Vidrine Jennifer Irvin, Reitzel Lorraine R, Figueroa Patricia Y, Velasquez Mary M, Mazas Carlos A, Cinciripini Paul M, Wetter David W
University of Texas MD Anderson Cancer Center.
The University of Texas-Austin.
Cogn Behav Pract. 2013 Nov;20(4):501-516. doi: 10.1016/j.cbpra.2011.11.001. Epub 2011 Dec 8.
Over 10 years ago, Baer and colleagues proposed the integration of skills training and motivational strategies for the treatment of substance abuse. Since that time, several studies evaluating the efficacy of such hybrid approaches have been published, but few have been efficacious. Motivation and Problem Solving (MAPS) is a comprehensive, dynamic, and holistic intervention that incorporates empirically supported cognitive behavioral and social cognitive theory-based treatment strategies within an overarching motivational framework, and has been demonstrated to be effective in a randomized clinical trial focused on the prevention of postpartum smoking relapse. MAPS was designed to be applicable to not only relapse prevention but also the cessation of substance use, and is relevant for individuals regardless of their motivation to change. MAPS views motivation as dynamically fluctuating from moment to moment throughout the behavior change process, and comprehensively addresses multiple issues important to the individual and relevant to change through the creation of a wellness program. As a result, we believe that MAPS enhances the likelihood that individuals will successfully achieve and maintain abstinence from substance use, and that its comprehensive focus on addressing diverse and salient issues enhances both engagement in treatment and its applicability in modifying other health risk behaviors. The current paper introduces MAPS, distinguishes it from other hybrid and stage-based substance use treatments, and provides detailed information and clinical text regarding how MAPS is specifically and uniquely implemented to address key mechanisms relevant to quitting smoking and maintaining abstinence.
10多年前，贝尔及其同事提出将技能培训和激励策略相结合以治疗药物滥用。自那时以来，已发表了几项评估此类混合方法疗效的研究，但很少有方法是有效的。动机与问题解决疗法（MAPS）是一种全面、动态且整体的干预措施，它在一个总体的动机框架内纳入了基于实证支持的认知行为和社会认知理论的治疗策略，并且在一项针对预防产后吸烟复发的随机临床试验中已被证明是有效的。MAPS的设计不仅适用于预防复发，也适用于停止药物使用，并且适用于任何改变动机的个体。MAPS认为动机在整个行为改变过程中时刻都在动态波动，并通过创建一个健康计划全面解决对个体重要且与改变相关的多个问题。因此，我们相信MAPS提高了个体成功实现并维持药物使用戒断的可能性，并且其对解决各种突出问题的全面关注增强了对治疗的参与度及其在改变其他健康风险行为方面的适用性。本文介绍了MAPS，将其与其他混合和基于阶段的药物使用治疗方法区分开来，并提供了有关如何具体且独特地实施MAPS以解决与戒烟和维持戒断相关的关键机制的详细信息和临床文本。
