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Module 3 - Behavioral Interventions: Integrating Tobacco Use Interventions into Chemical Dependence Services

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Module 3 - Behavioral Interventions: Integrating Tobacco Use Interventions into Chemical Dependence Services. Welcome. Add Trainer Names. This training was developed by the Professional Development Program, under a contract with the NYS Department of Health, Tobacco Control Program.

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Presentation Transcript
slide1

Module 3 - Behavioral Interventions:Integrating Tobacco Use Interventions into Chemical Dependence Services

welcome
Welcome
  • Add Trainer Names
slide3

This training was developed by the Professional Development Program, under a contract with the NYS Department of Health, Tobacco Control Program.

PDP developed five classroom-based curricula and seven online modules, which are available at www.tobaccorecovery.org

housekeeping
Housekeeping
  • Hours of Training
  • Breaks and Restrooms
  • Tobacco Use Policy
  • Cell Phones
  • Active Participation
  • Complete Training Evaluation
training modules
Training Modules

Module 1 - The Foundation

Module 2 - Assessment, Diagnosis, Pharmacotherapy

Module 3 - Behavioral Interventions

Module 4 - Treatment Planning

Module 5 - Co-occurring Disorders

E-Learning - All Modules (www.tobaccorecovery.org)

module 3 agenda
Module 3 Agenda
  • Counseling Techniques
      • Motivational Interviewing
      • Cognitive Behavioral Therapy
      • Relapse Prevention
  • Case Studies
  • Facilitating a Tobacco Awareness Group
discussion
Discussion

Understanding and Applying the

Stages of Change

PM 12

readiness to change
Readiness to Change

IMPORTANCE

READINESS

Skills/Knowledge

CONFIDENCE

PM 13

discussion13
Discussion

Treating Tobacco Use and Dependence:

Clinical Practice Guideline

2008 Update

PM 14

motivational interviewing
Motivational Interviewing

MI is considered an evidence-based practice for the treatment of substance use disorders, including tobacco dependence

“A patient-centered, directive method for enhancing intrinsic (internal) motivation to change by exploring and resolving ambivalence” (Miller and Rollnick, 2002)

discussion16
Discussion

What is the “spirit” of Motivational Interviewing?

PM 16 - 17

discussion17
Discussion

What are the four guiding principles of Motivational Interviewing?

PM 18

discussion19
Discussion

What is resistance?

What does resistance look like?

What makes resistance worse?

discussion21
Discussion

O - open questions

A - affirmation

R - reflective listening

S - summarizing

PM 21

activity
Activity

Identifying open and closed questions

PM 22

discussion23
Discussion

What are the different kinds of reflective responses?

PM 23 - 25

activity24
Activity

Reflective Listening

PM 26

discussion25
Discussion

What is “problem talk”?

What is “change talk”?

PM 27

slide26

The more change talk that patients demonstrate, the more likely it is that they will move towards making a change.

Status

Quo

Change

PM 27

using darn c for identifying change talk
Using DARN-C for Identifying Change Talk

D - Desire to Change

A - Ability to Change

R - Reasons to Change

N - Need to Change

C - Commitment

PM 28

activity28
Activity

Identifying change talk

Ten strategies for eliciting change talk

PM 29 - 31

discussion29
Discussion

What are the Five Rs?

PM 32 - 34

slide30

Roadblocks

PM 35

discussion and activity
Discussion and Activity

Providing Information vs. Giving Advice

Using Elicit-Provide-Elicit

PM 36 - 38

psychosocial therapies
Psychosocial Therapies
  • Psychosocial therapies are effective, but only received by 5% of tobacco users
  • Dose-response relationship
  • Combining with medication increases outcomes

PM 42

evidence based methods
Evidence-based Methods
  • CBT/RPT have been shown to be effective
  • CBT/RPT integrates with MI skills and SOC
  • Best used for patients in later stages of change

PM 43

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When to shift from MI to CBT?

When

CBT

Is Most Effective

PM 43

principles of cbt
Principles of CBT
  • Thoughts/beliefs drive feelings and behaviors
  • Patients learn to identify and examine thinking patterns that lead to troublesome emotional states and behavior
  • Clinicians teach practical problem-solving skills
  • Patients gain new knowledge, develop new coping skills, and change old behaviors

PM 44

principles of cbt cont d
Principles of CBT, cont’d

CBT Helps a Patient to Examine and Change:

  • What they believe and feel about their tobacco use
  • Their relationship with tobacco and AOD
  • Their rituals of use

PM 44

components of cbt
Components of CBT
  • Functional Analysis – identify patient thoughts, feelings, beliefs, and circumstances
  • Skills Training – learn coping skills, change behaviors, and use “homework” to practice change

PM 45 - 46

relapse prevention
Relapse Prevention
  • Relapse is a part of the disease of addiction. It is not failure or “a character defect” of the patient.
  • What are the major factors that contribute to relapse, and specifically for tobacco relapse?

PM 47

relapse prevention cont d
Relapse Prevention, cont’d
  • Minimal Components of Relapse Prevention
  • Components of Prescriptive Relapse Prevention (bio, psycho, social, and cultural)
  • Addressing behavioral patterns

PM 48 - 54

discussion43
Discussion

What stage of change is each patient in regarding his/her tobacco use?

Is the patient in the same or a different stage of change for their alcohol/other drug use?

What treatment approaches might work best regarding the patient’s tobacco use?

PM 58

review
Review

Group Facilitation Skills – using EPE, open and closed questions, non–judgmental approach, and supporting self-efficacy

Shifting to Recovery Language

PM 68

tobacco treatment groups
Tobacco Treatment Groups

Patient-Centered Psychoeducation

Tobacco Awareness Group

vs.

Tobacco Recovery Group

PM 70 - 71

tobacco awareness groups tag
Tobacco Awareness Groups (TAG)
  • Outcomes for TAGs
  • Topics for TAGs
  • Importance of using MI skills

PM 70 - 71

tag activity 1
TAG Activity 1

Trainer demonstration

Leading a tobacco awareness group

Debrief

PM 72 - 84

tag activities 2 and 3
TAG Activities 2 and 3

Participants practice facilitating a tobacco awareness group

Debrief

PM 85 - 97 and 98 - 105

resources
Resources

The Tobacco Recovery Resource Exchange http://www.tobaccorecovery.org

E-Learning and Online Resources

OASAS http://www.oasas.state.ny.us/tobacco/index.cfm

Email: [email protected]

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