Module of "Bebas Dari Narkoba" by Increasing Abstinence Self

Efficacy through Group Cognitive Behavioral Interventions

Irmawati

, Josetta M. R. Tuapattinaja

, and Juliana I. Saragih

Departement of Social Psychology, Universitas Sumatera Utara, Medan, Indonesia

Department of Clinical Psychology, Universitas Sumatera Utara, Medan, Indonesia

Keywords: Group Cognitive Behavioral, Cognitive Restructuring, Coping Skill, Abstinence Self Efficacy, Relapse,

High Risk Situation.

Abstract: Researchers in their second year of research have proven that the "Bebas dari Narkoba" Module with the

Group Cognitive Behavioral Concept can be used by non-psychologists in drug rehab centers to help drug

users improve Abstinence Self Efficacy. In this third year, researchers follow up to see the effectiveness of

the "Bebas dari Narkoba" Module provided by non-psychologists to former drug users who have returned to

society, using a qualitative and quantitative approach to gain more comprehensive understanding of the

modules tested. The methods used in data collection were focus group discussions with five non-

psychologist counselors, in-depth interviews and the Brief Situational Confident Questionaire to ten former

drug users who had been dealing with high risk situations trigger relapse. The results show that the "Bebas

dari Narkoba" Module is useful in increasing self-confidence to refuse to use drugs again after experiencing

cognitive restructuring and apply coping skills techniques. The high category Abstinence Self Efficacy is

shown by 70% of participants and very high category by 20% of participants and 10% in the medium

category. This shows that participants are confident enough to be able to face the high risk situation

encountered in the community or in the family environment.

1 INTRODUCTION

Drug abuse is no longer fresh news and is like an

iceberg phenomenon in increasing of numbers.

Various efforts have been made to address the

increasing number of drug users. One is through

agencies or rehabilitation centers to help users

regardless of their dependence on drugs. But they

remain vulnerable to relapse after leaving the

rehabilitation center due to the inability of former

drug users to reject the offer of using drugs again.

Not yet having the right coping technique and

rational mind in the face of high risk situation

(HRS), the situation triggered the desire to use drugs

again.

The first year of the study was to create a "Bebas

dari Narkoba" module by increasing Abstinence Self

Efficacy (ASE) through techniques in Group

Cognitive Behavioral interventions to help drug

users avoid relapse in the HRS. Through

experimental tests with pretest-posttest control group

design, the results showed that combining skill

coping and cognitive restructuring techniques is

more effective in enhancing ASE than by giving

these techniques separately.

In the first year of the study, the "Bebas dari

Narkoba" Module was conducted by a psychologist,

while the psychologist's rehabilitation centers were

so limited that it was certain that few drug users

could be treated to improve ASE. Researchers in the

second year validated the "Bebas dari Narkoba"

Module to be used by non-psychologists working in

drug rehab centers. This second year research uses

qualitative approach using focus group discussion

method, module and experiential learning test. The

results of a second year study proved that the "Bebas

dari Narkoba" Module by increasing drug users'

ASEs could be used by non-psychologists in

rehabilitation centers.

In this third year, researchers intend to follow up

on drug users who have been intervened by group

cognitive behavior approach by non-psychologist by

using qualitative and quantitative approach, in order

to get a comprehensive understanding about the

effectiveness of the module tested

1432

Soeprapto, I., Tuapattinaja, J. and Saragih, J.

Module of "Bebas Dari Narkoba" by Increasing Abstinence Self Efﬁcacy through Group Cognitive Behavioral Interventions.

DOI: 10.5220/0010081414321436

In Proceedings of the International Conference of Science, Technology, Engineering, Environmental and Ramiﬁcation Researches (ICOSTEERR 2018) - Research in Industry 4.0, pages

1432-1436

ISBN: 978-989-758-449-7

2 THEORITICAL REVIEW

Drug abuse in Indonesia has become a national

threat, even the President of the Republic of

Indonesia, Joko Widodo on the occasion of Anti-

Narcotics Day in mid 2016 declares war on drugs.

Based on the analysis of data on the prevention and

eradication of illegal Drugs Abuse and Distribution

(P4GN) nationally in 2010-2014 reported by the

National Narcotics Agency (BNN) of the Republic

of Indonesia, found that cases of drug abuse reached

a total of 34,443 cases and the number of drug

abusers reached 4,022,702 inhabitants 2014. The

high number of drug abusers, resulting in Indonesia

becoming a "target" of illicit drug trafficking.

Various preventive and repressive efforts have been

made by various parties but the recovery process of

the drug addicts was not an easy thing. The

vulnerable addicts experience relapse when

returning to society and dealing with high risk

situation (HRS). It takes a breakthrough solution to

help drug users survive and reject drug use again.

Related to this, drug rehabilitation centers need to be

strengthened in the form of improving the ability of

non-psychologists in rehabilitation centers in

conducting an effective intervention in order to help

drug users able to avoid relapse. One way to stay

clean and not to use drugs anymore is to increase

abstinence self efficacy (Ilgen, 2005) that is a belief

to abstain / not use drugs in specific situations such

as: negative emotional state, negative physical state

(in a state of physical illness), or in the existence of

interpersonal conflict.

In line with this, Witkiewitz & Marlatt (in

Sarafino, 2006) also explained that one that can

cause a relapse addict is a belief in his low ability.

An individual's belief in his ability to resist and

remain unconventional so that no relapse is called

abstinence self-efficacy (Majer, 2004). Marlat and

Gordon (in Handershot, 2011) provide that an

individual who is unsure of his or her ability to resist

drugs will be easier to relapse. Unlike the case with

individuals who believe in their ability to resist

drugs, it will be more difficult to experience relapse.

According to Hagman (2004), drug users who

already have confidence in their ability to avoid drug

use means having an effective skill technique.

Chiang (2006) stated that addicts need to do

cognitive restructuring by restructuring their

irrational thoughts about the benefits of drug use

such as: drugs can help solve problems, increase

self-esteem, without drugs it will reduce the physical

ability to work and be able to overcome various day-

to- day. While Rangé1 (2012) asserted that a drug

user not only requires the improvement of skill

coping skills, but it is necessary to establish a

rational cognitive status.

The application of cognitive behavioral

techniques can be done not only to an individual but

also to a group. Bieling (2006) explained that the

advantages of a grouping approach focus on

openness in interaction, which is characterized by

freedom of expression of thoughts and feelings,

mutual trust, mutual attention, mutual understanding

and mutual help. Morrison (in Bieling, 2006)

mentions that the advantages gained in the cognitive

behavior group approach compared to the individual

is efficiency in terms of time, cost and effort.

3 METHODS

3.1 Research Design

This research uses qualitative and quantitative

approach as the research design

3.2 Participants

Participants involved in the study were 5 (five)

counselors who had applied the "Bebas dari

Narkoba" Module, 10 (ten) former drug users who

had followed the module while still undergoing a

recovery process at the rehabilitation center and had

returned to the community and were dealing with

high risk situation.

3.3 Data Collection

Data collection is done through several methods,

namely focus group discussion (FGD), in-depth

interview and giving the scale of Brief Situational

Confident Questionaire (BSCQ).If any, should be

placed before the references section without

numbering.

3.1.1 FGD

The guidance in conducting FGDs involves the

counselor's experience in applying the "Bebas dari

Narkoba" Module using the cognitive behavioral

group and informing counselors about the abstinence

conditions of the participant self efficacy after

returning to the community and dealing with the

high risk situation.

Module of "Bebas Dari Narkoba" by Increasing Abstinence Self Efﬁcacy through Group Cognitive Behavioral Interventions

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3.1.2 In-depth Interview

In-depth interviews are conducted against former

drug users, with the aim of identifying cognitive

restructuring and the effectiveness of applying

coping skills when dealing with the high risk

situation contained in the "Bebas dari Narkoba"

Module, when the former drug users back to the

community and dealing with HRS. The results

obtained are processed through verbatim analysis.

In-depth interview guides include:

 Participants experience facing HRS when

returning home / community.

 Situations that can trigger relapse.

 Thoughts while facing of the situation.

 Techniques used to avoid relapse.

3.1.3 BSCQ Scale

BSCQ scale which has been tested in terms of

validity in the first year of research, aims to measure

individual beliefs about their ability to remain

abstain or refuse drug use in the face of high risk

situations (HRS). BSCQ score analysis using 5

(five) categorization that is very high, high, medium,

low, very low.

3.4 Data Analysis

Qualitative and quantitative descriptive analysis

were used as data analysis

4 RESULTS

4.1 Focus Group Discussion (FGD)

FGD shows data that:

• "Bebas dari Narkoba" modules can be applied by

counselors (non psychologists) because

they

have clear, concrete, measurable guidance and

are proven to increase abstinence self efficacy

among drug users.

• The "Bebas dari Narkoba" module can be applied

to drug users from adolescence to adulthood.

• The application of a group module with sharing

activities is valued to help participants to open up

and understand the concrete steps they can take

when facing HRS from other peers' experiences,

as well as the opportunity to encourage mutual

support.

• Experience sharing activities when applying

modules in the form of groups is considered very

helpful drug participants / users to open up and

provide support to other participants.

4.2 In-depth Interview

Based on in-depth interview obtained data:

 There is a shift / change / restructuring in the

cognitive ex drug user about the drug and its

benefits: the drug initially is everything (especially

in solving the problem at hand), shifts to the

destructive of life (drugs do not solve problems,

destroys and robs them of their happiness) .

 80% of participants using 3 techniques from 5

trained coping skills, self talk (no use of drugs, will

spend more time to be trusted, I have a future, drugs

will damage me back, I can survive without drugs,

God will guide me to survive), avoid (leave old

friends fellow drug users, avoid meeting with them,

do not call and / or accept invitations of fellow drug

users, choose not to go home to avoid situations

exposed to the environment friends fellow users

used to gather), and distract (doing other activities

when suggestions such as playing with children,

watching movies, cleaning motorcycles, contacting

counselors)

• 20% of participants who use endure techniques,

in addition to these three techniques, by not giving

attention to friends who are using drugs, prefer to

focus on talking and playing cards.

4.3 Skala Brief Situational Confident

Questionaire (BSCQ)

Results obtained from the BSCQ Scale, which

indicate how much participants' beliefs to refuse to

use drugs are as follows:

• 70% of participants had ASEs in high category,

even 20% in very high category, indicating that

participants rated confident of being able to deal

with HRS encountered in the community or in the

family environment.

• 10% of participants showed ASE in the

moderate category; showed enough confidence to be

able to refuse to use drugs again after returning to

the community, only very unsure to refuse to use

drugs again when dealing directly with drugs.

4.4 Other Factors

Other factors that also play a role in supporting the

success of participants are not relapse, able to refuse

to use drugs again are:

ICOSTEERR 2018 - International Conference of Science, Technology, Engineering, Environmental and Ramiﬁcation Researches

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4.4.1 Internal Factors

• A strong determination to prove to parents and

the surrounding community about changes in self

(already clean / not using drugs anymore). Some

participants stated strong willpower will persist by

using self talk as often as possible.

• Take the decision to be in the safe circle of

hanging out with counselors, following regular

religious activities with new friends, who are not

drug users.

4.4.2 External Factors

• Acceptance and trust given by the family to

former drug users.

• The time available for the counselor to open up

and listen to any complaints or concerns at any time

5 CONCLUSIONS

The results of this study indicate that the cognitive

behavioral approach that became the basis of the

"Bebas dari Narkoba" module successfully increased

the abstinence of self efficacy of former drug users

to avoid relapse. This is in line with the opinion of

Rangé (2012) that a drug user not only requires

increased coping skills but needs to build a rational

cognitive status in order to be able to resist drug use

again. According to Martin & Pears (2012),

cognitive behavioral group as a form of therapy is

generally performed by a professional, in this case is

a psychologist, who has undergone education and

mastered the principles of cognitive behavior

approach. This study proves that counselors at non-

psychological rehabilitation centers were able to

understand cognitive behavioral concepts to help

improve the abstinence of self-efficacy of former

drug users.

But even so, researchers are aware that in order

to use this module extensively, it is necessary to

increase the number of counselors who receive

training for trainers (TOT) of the "Bebas dari

Narkoba" Module. It also requires commitment from

the managers of drug rehabilitation centers to apply

this module as an integral part of the existing

programs in the rehabilitation process so that

counselors have intense experience, which can

improve their skills in applying the module

accurately.

ACKNOWLEDGMENT

Thank you to the University of Sumatera Utara for

the funds provided for this research through Non-

PNBP funds in accordance with TALENTA

University of Sumatera Utara Research Contract

Implementation Budget 2018 Number: 2590 /

UN5.IR / PPM / 2017 dated March 16, 2018. Thank

you also to counselors and former drug users who

have made this research possible as expected.

REFERENCES

APA, 2004. Diagnostic and Statistical Manual of Mental

Disorder 4th Edition Text Revision. Donneley & son

company: USA

BNN. (2007). Data penyalahgunaan narkoba.

WWW.BNN.go.id

Bieling Peter J. 2006. Cognitive Behavioral Therapy in

Groups. The Guilford Press: London

Chiang, Chen-Heng. 2006. The relationships among

personality traits, irrational beliefs,craving and

relapse intention of male amphetamine Abusers.

Taiwan University of Technology: Taiwan

Hagman, Brett T. 2004. Coping And Self-Efficacy As

Predictors Of Substance Use During The First Few

Critical Months Following Substance Abuse

Treatment Completion.

Hendershot, Christian S. 2011. Relapse prevention for

addictive behaviors. BioMed Central Ltd: Canada

Hankins, J Hayde. 2008. Increase Self-efficacy in the

Context of Addiction Behaviours. Journal of Health

Psychology SAGE Publications:King’s College

London, UK

Ilgen, Mark. 2005. Abstinence Self-Efficacy and

Abstinence 1 Year After Substance UseDisorder

Treatment. Journal of Consulting and Clinical

Psychology In the public domain: Stanford University

School of Medicine

Keshi, Ali Khaneh. 2013. Effectiveness of cognitive

behavior therapy on selfefficacy Among high school

students. Department of Psychology, University of

Mysore: INDIA.

Martin & Pear, 2012, Bahavior Modification 8

ed.

Pearson Prentice Hall: USA

Majer. John M. 2004. Optimism, Abstinence Self-Efficacy,

and Self-Mastery A Comparative Analysis of Cognitive

Resources. DePaul UniversityAssessment, Volume 11,

No. 1 Sage Publications: UK

Minervini, Iacopo. 2011. Desire and Coping Self-Efficacy

as Craving Measures in Addiction: The Self-Efficacy

and Desire Scale (SAD. The Open Behavioral Science

Journal: Italy

Rangé1 Rangé1 P. 2012. Cognitive-Behavior Therapy for

Substance Abuse. Federal University at Rio de

Janeiro: Brazil

Module of "Bebas Dari Narkoba" by Increasing Abstinence Self Efﬁcacy through Group Cognitive Behavioral Interventions

1435

Sarafino, Edward P. 2006. Health Psychology

Biopsychosocial Interaction. New York: JohnWiley &

Sons

Schultz, D. P (2011). Theories of Personality.9

ed.

Australia: Thomson Wadswarth Spiegler, Michael D.

2003. Contemporary Behavior Therapy. Wadswoth:

USA

ICOSTEERR 2018 - International Conference of Science, Technology, Engineering, Environmental and Ramiﬁcation Researches

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