Adapting psychological therapy as Ice treatment
Shorter courses of ice treatment
Providing psychological treatments to people who use methamphetamine presents special challenges because of cognitive problems that affect motivation and thinking. The study of ACT showed that people who use methamphetamine stayed in treatment for an average of three sessions. This suggests that shorter courses of treatment maybe more helpful than expecting people who use methamphetamine to engage in treatment for long periods.
Adjusting ice treatment for cognitive problems
People who are dependent on methamphetamine may have a range of cognitive difficulties. Standard approaches may need to be modified to account for these issues, including offering repetition, frequent summarising of material, written prompts, detailed planning strategies, reminders to attend appointments.
Many of the brain functions that are impaired by methamphetamine are needed to effectively engage in psychological therapy including taking in new information, thinking about the consequences of actions and predicting outcomes, setting goals, concentrating on a topic.
However, therapies like CBT are also considered to ‘exercise’ these parts of the brain as they involve repeated thinking practice required to make, and strengthen those neural connections.
Neuropsychologists are also researching the role of specific brain training in rehabilitation for these people, but the optimal approach has not yet been identified.
The importance of building and maintaining motivation to change
Brain effects of methamphetamine can amplify low motivation. People who use methamphetamine may need additional assistance to increase and maintain motivation for treatment. Remember that cognition among people who cease methamphetamine use can be worse than when they were using for up to 6 months. The slow cognitive recovery associated with longer term methamphetamine use can reduce motivation to reach and maintain goals for treatment.
Lack of motivation for treatment is associated with poorer treatment outcomes, including reduced abstinence and treatment drop out. For clients receiving treatment for substance use, incorporating motivational interviewing at the beginning of treatment has been shown to improve engagement and increase retention in treatment programs. Additional supports, such as appointment reminders or more frequent or shorter sessions, may be required to maintain motivation.
Learn here about Motivational Interviewing and how this can benefit the recovery progress.
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