Ch. 4: Summary

In this module you learned about different ways that the various biological, psychological, and social context/physical environment theories and models related to substance use, substance misuse, and substance use disorders might be integrated into a coherent biopsychosocial framework. We considered how the different theories, models, and evidence might inform prevention and change-promoting strategies. First, you read about four steps in a vulnerability, risk, resilience, and protective factors approach to substance misuse-related problems. The grid that can be created from evidence in the literature can inform prevention strategies at the population/subgroup level (not at the individual assessment level). Next, you were introduced to several key concepts and principles in prevention. Introduction to the continuum of care model included descriptions and examples of health promotion, prevention (universal, selective, indicated), treatment, and recovery/maintenance. Vulnerability/risk and resilience/protective factors related to substance misuse and to different developmental periods were presented as means of informing developmentally appropriate preventive intervention strategies. You read an analysis by McNeece and Madsen (2012) of evidence surrounding various prevention approaches, a well. Finally, you were introduced to the transtheoretical model of behavior change (TTM or TMBC), including stages commonly observed in the intentional behavior change process and factors that are important in the change process. These elements and factors were related to intervention strategies that might facilitate movement through the change process and assist individuals in achieving their behavior change goals.

At this point, we have concluded much of the work related to theories of substance use, misuse, and use disorders. We are now ready to launch into the second half of the course and look at specific types of substances, as well as topics related to prescription and over-the-counter drug misuse, pharmacotherapy opportunities, and how co-occurring problems might affect substance-related problems and outcomes.