Sponsored by the HealthcareTrainingInstitute.org providing Quality Education since 1979
Add to Shopping Cart

Tobacco Dependency: Treatment Behavioral Solutions for Quitting
Tobacco Dependency continuing education psychology CEUs

Section 12
A Stage Model for Behavioral Interventions
with Tobacco-Dependent Clients

CEU Question 12 | CEU Answer Booklet | Table of Contents | Addictions
Counselor CEUs, Social Worker CEUs, Psychologist CEs, MFT CEUs

Motivational Interviewing: Precontemplation Stage
To select the most appropriate interventions, the therapist needs to know the client's present readiness to change. Offering a prescription for nicotine replacement to a client who is in the precontemplation stage is unlikely to be successful, because doing so essentially asks the client to move from precontemplation to action without going through the necessary intervening stages. Rather, the therapist should encourage the client in the precontemplation stage to think about his or her smoking and to consider the possibility that smoking is a problem that needs attention. Brief interventions can be effective in the precontemplation stage and as the client moves from one stage to the next. Effective interventions include the following:
Educate the client about the effects of smoking.
Recommend changes in behavior.
List options for achieving behavioral change.
Discuss the client's reactions to the therapist’s feedback and recommendations.
Follow up to monitor and reinforce behavioral change.

This process, known as "motivational interviewing," uses empathy rather than confrontation. It acknowledges that the client, not the therapist, is responsible for changing behavior.

Contemplation Stage
If further discussion on the return visit reveals that the client now agrees that smoking is a problem and would like to consider quitting, the client has entered the contemplation stage. Interventions to consider at this stage include providing further education about the effects of smoking and encouraging the client to consider the positive aspects of not smoking, such as improved health, a more positive self image, and economic savings.

Preparation Stage
Once the client agrees that the benefits of not smoking outweigh the pleasure derived from smoking and has decided to quit, he or she has entered the preparation stage. At this point, it is appropriate to discuss various nicotine replacement systems, the possible use of bupropion, and the need for social and family support. The therapist should also help the client develop a clear plan for smoking cessation. Tasks for the client and therapist during the preparation stage may include the following:
Setting a definite quit date. Often, a meaningful date, such as a birthday or anniversary, provides the client with increased motivation.
Gathering support for smoking cessation. The client should let family members and other significant persons know that he or she has decided to quit smoking on a certain date, and should ask those individuals for help. The therapist might encourage the client to take part in a support group or a community or agency program that focuses on smoking cessation.
Preparing the environment. The client should be counseled to remove cigarettes, ashtrays, and other smoking-related paraphernalia from his or her home, car, and office. The client should ask others not to smoke in his or her presence.
Formulating plans to avoid triggers. When prompted, many clients can identify images, rituals, sensory experiences, and emotional rewards that they associate with smoking. The therapist and client can begin to discuss healthy substitution behaviors that might help prevent relapse. Counseling clients to avoid alcohol is a good strategy because drinking lowers inhibitions, thereby reducing the chance of successful smoking cessation.
Selecting a nicotine replacement system, if needed.

Action And Maintenance Stages
The action stage begins on the quit date. By this date, bupropion should have been started (if used), the nicotine replacement system of choice should be on hand (if used), and the client's environment should have been cleared of smoking-related materials.

During the action stage, behavioral support through self-help or professionally run group meetings, frequent office visits, and/or telephone calls from support personnel can enhance the effectiveness of the cessation attempt. The purpose of these contacts should be to support continued smoking cessation in the recently abstinent smoker. These contacts should be made at least weekly in the first month, and again when the clients stops nicotine replacement and bupropion therapy.
It is important for the client to report perceived benefits from having stopped smoking, side effects of medications, and current or anticipated difficulty in maintaining abstinence. Healthy substitution behaviors may help to prevent relapse.

Dealing with Relapse
Most clients relapse within the first six to 12 months of a smoking cessation attempt. If a client relapses, the therapist needs to encourage the client to try again. It is useful to review the treatment plan to determine what did and did not work.
A client may not return immediately after a relapse and may smoke for months before another visit. At that point, the client's readiness to change needs to be reevaluated, and the smoking cessation process must be repeated. Nicotine dependence is a tenacious and difficult addiction to treat successfully. Clearly, perseverance on the part of the client and the therapist is most effective for achieving permanent abstinence. The use of nicotine replacement and bupropion can improve results, and the application of readiness-to-change strategies and motivational interviewing techniques are essential for success. Behavioral therapy and support in a group setting have been shown to improve quit rates. Individual counseling can also be effective. A supportive telephone call during the first few days of abstinence may help the client who is trying to quit smoking.
- Mallin, Robert; Smoking Cessation: Integration of Behavioral and Drug Therapies; American Family Physician; March 2002; Vol. 65 Issue 6
The article above contains foundational information. Articles below contain optional updates.

Personal Reflection Exercise #5
The preceding section contained information about  a stage model for behavioral interventions with tobacco dependent clients.  Write Write three case study examples regarding how you might use the content of this section in your practice.

Online Continuing Education QUESTION 12
What are five tasks for the client and therapist during the preparation stage of smoking cessation? Record the letter of the correct answer the CEU Answer Booklet

 

CEU Answer Booklet for this course | Addictions
Forward to Section 13
Back to Section 11
Table of Contents
Top

The article above contains foundational information. Articles below contain optional updates.
Report finds fentanyl leading cause of overdose deaths, doubling annually - December 12, 2018
Fentanyl is still king of killers when it comes to drug overdoses in the United States, but another drug is combined with it in 70 percent of deadly overdoses. U.S. federal data show that overdose deaths caused by fentanyl have almost doubled every year from 2013 to 2016 and that fentanyl combined – knowingly or ...
The post Report finds fentanyl leading cause of overdose deaths, doubling annually appeared first on Addictions.
DEA agent charged with helping cartel in Chicago - December 11, 2018
Fernando Gomez, a former Evanston, Ill., cop and current agent for the U.S. Drug Enforcement Administration, was arrested at the DEA office where he worked on Tuesday morning, charged with conspiracy to smuggle both guns and drugs. Gomez, age 41, deliberately joined the DEA from the Evanston police force to work clandestinely with a Puerto ...
The post DEA agent charged with helping cartel in Chicago appeared first on Addictions.
Investigators look at price fixing for 300 generic drugs - December 10, 2018
Investigators following up on a lawsuit that began in 2016 are now looking into allegations that 16 pharmaceutical companies conspired to fix the prices of generic drugs. The brouhaha started with an antitrust lawsuit two years ago filed by several U.S. states, including Connecticut over just two drugs. Allegations in the expanding investigation include the ...
The post Investigators look at price fixing for 300 generic drugs appeared first on Addictions.
RAND Study recommends implementing prescription heroin sites in U.S. - December 06, 2018
Santa Monica think-tank Rand Corp. published a study this week saying that supervised heroin injection sites where addicts shoot up under supervision and the use of heroin in treatment could help stem the tide of opioid addiction and overdoses in the United States. So-called HAT, or “heroin-assisted treatment,” and carefully supervised sites similar to those ...
The post RAND Study recommends implementing prescription heroin sites in U.S. appeared first on Addictions.
Over 84 Italian mob members arrested in European cocaine bust - December 06, 2018
Police in four different European countries arrested 84 people this week in a coordinated crackdown on the Italian mafia, which has been involved in global cocaine smuggling. Those arrested, authorities said, are tied to the ‘Ndrangheta mob, based in Calabria, in the toe of the Italian boot. Experts say it is a far more powerful ...
The post Over 84 Italian mob members arrested in European cocaine bust appeared first on Addictions.

CEU Continuing Education for
Counselor CEUs, Social Worker CEUs, Psychology CEUs, MFT CEUs

 


OnlineCEUcredit.com Login


Forget your Password Reset it!