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P00: frame around

P01: olicognography

P02: addictions

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User

You?
Use?
Perspective?
Usage?
Concern

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OLICOGNOGRAPHY on ADDICTIONS

System

Engineering

Development

Scale

Health

Social

Addiction and Psychology

Basic Olicognograph: Addict Psychologic Management

Components of the mental state observe like: 1) Appearance and behaviour; 2) Orientation; 3) Attention and concentration; 4) Memory; 5) Mood and affect; 6) Speech and language; 7) Perceptions - Thought content - Insight.

Commonly Considered Character Defects: 1) Inappropriate 2) Anger 3) Self-Centeredness 4) Lust Impatience 5) Overcriticalness 6) Low Self-Esteem 7) Exploitativeness 8) Overconfidence 9) Dishonesty.

Psychotherapy Counselling: 1) Short and long term goals; 2) Cognition, emotional and behavioral goals; 3) Goals related to all areas of recovery; 4) Focus on the past and preserve the present.

Evidence-based practices for substance use disorders assessment. 1. Cognitive Behavioral Interventions – approach involves using awareness and skillbuilding activities with clients. 2. Community Reinforcement – approach involves connecting the client with other needed agencies and services in the community. 3. Motivational Enhancement Therapy – approach involves using motivational interviewing strategies and interventions that are based on a “stages of change model”. 4. 12-Step Facilitation – This is a structured, individualized approach for introducing clients to a 12-steps program. This can result in better meeting attendance for a longer period of time. 5. Contingency Management – approach includes behavioral contracting where clients have opportunities to earn rewards for specific desirable behaviors. Data demonstrates that stimulant users respond well to this approach, stay in treatment longer, make measurable progress and have better treatment outcomes. 6. Pharmacological Therapies – There is strong evidence that medication like Antabuse, Naltrexone, Methadone and Buprenorphine when used in conjunction with other therapies can help stabilize a person’s life when their alcohol or drug use is out of control. 7. Systems treatment – This term refers to treating clients in their natural social environment. Couples therapy, family therapy, and multi-systemic family therapy are examples . There is substantial evidence indicating that clients whose families are engaged in the treatment process show improved outcomes. Systems treatment appears to be effective with young people. 8. Integrated Dual Disorders Treatment – approach helps people recover by offering mental health and substance abuse treatment services together, in one setting. The same clinicians (or team of clinicians) offer an individualized treatment plan, which addresses both the mental health and substance abuse problems. A wide range of services is offered in a stage-wise fashion, as service needs change over the course of treatment.

Treatment Modality Matrix

behavioral pattern

intervention

goals

low self-esteem, anxiety, verbal hostility

relationship therapy, client centered approach

increase self esteem, reduce hostility and anxiety

defective personal constructs, ignorance of interpersonal means

cognitive restructuring including directive and group therapies

insight

focal anxiety such as fear of crowds

desensitization

change response to same cue

undesirable behaviors, lacking appropriate behaviors

aversive conditioning, operant conditioning, counter conditioning

eliminate or replace behavior

lack of information

provide information

have client act on information

difficult social circumstances

organizational intervention, environmental manipulation, family counseling

remove cause of social difficulty

poor social performance, rigid interpersonal behavior

sensitivity training, communication training, group therapy

increase interpersonal repertoire, desensitization to group functioning

grossly bizarre behavior

medical referral

protect from society, prepare for further treatment

source: nfm

Psychology-psychiatry has to catch a synchronic sense (since the diachronic moment) according the development of addictive pathways. Addiction in a psychologic sense is not so a matter of product problem but is patient centered. For example of the Stages of Adolescent Substance Abuse. Stage Description: 1) Potential for abuse - Decreased impulse control - Need for immediate gratification - Availability of tobacco, drugs, alcohol, inhalants - Need for peer acceptance. 2) Experimentation: learning the euphoria - Use of inhalants, tobacco, marijuana, and alcohol with friends - Few, if any, consequences. May increase to regular weekend use. Little change in behavior. 3) Regular use: seeking the euphoria - Use of other drugs, eg, stimulants, lysergic acid diethylamide (LSD), sedatives - Behavioral changes and some consequences - Increased frequency of use; use alone - Buying or stealing drugs. 4) Regular use: preoccupation with the “high” - Daily use of drugs - Loss of control - Multiple consequences and risk-taking - Estrangement from family and “straight” friends. 5) Burnout: use of drugs to feel normal - Use of multiple substances; cross-addiction - Anxiety, guilt, withdrawal, shame, remorse, depression - Physical and mental deterioration - Increased risk-taking, self-destructive behavior, or suicidal behavior.

Family violence is too an important register of intervention of the psychologist in the intent to solve conflict or assess the proper moment to protect: 1) At the individual level it has special importance to addiction: - being abused as a child or witnessing violence in the home - being a very young, under-resourced or ill parent (in the case of child abuse) - sexist attitudes about the role of men and women (in the case of partner abuse). 2) At the level of the family and relationship, there are risk factors present where: - family members are vulnerable, disempowered or in a dependent position, for example, women with very young children, or children themselves - families have a lack of practical, social, psychological and financial support - there is parental incapacity, parental illness, or a basic lack of parenting skills and support (in the case of child abuse) - there is male control of wealth and decision-making within the family (in the case of partner abuse) - one or both caregivers abuse substances. 3) At the community level, risk factors include: - the lack of safe, inclusive and nurturing communities, which may minimise opportunities - for intervention and the transmission of non-violent norms of behaviour and contribute to the isolation and lack of social support for both victims and caregivers - peer groups that condone and legitimise violence towards women and children - barriers to community participation, such as poverty, cultural alienation, and racism that create and sustain social isolation. 4) At the societal level, risk factors exist where there is: - acceptance of violence as a means to settle interpersonal disputes - reinforcement of violence as glamorous and exciting through film and television - social tolerance of physical punishment of women and children - a lack of effective sanctions against intra-familial violence - rigidly defined and enforced gender roles - the linkage of the concept of masculinity to toughness and dominance - the perception that men have ‘ownership’ of women, or parents have ‘ownership’ of children - barriers to independence, participation, self-fulfilment, dignity and the resulting isolation and low self esteem - a cultural norm about women’s role as caregivers - lack of funding for family violence prevention programmes. Women adddict care observe Criteria - Maintaining a comprehensive rather than a confrontational approach, especially at the beginning of the therapeutic process; - Maintaining privacy when treating traumatic experiences linked to abuse and maltreatment; - Focusing on women’s relationships (family and other relatives) to restore social networks; - Providing more focus on individual treatment for women (in comparison with men); - Allowing a longer time for treatment in order to establish linkage and therapeutic bonding.

Engaging women in treatment pose certain difficulties, importance should be given to: 1) Early intervention and engagement into treatment: - Women-only programmes - Early detection in primary-care settings - Create awareness and provide realistic and accurate information - Use motivational engagement strategies that are non-confrontational and non-moralizing and provide flexible programme options. 2) Lack of connection to psychiatric treatment to address needs of women with concurrent disorders: - Guidelines for agencies providing substance abuse treatment or treatment for mental health problems - Integrated rather than fragmented services - Early recognition of concurrent substance use and mental health problems and intervention needs to increase retention - Cross-training between substance abuse treatment and mental health systems, as well as health and social services - Cooperation and networking - Case management and shared care. 3) Addressing cultural traditions: - Community-based services - Home detoxification - Adaptation of intervention methods to cultural setting, respecting culture and language - In some cultures, involve members of the male population in service planning and development in order to overcome stigma and cultural taboos that affect women. 4) Taking into account culturally sanctioned substances: - Recognize that alcohol and tobacco are drugs - Provide information on and education about legal substances - Modify social use by acknowledging the problems they cause - Raise awareness that most societal harms come from drinkers who use alcohol socially. 5. Poly-substance use among women: - Assess and provide treatment for all substance use problems in one setting - Incorporate harm-reduction approaches - Help women set priorities - Carry out research to determine profiles of women with alcohol or illicit drug problems.

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