WHY PEOPLE CHANGE THEIR BEHAVIOUR

What Does The Research Tell Us About Why People Change Their Behaviour?

What Does The Research Tell Us About Why People Change Their Behaviour?

Substance Use and Abuse

Substance abuse and dependence are complex problems that are often encountered in a counseling practice. Substance abuse and dependence have been defined as disorders that affect the mind, the body, and the spirit. This entry summarizes the background, definitions of the clinical problem, levels of care and counseling modalities, components of counseling and clinical approaches, and future of counseling for substance abuse.

Many terms are used to describe alcoholism and other substance related disorders. Some use substance misuse as a general term for the unhealthy or harmful use of substances. Substance misuse can include use of alcohol or other drugs with negative consequences to individuals' social, psychological, and physical well-being.

Substance abuse, the most widely used term, has both general and specific meanings. In general usage, substance abuse is the catch-all term that is used in governmental department titles and federal grant programs to describe programs and services dealing with illicit drug use and alcohol misuse or abuse. More precisely, the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) divides substance misuse into two main classifications: substance abuse and substance dependence. Substance abuse is a diagnosis having four criteria, at least one of which must be met within a 12-month period: (1) recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home; (2) recurrent use in situations in which it is physically hazardous such as driving an automobile; (3) recurrent substance-related legal problems; and (4) continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of substances. In addition, individuals cannot have ever met the criteria for substance dependence for the particular class of substances.

Substance dependence is a more serious problem related to substance use. The term chemical dependency is often used to mean substance dependence and is used more often than substance dependence in Alcoholics Anonymous-oriented programs. Others use the term addiction or addictive disease to describe substance dependence, although addiction can include compulsive behaviors other than substance use, as in sexual addiction or gambling addiction.

What Does The Research Tell Us About Why People Change Their Behaviour?

One of the more ambitious and useful models for promoting social and individual change comes from the work of James Prochaska, Carlo DiClemente, and their colleagues (1983, 1984, 1992, 1997). Through their review of some 200 theoretical approaches and paradigms, Prochaska and others have identified a set of principles and concepts common or integral to most change efforts. The resulting “transtheoretical” model therefore is an interdisciplinary amalgamation of many theories and philosophies of change, a distillation of best practices derived from disparate schools of thought and tested in a variety of settings and topics.

McCoy (2002) mentions undergirding this model is a set of assumptions. First, change does not occur in a single step, but rather through a series ...