I am just resurfacing this thread as I wanted to ask a couple of questions and check my understanding....
Every time I think about the "applying psychological theory to practice" question, I seem to get really bogged down in the wording of this question.
For example, in preparation for a training course interview, I have been thinking about some examples to link theory to practice. Most of my thoughts have linked in with the sorts of questions maven suggested.
I have experience in helping to develop a stop smoking intervention for clients within a substance misuse service.
- what I know from the literature is that people who use drugs and/or alcohol are much more likely to smoke than the general population. Smoking is associated with poverty, poorer mental and physical health outcomes and increased risk of communicable diseases. People who use substances often need extra support to give up smoking, although are no less motivated to do so than people who don't use drugs or alcohol. I also know that people who misuse substances often die from smoking-related deaths, and smoking is a cause of premature death for this group. To me this outlines a rationale for why smoking cessation interventions are important for both the general population, and for a substance-using population who may not access traditional services.
- research suggests that smoking cessation interventions are effective for people who use substances. There are various RCTs, meta-analyses and systematic literature reviews which suggest that various interventios are effective including contingency management, coping skills training, relapse prevention work, and nicotine replacement therapy. NICE guidance suggests that all substance misuse services should offer smoking cessation as standard (although this rarely happens in practice).
- other relevant factors include that many people using substances may not access traditional stop smoking services and instead prefer to come to one place for their substance misuse and smoking treatment. Barriers to treatment include the perception that quitting smoking may harm recovery from other drugs or alchol, or cause them to relapse. This view is actually inconsistent with the literature which suggests that quitting smoking can help people to stay abstinent from other substances, and that cues for smoking and drug use are often very similar. Staff attitudes towards smoking can influence whether they talk about smoking cessation to service users, with staff smokers being much less likely to talk about quitting smoking. Many staff in substance misuse services do smoke (much more so than the general population) and so there is a shift in culture and knwoledge needed here. Most research has been conducted using the general population rather than people in substance misuse treatment. People who are in treatment for drug use are more likely to be heavier smokers and have smoked for longer which suggests that a different approach (such as harm reduction) might be needed.
- in terms of applying this knowledge to practice, a stop smoking group intervention was developed based on NICE guidance and guidance from the National Centre for Smoking Cessation and Training - both of which are based on evidence. The group contained a number of cognitive and behavioural strategies to behavior change, as well as education about smoking cessation, and myth-busting in terms of how stopping smoking may impact on substance misuse. Another key factor was recognising that many of the strategies used to stop smoking (recognising triggers, managing cravings, managing withdrawal, recognising and learning to manage high risk situation, behaviour monitoring etc) are also used to help reduce or stop substance use.
Just to stop there - the thing I get bogged down with is feeling like this isn't really applying theory to practice. I feel like to answer a question I need to talk about more general theory behind smoking and why people might smoke - or is the above example enough? I feel like I haven't really mentioned theory but I don't know if 'theory' applies to more general models, evidence from the literature etc?
Potentially I could go further and discuss how behavioural theories and cogntivie theories inform how smoking may start and be maintained but is this a step too far?
Can anyone clear this up for me? Thank you!