SUBSTANCE ABUSE: THE NEED FOR SECOND-ORDER CHANGE

LEONARD A. JASON
BRADLEY D. OLSON
JOSEPH R. FERRARI
MARGARET I. DAVIS


DOI: 10.2190/7EEP-D4HH-PAAA-L87P

Abstract

Under modern managed care, private and public sector inpatient substance abuse have reduced their services dramatically. Compounding this problem is the finding that various traditional substance abuse treatment programs, including inpatient and outpatient treatment programs, have high rates of recidivism. There is a need to develop and evaluate lower cost, non-medical, community-based care options for individuals recovering from substance-related disorders. Therapeutic communities, self-help groups, communal recovery homes, harm reduction interventions, and preventive community-based interventions have features that might impact "processes of change," particularly those proposed in the transtheoretical model of change (Prochaska, DiClemente, & Norcross, 1992). These more comprehensive community-based interventions might influence a wide range of processes to produce second-order change (Watzlawick, Weakland, & Fisch, 1974).

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