Features of motivational structure of an opioid addicted personality

Meta. This article aims to reveal the features of empirical research motyatsiynoyi part of persons dependent on opioids.

Presenting experimental material. The system consists of elements, each of them being a subsystem immersed in an environment in which the continuous life motion is going on.

We have developed stages of undergoing by the patient the psychological rehabilitation of opioid addicts program. Here are the stages of going through the program of psychological rehabilitation by a client.

1. Diagnostic (up to 1 month)

1.1. Setting the initial compliance. An indicator of the quality of the work done is the presence of counseling and consent of a dependent person to participate in the rehabilitation program, improvement in health by mutual agreement with the patient.

1.2. Problem description.

At this stage it is necessary to identify and describe the problem. The major problem of a drug dependent person, in our opinion, is organic, psychological, social, psychological and social degradation.

It is impossible to identify the supporting addiction attitudes and affect them, without taking into consideration the personal characteristics of patients [1].

The cardinal problem will be relatively independent but interrelated structural features of a drug addicted personality, including:

- destroyed psychophysiological self-regulation system,

- disintegrated "self-concept" system of illusory-compensatory sense of self,

- destroyed system of interpersonal relations,

- asocial, rigid role pattern of behavior,

- system of concepts of values and importance of transpersonal emotional experience,

- pathological demanding-motivational-semantic structure,

- pressing emotional state - anxiety, depression, frustration, etc.,

- reduction or loss of critical attitude to one's own disease (the notion of the disease).

A number of authors explain anosognosia of opium addicts by significant deformation of personality and believe that the reduction or loss of critical attitude to one's own disease and oneself is the most characteristic feature of this contingent of patients [2].

The awareness of disease becomes apparent in the process of collecting diagnostic data, and then psychological diagnosis is determined.

At the beginning and at the end of the rehabilitation program a diagnostic counseling is conducted. The methodology applied included:

- self-exploration techniques,

- psycho-emotional state examination,

- interpersonal relationships diagnosis.

Support methodologies:

- psychodiagnosis of personality traits (SMIL),

- cognitive functions examination (Schulte Table, classifications, exclusion and generalization of concepts, diagnostics of thinking).

An indicator of quality is the available psychodiagnostic examination conclusion. The description of the problem includes: structural characteristics analysis, level of motivation, intelligence, emotional development, and taking into account the severity of disorders, range and duration of chronic disease, drug-addicted person's ability to adequately assess the social situation, his power to introspect and work autonomously on his own problems.

While revealing the second component of our pattern of drug addicts' psychological rehabilitation, the description of the problem, we should emphasize the describing not only of the problem of the drug-dependent person, but also of his family. Since chemical addiction is a family illness, the whole family is sick, both physically, mentally and spiritually, so the recovery must correspondingly begin with each family member.

2. Motivational (1^st -2^nd month)

The system is a rehabilitation process that includes individual and group psychotherapy, theoretical unit of teaching the patients, teaching the basics of psychophysiological self-regulation in a psychologist-patient system: psychocorrection and psychotherapeutic work with both the drug addict, and his relatives as well.

A clinical psychologist, a psychologist, a social worker conduct the following necessary steps:

a) reinforce the motivation for positive changes.

The Task is to:

- determine the events that led to hospitalization,

- identify the client's attitude to the existence of the problem,

- define the social resources,

- define the personal resources,

- determine the disposition to change.

b) take measures to improve psycho-emotional state.

The Task is:

- empathic listening;

- non evaluating acceptance of a client and his problem.

c) prevent HIV infection spreading and risk behavior,

d) inform on assistance available for vulnerable sectors of population.

Redirecting to other care/prevention facilities and non-governmental organizations, the use of printed information and motivation materials of various forms.

U. John notes that the optimal scheme in outpatient treatment is detoxification, motivation, treatment and maintenance therapy. The effectiveness of providing the direct medical care depends on how much the patient is motivated for the medical process. Without motivation to be treated, the assistance to drug addicted patients reduces to mere detoxification [3].

The main aim of the measures taken is counseling and motivational influence. The objective is: to determine the process of rendering psychological assistance and indicators for monitoring the quality of psychological care.

Drug addicts and their relatives are getting informed of the main aspects of the abuse of PAS and receive recommendations of the main ways to overcome the problem.

This phase of psychological rehabilitation program includes: research and advisory work, the main objective of which is the motivation for long-term treatment and active, responsible participation in it. Another important area is consulting relatives and people from the immediate environment.

Motivational dialogue is based on three main elements:

- cooperation between a patient and a psychotherapist,

- production and detection of typical for a client opinions about the necessary changes, - emphasizing the autonomy and responsibility of a client in implementing the changes.

Our technology of psychological rehabilitation of opioid addicts is based on the transtheoretical model of behavior change, developed by American psychologists of the University of Rhode Island, J. Prochaska and C. DiClemente, which describes a certain sequence in the stages of behavior changes of those under investigation, regardless of the therapy applied. Five stages of the model realization are distinguished [4].

According to transtheoretical model, the process of changing of human behavior involves six stages:

1. Preceding the considering of necessity for change.

2. Considering.

3. Preparatory stage.

4. The active actions stage.

5. Maintaining and consolidation of changes.

6. Changes already brought to effect.

The first stage precedes the considering of necessity for change. A person at this stage is not yet aware of the need for change that is obvious to those around him.

The second stage is the stage of considering when a person recognizes the existence of the problem, realizes the necessity for change and starts reflecting upon why things are not going as they should, and what needs be done to ensure that they were going better. At this stage an opioid addict can stay long. At this stage he usually evaluates pros and cons, weighs the positive and negative aspects of the use of opioids. This stage is marked by some change processes, particularly the empirical ones, determined by cognitive and emotional components.

The third stage is preparing for change. At this stage, attention of dependent people is switched from past problems to looking for ways to resolve them in the future. An important thing at this stage is change of the attitude to the problem, as well as self-confidence. Of course, the individuals are already taking a number of measures on their way to this stage. Empirical processes of change are used extensively; however, intensification of behavioral processes may occur.

The fourth stage is the active actions stage, at which the individuals are engaged in processing the new style of conduct. Real life implementation of the changes is always accompanied by a clear understanding of the way to put them into effect. It is important that the client took the decision by himself. This stage is the most responsible. At the stage of implementation of changes into life, behavioral processes of change are the most actively occurring, degree of temptation is reduced.

The fifth stage is abstinence or stabilization. In order for the changes to have a successful outcome, the stage of active actions should be followed by quite a long phase of maintenance and consolidation of changes. If the newly acquired behavior is neither supported, nor encouraged by the entourage, a person tends to return to old habits. This stage requires exercising persistence, perseverance and patience.

The sixth stage, the final one, is completion of the changes, that is achieving the moment when transformation is finished completely, whereas old attitudes and corresponding behavior patterns have completely given way to the new ones, which have already become habitual.

The results of the research. To assess the motivational changes, we used a modified questionnaire called "Diagnostics of Motivational Structure of Personality", by V. E. Milman, aimed at diagnosing the motivational structure of personality (the adult version). Using this technique, we examined the basic life aspirations of opioid addicts, identified the types of emotional profiles. Inclusion of emotional profile into a general motivational component is justified by commonality of motivation and emotionality.

According to V. E. Milman, the structure of personality contains two types of motivation: the productive and the consumptive one. Productive motivation (the values) determines the creative development of personality and promotes adaptation of a human in the society. This type of values orients an individual towards the future and contains preconditions of substantive, meaningful development both of a specific individual and society as a whole. Productive motivation is creative, since it promotes the generation of socially significant material and spiritual values.

Consumptive motivation is aimed at supporting an individual's life and is determined by his needs.

To evaluate stable motivational tendencies, V. E. Milman propounded the technique including 14 items with 8 subitems, while each of the subitems should be evaluated by the person under investigation on a 4-level scale of responses. In this technique, each response of the investigated is marked with 0 to 2, the marks are summarized according to the keys of the technique, and as a result we get mark scores on 7 scales.

V. E. Milman identifies seven scales in his technique of motivational structure of personality:

1. Life sustenance.

2. Comfort.

3. Social status.

4. Communication.

5. General activity.

6. Creative activity.

7. Social utility.

The first four scales characterize the life orientation of an individual, the "general activity", "creative activity" and "social utility" scales characterize his productive orientation.

The key to the test.