The theory of reasoned action
This theory was devised by Fishbein and Ajzen. It states that a persons actions are determined and predicted by two factors.
1- Attitude= This is usually shaped by the persons beliefs about the outcome of the behaviour and how they feel about it. e.g. 'smoking is so skanky'- the likelyhood of this person smoking is much less than someone who thinks that it will make them look cool.
2- Subjective norms= This is all to do with social expectations and concequences of the behaviour. For example; someone whose friends hate the idea of smoking and think its a waste of time will be less likely to smoke as opposed to someone whose friends all smoke themselves.
3, the third principle of the TRA is where attitude and subjective norms combine to influence behavioural intention. This is how a person decides whether to engage in the behaviour or not.
The theory of planned behaviour.
This is where Ajzen went off on his own accord and made changes to the previous TRA and added a stage.
Stages 1 and two still remain as 'attiude' and 'subjective norm'
However stage three is now percieved behavioural control. This is basically self efficacy and how capable the person veiws themself as being able to control thier behaviour once it starts. If someone thinks that they will end up smoking 2190348120983029801 a day, not being able to stop and dying young it is highly unlikely that they will begin smoking in the first place.
Attitude, Subjective norms and percieved behavioural control then combine to give the behavioural intention.
Guo studied 14,000 chinese students and found that the TPB was relatively good at predicting later smoking behaviour!
The stages of change model
This model was put forward by Prochaska and DiClemente who suggested that there are a number of stages that addicts pass through when deciding to quit thier addiction.
1- Pre contemplation-not thinking about giving up.
2- Contemplation- Thinking about giving up
3- Preparation- Thinking of a date to give up, maybe seeking help from a healthcare professional.
4- Action- actually stopping the addiction
5- maintain- maintaining it.
NRT stands for nicotine replacement therapy and is a smoking alternative which works by helping to maintain nicotine levels in the body without actually smoking. Things such as patches, gum and inhalers provide addicts with a nicotine buzz. It is also said that such therapy reduces the sensitivity of nicotine receptors in the brain, so that when a smoker actually does smoke, it's much less rewarding.
The two main types of drugs used to combat addiction are Bupropion and Varenicline which are both anti depressant drugs which work in similar ways. These drugs increase dopamine and noradrenaline in the brain and is thought to reduce nicotine receptors too. This reduces cravings in smokers and makes it less enjoyable when they do actually smoke.
Although these drugs are the same, varenicline has been found to be better than Bupropion.
Behavioral therapies- aversion therapy
just a sidenote, why the hell does it not let me spell behavioural < like that without telling me its wrong. ew.
The main behavioural therapy is Aversion therapy, this treatment focusses on punishment rather than reward. For alcoholics, the drug Antabuse works by making the alcoholic sick every time he or she drinks.
Lang and Marlatt found this to be extremely effective with two major setbacks;
1- It is reductionist in tha it ignores the cause of addiction
2- The alcoholic actually has to take the drug in the first place.
Another type of Aversion therapy is rapid smoking- This is where a smoker is made to take puffs on a cigarette every 6 seconds. It is hoped that the smoker will then associate the nausea with smoking.
Although this has obvious health risks.
Self management techniques and cue exposure
Self management- The addict is encouraged by a therapist to keep a diary/ log of thier addictive habits. This is to try and make the addict aware of thier behaviour, things that trigger it and how it makes them feel.
On its own this therapy has not been found to be effective. But hall found that it can be more successful when used as part of a multi component approach.
Cue exposure- This therapy aims to identify the cues that make the addict want to engage in thier behaviour. For example, a smoker may smoke every time they have a meal, having a meal is a cue. This therapy aims to tech the addict coping strategies to help them deal with such cues.
Cognitive therapies are CBT and MI ( motivational interviewing )
CBT in terms of addiction involves training the addict in social skills and developing strategies with them to help prevent relapse.
This therapy is based on the assumptions that behaviour can be unlearned in correcting faulty thought processes will help abstain from the addiction.
CBT programmes for addiction also sometimes incorporate spouses into the programme to help with the addicts social skills. This is especially important if the addiction is something the addict has not functioned without for many years.
Feeny found that there was a 38% success rate of CBT and Drugs
only 14% with CBT alone
Motivational interviewing is an interview technique whereby the addict is encouraged to weigh up the pros and cons of his or her behaviour.
It is hoped that by doing this the addict will actually see a reason as to why they should quit.
This is coupled with motivational advice and tips from a trained therapist who encourages progress.
Burke found that MI lead to a 56% reduction in alcohol consumption
Dun Deroo and Rivara also found that it was effective for helping people with substance abuse.