While the patient is engaging in positive recovery activities, he or she is receiving immediate positive support for a new way of behaving and thinking. This has a very important benefit to self-esteem. In punishment, it is the individual who receives the negative consequence, whereas in aversion therapy the negative consequence is only paired with the act of using a drug. It is important not to confuse aversion with punishment. People need care-behavior needs modification. It is first reported to be used in America by Benjamin Rush, a physician, in 1789 ( 2). Aversion therapy provides a means of achieving control over injurious behavior for a period of time, during which alternative and more rewarding modes of response can be established and strengthened ( 1). This treatment is not designed to appeal to the logical part of the individual’s brain, which often is all too aware of the negative consequences of alcohol and other drug use, but to the part of the brain where emotional attachments are made or broken through experienced associations of pleasure or discomfort. Unlike punishments (jail, firings, fines, divorce, hangovers, cirrhosis, and the like), which often are delayed in time from the use episode, aversion therapy relies on the immediate association of the sight, smell, taste, and act of using the substance with an unpleasant or “aversive” experience. Its goal is to reduce or eliminate the “hedonic memory” or craving for a drug and to simultaneously develop a distaste and avoidance response to the substance. ■ AVERSION THERAPY AS PART OF ESTABLISHED CARE FOR ADDICTIVE DISEASEĪVERSION THERAPY AS PART OF A MULTIMODALITY TREATMENT PROGRAMĪversion therapy, or counterconditioning, is a powerful tool in the treatment of alcohol and other drug addiction. ■ DETERMINANTS OF RELAPSE AFTER AVERSION TREATMENT ■ EFFECT OF AVERSION ON URGES TO DRINK ALCOHOL ■ AVERSION THERAPY AS PART OF A MULTIMODALITY TREATMENT PROGRAM Such treatment may include increased reinforcement treatments, treatment of depression, and additional assistance in coping with intrapersonal and interpersonal determinants of relapse.The ASAM Principles of Addiction Medicine 5th Edition 62.
#Schick shadel employment update
This suggests the need to take seriously patient reports of "urges" in the first year after treatment and to carefully assess the cause and initiate or update an individualized plan of treatment. In contrast, increased frequency of support group utilization was associated with increased urges to drink/use and lower abstinence rates. Increased utilization of reinforcement treatments was associated with decreased urges to drink/use and increased abstinence rates. However, interpersonal determinants were far more important in the cocaine and marijuana treated patients. The two factors were of equal importance in the alcoholics. The two most prominent factors initiating a relapse were "intrapersonal determinants" such as stress from work or marriage/family relationships and "interpersonal determinants" such as being around others who were drinking/using or being at a celebration or special event. Of additional importance was the use of support groups and reinforcement treatments after completion of the initial hospitalization. The most powerful predictor of success was whether or not all urges to drink or use had been eliminated (presumably by aversion therapy). Abstinence rates for alcohol and/or other drugs were also calculated including noncontacted patients who had chart documented evidence of relapse. The marijuana 12 month and "total" abstinence (mean 14.7 mos.) rates for the 30 contacted patients was 70.0% for both groups. The cocaine 12 month and "total" abstinence (mean 14.7 mos.) rates for the 49 contacted patients were 83.7% and 81.6%, respectively. Seventy-five of these treated for cocaine dependence and 47 treated for marijuana dependence. Fifty-two percent of the alcoholics were using or dependent on other drugs at admission. Of these, 65.1% were totally abstinent for 1 year after treatment and 60.2% were abstinent until follow-up a mean of 14.7 months later. Telephone contact was made by an independent research organization with 427 of the patients (71.2%).
Contact was made a minimum of 12 months and as many as 20 months after completion of treatment (mean 14.7 mos.). A sample of 600 patients treated in a multimodal treatment program using aversion therapy and narcotherapy at three Schick freestanding addiction treatment hospitals and one Schick unit in a general hospital were followed-up.
0 kommentar(er)
