NCJ Number
170451
Date Published
1997
Length
16 pages
Annotation
This paper describes the implementation of a model for early group intervention with active drug and alcohol users in community-based settings in New York City.
Abstract
The model is based on research by James Prochaska and Carlo DiClemente (1982), which identified five stages of changing addictive behaviors. In the first stage, pre-contemplation, individuals perceive no problem with their drug and alcohol use and thus see no reason to change their use patterns nor any reason to develop motivation toward change. During the second stage, contemplation, individuals have begun to experience some negative consequences associated with their drug and alcohol use, and thus they are more open to information and feedback from others. Stage three, preparation, combines intention and action to change. Stage four, action, is the point at which most individuals become engaged with traditional drug and alcohol treatment. Stage five, maintenance, is a continuation of, not an absence of, change; the major focus is relapse prevention. Project Connect in New York City bases its work on this model. Under the Prochaska-DiClemente model, the program assumes a proactive role in building motivation for change. By avoiding the demand that participants be committed to abstinence, or to any particular change goal, it allows clinicians to work with individuals wherever they may fall along the spectrum of substance use. The model is client-centered. Counselors work cooperatively with individuals to empower them to set their own priorities for change and develop their own timeline for action. Using a group work model is critical to the implementation of the program. The group provides an opportunity to experience oneself in the presence of others, thus breaking down the isolation, fear, and shame that surrounds so many of the participants. Second, the group provides a mirroring process whereby individuals can observe or experience similarities or contrasts in thoughts, feelings, beliefs, and actions. Third, the group experience provides clear parameters or limits for interaction and growth. Fourth, the group provides immediate and ongoing support for the development of alternative social networks that reinforce the process of change. Although the program was developed for use within two community-based organizations, its basic principles could be applied to a wide variety of health care or substance abuse treatment settings. 28 references