Autoeficácia e tentação em dependentes de cocaína/crack com tratamento baseado no modelo transteórico de mudança (MTT)

Abstract

The use of cocaine/crack is a concern in healthcare getting attention due to the increase of users and consequences that may result. There is no definition as to the best treatment for this population. One of them is the Transtheoretical model of change (TTM) that assists the user in intentional behavior change. The concepts of self-efficacy and temptation are part of TTM change mechanisms present in behavior modification as well as the processes of change that are divided into experiential processes and behavioral processes. This dissertation aims to evaluate self-efficacy for abstinence and the temptation to use drugs after intervention based on TTM in cocaine/crack dependents. It was used a secondary data analysis of the original study with was a randomized clinical trial. The participants were dependent on cocaine and/or crack, men and women, aged between 18-59, with minimum education of five years, and admitted to treatment facilities for drug addiction. The sample was divided into experimental group (n=39) that received eight sessions of TTM and the control group (n=30) that received eight sessions of psychoeducation about drugs. The following instruments were applied before and after the intervention: interview protocol; Wechsler Intelligence Scale for adults (WAIS-III); Mini-Mental State Examination (MMSE); Drug Abstinence Self-efficacy Scale (DASE); Temptation to Use Drugs Scale (TUD); and scale of processes change (EPM). Empirical Section I aimed to compare self-efficacy for abstinence and temptation to use drugs in cocaine/crack users after intervention with TTM. The results of the Student t test showed that there were significant differences in all factors of DASE (p<.05 e p≤.001) in the experimental group between the initial assessment and revaluation, and all the TUD factors (p≤.001). These findings indicate that self-efficacy increased and the temptation decreased after the intervention. The control group also showed differences in self-efficacy and temptation, but at a lower magnitude. The effect of the intervention was greater in the experimental group, both in DASE and TUD, with moderate effect and of great magnitude. Empirical Section II aimed to verify the association between self-efficacy for abstinence, temptation to use drugs and the processes of change after the intervention based on TTM. The Student t test results showed in the revaluation of the EPM that the experimental group used more behavioral processes (p=.000). The Pearson correlation observed that there was a association between DASE, TUD and EPM in the experimental group, the more self-efficacy and less temptation, the more behavioral processes were used such as self-deliberation, counter-conditioning and aid relationships. Thus, it is understood that after the intervention with TTM there was an increase in self-efficacy of the participants, reduction of temptation and association between these constructs with the processes of change, i.e., results consistent with the change toward abstinence from cocaine/crack.