Summary

This practical manual presents a 29-session treatment program designed to engage, motivate, and stimulate processes of change in clients at all stages of recovery. The program is based on the research-supported transtheoretical model of behavior change. The manual describes skills-building activities and interventions that are likely to be most effective with clients as they cycle from the earlier stages of change/m-/precontemplation, contemplation, and preparation/m-/to the later stages, action and maintenance. Each of the structured sessions is presented in a consistent, highly accessible format, including a clear rationale, summary of objectives, and overview of the main activities that will take place. Step-by-step guidelines for implementation are provided, as well as strategies for using a motivational interviewing style. The manual is complete with all needed handouts and exercise forms, ready to photocopy and distribute to clients. Ideal for use with groups, the approach can easily be adapted to individual treatment.

Author Biography

6/01: Need to get corrected bios for Maurer and Crouch before using in promotions. Information in "Full Author" field in Title Information is correct.

Mary Marden Velasquez, PhD, is an Associate Professor in the Department of Family Practice and Community Medicine at the University of Texas/m-/Houston Medical School. Dr. Velasquez's background and training are in the areas of clinical psychology, health psychology, and public health. For the past 15 years, she has been involved in the conceptualization, design, and implementation of many studies using the Transtheoretical Model of behavior change (TTM). Dr. Velasquez's recent work has included development if stage-based interventions in the areas of HIV prevention, respiratory health, prenatal health, alcohol abuse, smoking cessation, and the prevention of fetal alcohol syndrome.

Gaylyn Gaddy Maurer, MA, has worked with the Transtheoretical Model for the past 10 years. She is currently a faculty member with the Addiction Research and Treatment Division of the University of Colorado Health Sciences Center. (Denver). She has worked in the substance abuse field in both research and clinical settings with a variety of populations, including veterans, felony probationers, the dually diagnosed homeless, women at risk for alcohol-exposed pregnancies, and adolescents in residential treatment and day treatment.

Cathy Crouch, MSW, has extensive management experience in corporate, academic, and social service settings. Cathy is a licensed clinical social worker who has worked in research institutions, as well as inpatient and outpatient treatment facilities. She is published in the area of mental illness and substance abuse among the homeless. (Houston, TX)

Carlo C. DiClemente, PhD, is professor and chair of the Department of Psychology at the University of Maryland, Baltimore County. Dr. DiClemente is the codeveloper of the Transtheoretical Model of behavior change with Dr. James Prochaska. Over the past 20 years, he has written numerous scientific articles, books, and book chapters examining the process of human behavior change and the application of this model to a variety of behaviors. Dr. DiClemente has directed an outpatient alcoholism treatment program based on the Transtheoretical Model and served as a consultant to NIDA, NIAAA, CSAT and both private and public treatment programs. Dr. DiClemente is a coauthor of a self-help book based on this model of change, Changing for Good, and several professional books applying the model to addictive and health behaviors. He has presented this model in training workshops in the United States, Canada, Great Britain, Europe, Mexico, and New Zealand.

Introduction	p. 1
How To Help People Change
How People Change: The Transtheoretical Model	p. 7
An Overview of the Model	p. 7
Doing the Right Thing at the Right Time	p. 9
Moving through the Stages of Change	p. 11
How the Processes Facilitate Movement through the Stages	p. 13
The Differences between Processes of Change and Techniques	p. 16
Adapting This Manual to Your Needs	p. 16
Strategies for Facilitating Change	p. 17
A Motivational Approach	p. 17
Principles of Motivational Interviewing	p. 18
Using Motivational Interviewing to Enhance Change Process Use	p. 19
Motivational Strategies	p. 20
Overview of Techniques	p. 21
Putting It All Together: Setting Up and Carrying Out the Intervention	p. 27
Overview of This Treatment	p. 27
Who Should Conduct This Treatment	p. 28
In What Settings Is This Treatment Appropriate?	p. 28
Suggested Group Size, Frequency of Sessions, and Session Length	p. 29
Intake Screening and Assessment	p. 29
Session Format	p. 32
Brief Refresher on Group Work	p. 33
Conclusion	p. 35
Thinking About Changing Substance Use
P/C/P Sequence: Precontemplation-Contemplation-Preparation
The Stages of Change	p. 39
Change Process Objective: Consciousness Raising
A Day in the Life	p. 47
Change Process Objective: Consciousness Raising
Physiological Effects of Alcohol	p. 52
Change Process Objective: Consciousness Raising
Physiological Effects of Drugs	p. 61
Change Process Objective: Consciousness Raising
Expectations	p. 70
Change Process Objective: Consciousness Raising
Expressions of Concern	p. 75
Change Process Objectives: Self-Reevaluation, Dramatic Relief
Values	p. 80
Change Process Objective: Self-Reevaluation
Pros and Cons	p. 84
Change Process Objective: Decisional Balance
Relationships	p. 91
Change Process Objective: Environmental Reevaluation
Roles	p. 97
Change Process Objective: Environmental Reevaluation
Confidence and Temptation	p. 102
Change Process Objective: Self-Efficacy
Problem Solving	p. 108
Change Process Objective: Self-Efficacy
Setting a Goal and Preparing to Change	p. 113
Change Process Objective: Self-Liberation
Review and Termination	p. 119
Making Changes In Substance Use
A/M Sequence: Action-Maintenance
The Stages of Change	p. 127
Change Process Objective: Consciousness Raising
Identifying "Triggers"	p. 135
Change Process Objective: Stimulus Control
Managing Stress	p. 140
Change Process Objective: Counterconditioning
Rewarding My Successes	p. 146
Change Process Objective: Reinforcement Management
Effective Communication	p. 151
Change Process Objectives: Counterconditioning, Reinforcement Management
Effective Refusals	p. 156
Change Process Objectives: Counterconditioning, Reinforcement Management
Managing Criticism	p. 161
Change Process Objectives: Counterconditioning, Reinforcement Management
Managing Thoughts	p. 166
Change Process Objectives: Stimulus Control, Counterconditioning, Reinforcement Management
Managing Cravings and Urges	p. 172
Change Process Objectives: Stimulus Control, Counterconditioning, Reinforcement Management
New Ways to Enjoy Life	p. 177
Change Process Objectives: Stimulus Control, Counterconditioning, Reinforcement Management
Developing an Action Plan	p. 182
Change Process Objective: Self-Liberation
Recommitting after a Slip	p. 189
Change Process Objective: Self-Liberation
Social Support	p. 194
Change Process Objective: Helping Relationships
Identifying Needs and Resources	p. 199
Change Process Objective: Social Liberation
Review and Termination	p. 206
Change Process Objectives: Self-Efficacy, Reinforcement Management
Professional Contacts and Suggested Resources	p. 211
References	p. 213
Index	p. 217
Table of Contents provided by Syndetics. All Rights Reserved.

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