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Moving Co-Occurring Clients Through the Stages of Change Moving Co-Occurring Clients Through the Stages of Change

If Physical Health Px Were Treated Like MH Px If Physical Health Px Were Treated Like MH Px

Why Does Change Occur? Why Does Change Occur?

Experiences that often prompt change Experiences that often prompt change

Changes takes place…. Changes takes place….

3 Types of Behavior Change 3 Types of Behavior Change

Myths Myths

Ch…ch…ch…changes 10 Ch…ch…ch…changes 10

Common Natural Changes Common Natural Changes

Natural Changes in SU Natural Changes in SU

Models of Addiction/Mental Health Models of Addiction/Mental Health

How Change Occurs 15 How Change Occurs 15

Ch…ch…ch…changes 16 Ch…ch…ch…changes 16

Ch…ch…ch…changes 17 Ch…ch…ch…changes 17

Ch…ch…ch…changes 18 Ch…ch…ch…changes 18

Ch…ch…ch…changes Ch…ch…ch…changes

Transtheoretical Model (TTM) Transtheoretical Model (TTM)

Problem vs. Preference Problem vs. Preference

Motivation Motivation

Benefits of Motivation Enhancement Benefits of Motivation Enhancement

Strategies Strategies

Continued Continued

Continued Continued

4 Dimensions of Change 4 Dimensions of Change

When Change Occurs 29 When Change Occurs 29

Treatment Tasks Treatment Tasks

Quick Assessment Quick Assessment

Assessment Key Assessment Key

How Change Occurs 33 How Change Occurs 33

How Change Occurs 34 How Change Occurs 34

Markers of Change Markers of Change

5 General Areas of Functioning (Context of Change) 5 General Areas of Functioning (Context of Change)

The Stages of Change Model The Stages of Change Model

Maintenance of Addiction Maintenance of Addiction

Markers of Change Markers of Change

Context of Change Context of Change

When Change Occurs When Change Occurs

Precontemplation Precontemplation

Types of Precontemplators Types of Precontemplators

Defenses: Fool ourselves but not others Defenses: Fool ourselves but not others

Precontemplation Precontemplation

Markers of Change Markers of Change

Context of Change Context of Change

Strategies Strategies

TFV—The Funniest Videos— MH Humor TFV—The Funniest Videos— MH Humor

12 Signs of Nonempathetic Responses 12 Signs of Nonempathetic Responses

Columbo Approach Columbo Approach

Avoiding Arguments Avoiding Arguments

Strategies Strategies

Intervening Through S. O. Intervening Through S. O.

When Change Occurs When Change Occurs

Contemplation Contemplation

Markers of Change Markers of Change

Context of Change Context of Change

Barriers Barriers

Action Seems Scarey Action Seems Scarey

Ambivalence Ambivalence

Ambivalence (MI) Ambivalence (MI)

Inappropriate Things to Say at a Meeting Inappropriate Things to Say at a Meeting

Chronic Contemplation Chronic Contemplation

Negative Responses to Change Negative Responses to Change

Consciousness Raising Consciousness Raising

Goals of Consciousness Raising Goals of Consciousness Raising

How Do We Help? How Do We Help?

Emotional Arousal Emotional Arousal

Techniques Techniques

Assessment Questions Emotional Arousal Assessment Questions Emotional Arousal

Self-Reevaluation Self-Reevaluation

Decisional Balance Decisional Balance

Assessment Questions for Self. Reevaluation Assessment Questions for Self. Reevaluation

How Do We Help? How Do We Help?

Helping Relationships Helping Relationships

When Change Occurs When Change Occurs

Preparation Preparation

Markers of Change Markers of Change

Context of Change Context of Change

Commitment Assessment Questions Commitment Assessment Questions

Decisional Balance Scale Decisional Balance Scale

Strategies Strategies

When Change Occurs When Change Occurs

Action Action

Markers of Change Markers of Change

Context of Change Context of Change

4 Main Tasks of Maintenance 4 Main Tasks of Maintenance

Processes Processes

Markers of Change Markers of Change

Context of Change Context of Change

Biggest Mistakes Biggest Mistakes

What Does Action Look Like? What Does Action Look Like?

Compliance vs. Commitment Compliance vs. Commitment

Recognizing Readiness Recognizing Readiness

Coping Skills Coping Skills

Countering Countering

Continued Continued

Counterthinking Counterthinking

Continued Continued

Assertiveness Assertiveness

Continued Continued

Continued Continued

Countering Self-Assessment Countering Self-Assessment

Environment Control Environment Control

Continued Continued

Continued Continued

Environment Control Assessment Questions Environment Control Assessment Questions

Reward Reward

Continued Continued

Continued Continued

Continued Continued

Reward Self-Assessment Reward Self-Assessment

Helping Relationships Helping Relationships

Continued Continued

When Change Occurs When Change Occurs

Maintenance Maintenance

Goal of Maintenance Goal of Maintenance

Continued Continued

Maintenance Maintenance

Markers of Change Markers of Change

Context of Change Context of Change

Common Threats Common Threats

Studies show (smoking): Studies show (smoking):

Example #1 Example #1

Example #2 Example #2

3 Common Internal Challenges 3 Common Internal Challenges

Maintain Commitment Maintain Commitment

Maintain Commitment Maintain Commitment

Self-Efficacy Self-Efficacy

Helping Relationships Helping Relationships

Making Changes Making Changes

Cultural Competence Cultural Competence

Coerced Clients Coerced Clients

How to Keep a Slip from Becoming a Relapse How to Keep a Slip from Becoming a Relapse

AA Mtg Gone Wrong AA Mtg Gone Wrong

Lessons of Relapse Lessons of Relapse

Lessons of Relapse Lessons of Relapse

Continued Continued

165 165

Continued Continued

FRAMES (MI) FRAMES (MI)

Continued Continued

MI MI

Continued Continued

Continued Continued

Change is Possible Change is Possible