduction programs (e.g., in heroin dependence). In addition, as in other disorders, the psychologist has to implement all available therapeutic resources that our science provides us.
Techniques for Addictions
The different techniques for the above objectives are explained below:
Increased motivation for change
Today we know the importance of motivation for change. In addictive behaviours, it is frequent that many patients do not go to treatment. Of those who attend, a part abandons it after the first sessions, and those who attend only sometimes follow the instructions. Hence, this aspect has become another therapeutic element called motivational interviewing (Miller & Rollnick, 1999).
The Motivational Interview
This type of interview for Addictions is the most suitable way to increase motivation for change. It should not be forgotten that not all people with an addiction voluntarily go to treatment for the first time; this is the exception. Sometimes they come for external reasons, whether family or legal. In other cases, to seek specific help. Retaining the subject in treatment, or retaining him at the beginning so that he can start treatment, is a fundamental question.
The motivational interview (MI) in Addictions allows for addressing the lack of motivation in those subjects in the pre-contemplation or contemplation phases. It uses eight motivational strategies, which effectively motivate the patient to change her behaviour. These are:
- Give information and advice.
- remove obstacles
- Give several options to the patient so that he can choose.
- Decrease the factors that make consumption behaviour desirable
- and promote empathy
- Give feedback.
- Clarify objectives
- Provide you with active help.
With EM, we can not only motivate the subject to carry out the treatment but also break down the barriers and effectively start the change process.