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Research has shown that social pressure is related to treatment motivation and plays an important role in treatment engagement in adults with problematic substance use. Despite the shifts in autonomy and decision-making in emerging adulthood, the factors affecting treatment motivation (e.g., readiness to comply with treatment) and motivation to change (e.g., problem recognition and taking steps towards change) during this period have been largely ignored. In this study, 134 youth presenting to an outpatient substance abuse program completed questionnaires investigating substance use history, mental health, social pressure to reduce use and enter treatment, and motivation. Results indicated that peer pressure accounted for significant variance in internal positive and internal negative treatment motivation. Family pressure was related only to external treatment motivation. Neither social network source had a significant impact on motivation to change. Limitations, directions for future research and treatment implications are discussed.

Research has shown that social pressure is related to treatment motivation and plays an important role in treatment engagement in adults with problematic substance use. Despite the shifts in autonomy and decision-making in emerging adulthood, the factors affecting treatment motivation (e.g., readiness to comply with treatment) and motivation to change (e.g., problem recognition and taking steps towards change) during this period have been largely ignored. In this study, 134 youth presenting to an outpatient substance abuse program completed questionnaires investigating substance use history, mental health, social pressure to reduce use and enter treatment, and motivation. Results indicated that peer pressure accounted for significant variance in internal positive and internal negative treatment motivation. Family pressure was related only to external treatment motivation. Neither social network source had a significant impact on motivation to change. Limitations, directions for future research and treatment implications are discussed.

The aim of the thesis was to facilitate the implementation of process change in the company KS-Europe, s.r.o. For this purpose, I conducted a survey in that enterprise through which I examined the feelings and opinions of employees for future change. On the basis of the survey was identified risk areas in preparation for the change about which I informed the director of the company that he could possibly take appropriate measures to alleviate the course of change. Approximately two months after the introduction of the change I conducted structured interviews with the director of the company, the chief of Heftshop and two employees. These interviews were analyzed by comparison to assess the overall course changes.

Despite the well-established effectiveness of couple therapy for reducing distress and improving relationship satisfaction (Cohen, 1988; Christensen and Heavey, 1999), less than a fourth of couples seek couple therapy prior to divorce (Albrecht, Bahr, and Goodman, 1983; Wolcott, 1986). Rather, the majority of couples wait over 5 years before seeking therapy (Johnson et al., 2002). Barriers to seeking individual therapy are well established and are associated with decreased rates of therapy attendance and the negative consequences of untreated distress and mental health problems (Corrigan, 2004; Killaspy, Banerjee, King, and Lloyd, 2000; Vogel, Wade and Hackler, 2007). It is unclear as to whether the same barriers exist for individuals who are seeking couple therapy. This study examined the applicability of the Health Belief Model (HBM; Rosenstock, 1966), with the addition of demographic characteristics (gender, income, education, and religion) and contextualizing individual factors (relational distress and perceived stigma), to predict an individual in a committed relationship's (N =158) motivation to seek couple therapy. When controlling for demographic variables and contextualizing factors, the Health Belief Model factors of lower barriers and lower benefits were predictive of higher motivation to seek couple therapy. Throughout all iterations of the model, lower income and lower relational distress were also associated with higher rates of motivation to seek couple therapy. This research indicates that barriers, including high levels of relational distress, impact an individual's motivation to seek couple therapy. Further investigation of the application of the HBM factors to mental health, including research into more systemic measurements of these factors, is needed. Future research should also identify other potentially contextualizing factors, as the overall model accounted for a relatively small amount of variation in the individual's motivation to seek couple therapy. / Ph. D. / Couple therapy has been shown to provide relief for relationship distress and individual mental health problems (Cohen, 1988; Christensen & Heavey, 1999). Despite this, the majority of couples choose to either live with relationship distress prior to seeking couple therapy or never seek treatment prior to getting divorced (Albrecht, Bahr, & Goodman, 1983; Gottman & Gottman, 2013; Johnson et al., 2002; Wolcott, 1986). Unfortunately, very little is known about the reasons couples avoid couple therapy; therefore, this research is based on the established barriers found in the literature on why individuals do not seek mental health treatment. Because of the inclusion of an established help-seeking theory, known as the Health Belief Model (HBM; Rosenstock, 1966), the results of this study can more broadly inform individuals, couples, therapists, and policy makers about the reasons individuals may not seek couple therapy. An online survey of 158 couples indicated that higher levels of relationship satisfaction, lower income levels, lower perceived benefits to couple therapy, and lower perceived barriers to accessing treatment were associated with higher motivation to seek couple therapy. Overall, research should continue to examine the application of the Health Belief Model constructs (perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action) to mental health seeking behavior, especially couple and family therapy. Research should also identify other potential constructs, beyond those used in this study (gender, income, education, religion, self-stigma, and relational distress), that impact an individual’s motivation to seek couple therapy.

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OF THE THESIS Name: Mgr. Markéta Šídová Specialization: Adiktologie Head of the thesis: Mgr. Lenka Šťastná, Ph.D. Pages: 145 The name of thesis: Tobacco smoking and motivation to change in relation to pregnancy Abstract: Background: The pregnancy gives the smoking women the opportunity to change their attitude to smoking tobacco. In the Czech Republic is still missing a study describing the motivation to change smoking specifically in connection with pregnancy. Goals: Describe the basic motivation to stop smoking by pregnant women. Methods: Quantitative survey. The questionnaire consists of four sections (anamnesis, gathering information about smoking during pregnancy, motivation to change smoking behaviour, Fagerström Test of Nicotine Dependence). Motivation section is inspired by Reasons for Quiting Scale (RFQ). Evaluation using the descriptive statistics and non-parametric statistical tests. File: The study analyses two sets of pregnant women - electronic (collection via web form, N = 96) and clinical (collection from the Department of Gynaecology and Obstetrics, 1st Faculty of Medicine and VFN, N = 40). The files are divided into 4 subgroups according to the current smoking behaviour. Results: Most women in both groups do not smoke and have never smoked or stopped in connection with pregnancy....

<p>ABSTRACT</p><p>Denna uppsats var en undersökning av motivationsarbetet på ett hälsoföretag i Sverige. Syftet med undersökningen var att beskriva vad hälsoföretaget använder sig av för teorier och metoder för att motivera sina klienter. Uppsatsen baserades på fyra intervjuer och två observationer. Personerna som ingick i undersökningen var alla anställda på företaget. Ledarna använder sig av olika teorier och modeller för att motivera sina deltagare. Några av dessa var motiverande samtal, kroppsspråk och motivationskorset. En viktig del av Hälsoföretagets arbete var att sprida glädje bland sina deltagare. De vill få alla att känna sig sedda och detta gjorde de genom uppmuntrande kommentarer och blickar. Trots det så upplevde vi att ingen av dem har reflekterat särskilt över hur de gör när de ska motivera sina klienter. Ett annat resultat vi fann var att inte alla använder sig av någon vetenskapligt baserad motivationsmodell. För att öka chansen för bättre resultat kan det vara en fördel att ta stöd från forskningen.</p>

ABSTRACT Denna uppsats var en undersökning av motivationsarbetet på ett hälsoföretag i Sverige. Syftet med undersökningen var att beskriva vad hälsoföretaget använder sig av för teorier och metoder för att motivera sina klienter. Uppsatsen baserades på fyra intervjuer och två observationer. Personerna som ingick i undersökningen var alla anställda på företaget. Ledarna använder sig av olika teorier och modeller för att motivera sina deltagare. Några av dessa var motiverande samtal, kroppsspråk och motivationskorset. En viktig del av Hälsoföretagets arbete var att sprida glädje bland sina deltagare. De vill få alla att känna sig sedda och detta gjorde de genom uppmuntrande kommentarer och blickar. Trots det så upplevde vi att ingen av dem har reflekterat särskilt över hur de gör när de ska motivera sina klienter. Ett annat resultat vi fann var att inte alla använder sig av någon vetenskapligt baserad motivationsmodell. För att öka chansen för bättre resultat kan det vara en fördel att ta stöd från forskningen.

Submitted by Maicon Juliano Schmidt (maicons) on 2015-07-14T13:42:06Z No. of bitstreams: 1 Iracil Rosinda Pires Soares.pdf: 5974329 bytes, checksum: ac4333b5efc51234ae48c04c15c79d7d (MD5) / Made available in DSpace on 2015-07-14T13:42:06Z (GMT). No. of bitstreams: 1 Iracil Rosinda Pires Soares.pdf: 5974329 bytes, checksum: ac4333b5efc51234ae48c04c15c79d7d (MD5) Previous issue date: 2014-01-31 / Nenhuma / A dependência de substâncias é um dos problemas mais graves e complexos de saúde pública, reconhecida mundialmente. A necessidade de desenvolvimento de tratamento é fundamental e deve levar em conta diferenças entre os sexos no que diz respeito à depressão e à ansiedade, à motivação para a mudança do comportamento problema e à fissura (craving) pelo crack. Para tal, conhecer as características e especificidades do dependente químico é essencial para o desenvolvimento de medidas efetivas de prevenção e intervenção. Esta dissertação de mestrado está organizada em dois artigos empíricos. O primeiro artigo apresenta os resultados do perfil sociodemográfico de homens e mulheres dependentes de crack internados para desintoxicação nos sistemas de saúde público e privado. Participaram 159 adultos (80 homens e 79 mulheres), com idades entre 18 e 60 anos, com média de 30,7 anos (DP=8,54). Dos participantes, 99 (62,3%) estavam internados em duas instituições públicas, e 60 (37,7%) em uma instituição privada, localizadas em Porto Alegre, RS, Brasil. A média de idade para a primeira situação de consumo de crack foi de 24 anos (DP=8,6). Os instrumentos utilizados foram uma entrevista sociodemográfica e padrão de consumo de substâncias psicoativas e o Mini International Neuropsychiatric Interview (M.I.N.I. Plus). Os resultados identificaram vulnerabilidades em ambos os sexos e em ambas as instituições, no presente estudo, nas seguintes variáveis: escolaridade, renda familiar, doenças diagnosticadas, uso de drogas lícitas e/ou ilícitas na família, motivos do consumo de crack, frequência do consumo de pedras de crack no início do uso e antes da internação, recursos para obtenção do crack, locais de tratamento, processo penal e ato infracional. Os dados indicam a importância de conhecer o perfil do dependente de crack, delineamento este que pode contribuir para o planejamento de programas preventivos em relação ao uso e abuso de substâncias psicoativas. O segundo artigo empírico teve como objetivo verificar os sintomas de ansiedade e depressão, avaliar a fissura pelo crack e identificar a motivação para mudança do comportamento, caracterizando as diferenças entre adultos do sexo feminino e masculino dependentes de crack internados para desintoxicação em instituições públicas e privadas. Os instrumentos utilizados foram o Inventário de Ansiedade de Beck (BAI), Inventário de Depressão de Beck (BDI-II), Cocaine Craving Questionnaire-Brief (CCQ-B) para o Crack, Escala URICA (University of Rhode Island Change Assessment) e Régua de Prontidão para Mudança. De acordo com os resultados, a amostra (N=159) apresentou sintomas de ansiedade moderada; sintomas de depressão mínima; fissura pelo crack moderada; encontrava-se no estágio de pré-contemplação e manutenção em relação à motivação para mudança do comportamento aditivo, no entanto, quando investigado o escore de prontidão para mudança, a amostra apresentou-se desmotivada em relação à mudança do comportamento, ao passo que, na Régua de Prontidão para a mudança mostrou vontade de mudar e confiança para alcançar a mudança. Observou-se uma frequência maior de casos graves de ansiedade no sistema público e maior frequência de mulheres com ansiedade grave no sistema público. Verificou-se que os principais preditores de prontidão para mudança (URICA) foram: em relação ao sexo, feminino; ao local de internação, instituição privada; e que não tenham vivenciado perdas significativas no decorrer da vida. Esses achados sugerem que o sexo tem relevante papel na dependência química, visto que apresentaram diferenças estatisticamente significativas no que se refere à ansiedade e à motivação para mudança do comportamento. Estes resultados confirmam a necessidade de mais pesquisas envolvendo as questões investigativas entre homens e mulheres na dependência de crack e outras substâncias psicoativas. / Substance dependence is recognized as one of the most serious and complex public health problems worldwide. The need to develop treatment is essential and must take into account the differences between sexes when concerning depression and anxiety, motivation to change problem behavior and craving for crack. To this end, it is essential to identify the characteristics and specificities of the chemically dependent in order to develop effective prevention and intervention measures. This dissertation is organized in two empirical articles. The first article presents the results of the demographic profile of men and women addicted to crack hospitalized for detoxification in public and private health systems. Participated 159 adults (80 men and 79 women), aged between 18 and 60 years, mean age of 30.7 years (SD=8.54). Of the participants, 99 (62.3%) were hospitalized in two public institutions, and 60 (37.7%) in a private institution located in Porto Alegre, RS, Brazil. The average age for the first situation of crack consumption was 24 years (SD=8.6). The instruments used were a sociodemographic interview and pattern of psychoactive substance use and the Mini International Neuropsychiatric Interview (M.I.N.I. Plus). The results identified, in the present study, vulnerabilities in both sexes and at both institutions in the following variables: education, family income, diagnosed diseases, use of licit and/or illicit drugs in the family, reasons for crack consumption, frequency of consumption of crack rocks at the beginning of use and before hospitalization, resources for obtaining crack, treatment settings (rehabilitation centers, inpatient settings), criminal prosecution and offense. The data indicate the importance of knowing the profile of the crack dependent for this can contribute to the planning of preventive programs regarding the use and abuse of psychoactive substances. The second empirical article aimed to verify the anxiety and depression symptoms, assess the craving for crack and identify the motivation for behavior change, characterizing the differences between male and female crack dependent adults admitted for detoxification in public and private institutions. The instruments used were the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI-II), Cocaine Craving Questionnaire-Brief (CCQ-B) for Crack, Scale URICA (University of Rhode Island Change Assessment) and The Readiness-to-Change ruler. According to the results, the sample (N=159) presented moderate symptoms of anxiety; minimal symptoms of depression; moderate craving for crack; it was found on the stage of contemplation and action regarding the motivation to change the addictive behavior, however, when the score of readiness to change was inquired, the sample was unmotivated 18 regarding behavior change, whereas The Readiness-to-Change ruler showed willingness to change and confidence to achieve change. We observed a higher frequency of severe cases of anxiety in the public system and increased frequency of women with severe anxiety in the public system. It was verified that the main predictors of readiness to change (RTC) were in relation to sex, female; the place of addmition, private institution; and who have not experienced significant losses throughout life. These findings suggest that sex plays an important role in chemical dependency, since they showed statistically significant differences with respect to anxiety and motivation to change behavior. These results confirm the need for more research involving investigative issues between male and female in crack dependence and other psychoactive substances.