Promoting Self-Change From Addictive Behaviors (eBook)

Dr. Harald Klingemann studied at Cologne University (Germany) where he received the degree of Doctor of Economics and Social Sciences. He has taught at the University of Bonn, where he was a senior researcher in criminology, and has been Research Director at the Swiss Institute for the Prevention of Alcohol and Drug Problems (SIPA) (Lausanne). He is currently the Research Director of the Swiss Consortium for Alcohol Treatment Research and project director at the Substance Use Disorders Research Department of the University of Zurich (SUD). His main research interests include the cross cultural analysis of treatment systems and the natural history of alcohol and heroin use for which he received the honorary doctor of the University of Stockholm in 2003. He has published about 100 articles and four books. He has served as temporary advisor for WHO Geneva and on several editorial boards. He is currently involved as PI in projects on controlled drinking as well as gender specific treatment needs and masculinity Dr. Linda Carter Sobell is Professor at Center for Psychological Studies, Nova Southeastern University in Florida. She is nationally and internationally known for her clinical research in the addiction field, particularly brief motivational interventions, natural recovery, and the Timeline Follow-up. She has received several awards, given over 200 invited presentations/workshops and published over 250 articles book chapters, and 7 books, and serves on several editorial boards. She is a Fellow in the American Psychological Association, is a Motivational Interviewing Trainer (MINT) and holds a Diplomate in Behavioral Psychology from the American Board of Professional Psychology. She is past President of the Association for Advancement of Behavior Therapy and the Society of Clinical Psychology of the American Psychological Association.

Dedication 5
Acknowledgments 6
Foreword Considering the Unimaginable: Challenges to Accepting Self- Change or Natural Recovery from Addiction 7
References 11
Preface 12
References 15
Contents 16
Contributors 18
The Phenomenon of Self-Change: Overview and Key Issues 21
Introduction 21
The Respondents Speak 22
Is What We Call the Phenomenon Important? 23
Defining Treatment and How Little Is Too Much 24
Mixing Treated and Untreated Respondents 25
State-of-the-Art in Self-Change 26
Advantages of Survey and Other Methods for Studying the Process of Self- Change 27
Why Has Self-Change as an Area of Study Been So Long Overlooked or Ignored? 27
Nonabstinent Outcomes and Natural Recovery 28
What Can Be Gained by Studying the Process of Self- Change? 29
Barriers to Treatment or Help-Seeking for Racial/Ethnic Minorities and Women 31
Models of Change 33
Conflict Theory 33
Transtheoretical Model of Change 34
Crystallization of Discontent 35
Becoming an Ex 35
Major Findings from Self-Change Studies 36
Self-Change: A Major Pathway to Recovery 36
Can We Believe What They Tell Us? 36
Stability of Natural Recoveries 37
What Triggers Self-Change? Thinking about Changing 38
Maintaining Recoveries 39
Conclusions and Future Directions 39
References 40
Self-Change from Alcohol and Drug Abuse: Often- Cited Classics 51
The Setting 51
The “Pioneering Studies” 52
Subsequent Research on Self-Change 53
Studies of Drug Use and Drug Addiction 54
Studies of Alcoholism, Drinking Patterns, and Drinking Problems 60
Summing Up: Conclusions and Implications 73
References 74
Natural Recovery or Recovery without Treatment from Alcohol and Drug Problems as Seen from Survey Data 78
Early Drinking Survey Results 78
Specialized Survey Studies of Natural Recovery 79
Community Studies of Self-Change 81
Drug Users and Natural Recovery 82
Advantages of Survey and Other Methods for Studying Natural Recovery 83
Snowball, Media-Derived, and Convenience Samples in Self- Change Studies 84
Do Those Who Recover Naturally Have Fewer Problems Than Those Who Seek Treatment? 86
What Can We Conclude about Self-Change? 87
References 88
Remission without Formal Help: New Directions in Studies Using Survey Data 91
Methodological Issues 91
Sampling Methods 92
Definition of the Substance Use Problem 92
Definition of Treatment 93
Occurrence of Natural Remission in the General Population 93
Stability of Untreated Remission 94
Factors Supporting Remission 95
Media-Recruited or Other Nonrepresentative Samples 96
General Population Samples 98
Conclusion and Suggestions for Future Research 101
References 101
Natural Recovery from Alcohol and Drug Problems: A Methodological Review of the Literature from 1999 through 2005 104
Introduction 104
Method 105
Results 106
Discussion and Conclusions 112
References 115
Appendix Primary References 117
Secondary References 118
Self-Change in a Broader Context: Beyond Alcohol and Drugs 119
Self-Change: The Rule among Smokers 120
Epidemiology of Smoking and Quitting 120
Self-Quitting 121
Success in a Given Self-Quit Attempt 122
Reduction as Outcome 122
Reasons for Quitting 123
Predictors of Successful Self-Quitting 124
References 124
Natural Recovery from Problem Gambling 127
References 130
The Natural Course and Outcome of Eating Disorders and Obesity 133
References 138
Spontaneous Desistance from Crime 141
What Is to Stop Crime Spontaneously? 142
Correlates of Desistance and the Desistance Process 144
Maturation and Morality 145
Growing Aversion for Risk 146
Changes in Adult Life 146
Turning Points: Inside and Outside Views 147
Against All Odds 148
Family Violence and Question of Change without Treatment 148
Conclusion 150
References 150
Self-Change from Stuttering: An Overview 152
What Is Stuttering? 152
Natural Recovery during Early Childhood Stuttering 152
Treatment Approaches for Managing Stuttering After Childhood 153
The Phenomenon of Untreated Recovery after Childhood 154
Findings from Late Recovery Research Methodological Challenges 155
Mechanisms of Self-change 156
Are These Accounts of Self-Change Credible? 157
Outcomes of Self-Managed Late Recovery 157
Recent Findings and Future Directions 158
References 159
One Way to Leave Your Lover: The Role of Treatment in Changing Addictive Behaviors 163
Meaningful Explanations of Change in Addictive Behavior 163
Fifty Ways to Leave Your Lover 164
Factors Influencing Route of Change 167
The Role of Treatment in Changing Addictive Behavior 170
Stepped-Care Approach 170
Multiple Functions of Treatment 171
Summary: Many Ways to Leave Your Lover 172
References 172
Promoting Self-Change: Taking the Treatment to the Community 175
Self–Change Approaches 176
Tailored Nontraditional Messages 178
A Community Mail Intervention: Background and Rationale 183
An Empirically Crafted Advertisement 184
PSC Study Results 186
What Triggered the Change Process? 186
Responding to Advertisements: A Critical Event in Promoting Self- Change 187
Public Health Implications of Community Interventions 189
Conclusion and Future Directions 191
References 191
Hostile and Favorable Societal Climates for Self- Change: Some Lessons for Policymakers 199
Introduction 199
Images of Alcohol and Drug Addiction in the General Population: Stigma, Social Support, and Change Optimism 200
Treatment Systems and the Acceptance of Treatment 203
Self-Change in the Global Village: Media Images and Health Information Management as Social Capital The Portrayal of Alcohol and Drug Users in the Media 206
Active Information Retrieval and Media Use as a Tool for Self- Change 208
Media Campaigns Setting the Stage for Change? 210
“ A Sober Look at Drugs” 211
“Handle With Care” 212
“Milestone” 213
Structural Prevention and Chances of Change: How Far Is It to the Next Pub and Where Am I Still Allowed to Smoke? 216
Motivation of Change and References to Society and Politics of Self- Change 220
References 221
Natural Recovery: A Cross-Cultural Perspective 225
Cross-Cultural Variation in Beliefs and Normative Behaviors 226
Cultural Types: Broadly Drawn 227
Specialist Cultures 228
Generalist Cultures 229
Ethnic Minorities and Mainstream Populations 230
Some Central Domains for Self-Change 233
Problem Definition and Trajectory 233
Time 236
Emotion 238
Identity 240
Expertise 242
Conclusion: Implications for Research and Clinical Practice 244
References 246
Self-Change Toolbox: Tools, Tips, Websites, and Other Informational Resources for Assessing and Promoting Self- Change 250
Introduction 250
Assessment Instruments to Promote Self-Change 250
Tools for Assessing Problem Severity or Adverse Consequences of Addictive Behaviors 251
Assessing Addictive Behaviors 252
Assessing High-Risk Triggers to Addictive Behaviors 253
Assessing Motivation and Readiness to Change 253
Addiction Self-Change Websites by Country North America 255
Great Britain 256
Austria, Germany, and Switzerland 258
Finland 261
France 261
Italy 261
Sweden 262
Mexico 262
Spain 262
Additional Addiction Self-Change Resources Available Online by Request 262
References 264
Index 267