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Table of Contents
Year : 2020  |  Volume : 34  |  Issue : 2  |  Page : 57-58

Three “M” approaches for treating addictive behaviors

1 Department of Educational Psychology and Counseling, National Tsing Hua University, Hsinchu, Taiwan
2 Department of Psychiatry, Hualien Armed Forces General Hospital, Hualien, Taiwan
3 General Education Center, National Yunlin University of Science and Technology, Touliou; Department of Family Medicine, National Cheng Kung University, Tainan, Taiwan

Date of Submission10-Dec-2019
Date of Decision20-Feb-2020
Date of Acceptance23-Feb-2020
Date of Web Publication26-Jun-2020

Correspondence Address:
Shih- Ming Li
No. 123, University Road, Section 3, Douliou, Yunlin 64002
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/TPSY.TPSY_13_20

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How to cite this article:
Lee KH, Hsieh CH, Li SM. Three “M” approaches for treating addictive behaviors. Taiwan J Psychiatry 2020;34:57-8

How to cite this URL:
Lee KH, Hsieh CH, Li SM. Three “M” approaches for treating addictive behaviors. Taiwan J Psychiatry [serial online] 2020 [cited 2023 Jan 31];34:57-8. Available from: http://www.e-tjp.org/text.asp?2020/34/2/57/288005

According to the transtheoretical model (TTM) [1], addictive behaviors change involves five stages – precontemplation, contemplation, preparation for action, action, and maintenance. Substance users in each stage have different psychological states and need different interventions to treat the addictive behaviors [1],[2].

In the TTM, the motivational interviewing and behavior therapy are integrated to deal with the addictive behaviors from the precontemplation stage to the maintenance stage [1]. Recently, the mindfulness-based relapse prevention is also useful to treat the addictive behaviors [3].

Considering the process and stage of the TTM [1], We propose a framework for psychotherapy for treating patients with addictive behavior. This framework has three psychological interventions – motivational interview, mindfulness-based relapse prevention, and modified of lifestyles [Table 1].
Table 1: Three “M” approach for psychological interventions

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  Three “M” Approaches for Psychological Interventions Top

According to this three “M” model, people in different stages of addict behaviors can be treated through specific interventions to facilitate their movement to the next stage of change. In this section, three psychological interventions are introduced, and how the patient process changes in stages of the three-M model is discussed in the future perspective.

In the three “M” model, the first “M” stands for motivational interviewing, which is a client-centered counseling style designed to help people make behavioral changes, ranging from reducing substance use to increasing exercise [2],[4]. When patients are conscious of their addictive behavior with decision balance or feedback, they move on from the precontemplation stage to contemplation and preparation for the action stage [1]. The motivational interviewing enhances one's consciousness and enables people to face their addictive behavior without resistance.

The second “M” stands for mindfulness-based intervention. From the contemplation to the action stage, drug abusers self-re-evaluate their addictive behavior and face cravings, withdrawal, and lapses. In the action stage, drug abusers may benefit more from mindfulness-based practices. In a meta-analysis, mindfulness intervention was discovered to affect depression, smoking, and addictive behavior [3]. Mindfulness is nonelaborative awareness of present-moment experiences [5]. Furthermore, people with substance use can learn alternative skills to cope with cravings and withdrawal symptoms, such as adopting a nonjudgmental attitude and awareness. Through mindfulness-based practices, people can effectively regulate negative emotions resulting from withdrawal or cravings. They have more confidence in resisting relapses and remaining sober for longer.

The third “M” stands for modified of lifestyles with behavior therapy. Walsh identified eight aspects of lifestyle related to mental health – exercise, good nutrition and diet, time spent in nature, favorable relationships, recreation, relaxation and stress management, religious or spiritual involvement, as well as service to others [6]. Based on the incremental theory of well-being, people with lifestyles that are beneficial to mental health have greater well-being and functioning [7]. When people change from the preparation stage to the maintenance stage, therapist can help substance users to modify unhealthy lifestyle with behavior therapy [1]. If the people engage in those mental health lifestyle, they will keep the mental health state [7] and stay in the maintain stage of TTM [1].

  Future Perspective Top

In the three “M” model, therapists use motivational interviewing to enhance one's consciousness with feedback, teach mindfulness skills for facing cravings, and modify lifestyles that facilitate good mental health in patients, enabling patients' self-efficacy to more easily remain in the maintenance stage. With the three “M” model, interventions are matched to the patient's stage of change and process patients transition from the pre-contemplation to the maintenance stage. In the future, the three “M” model can be used for treating addictive behavior, and empirical research needs to be conducted to verify its effectiveness.

The proposed ideas in this editorial, is purely based on theories. We need to test all those proposed ideas on patients with addictive behaviors.

  Financial Support and Sponsorship Top


  Conflicts of Interest Top

The author declares no potential conflicts of interest in writing this editorial.

  References Top

Prochaska JO, Norcross JC: Systems of Psychotherapy. London, United Kingdom: Oxford Press, 2018.  Back to cited text no. 1
Chiu NY, Chang CJ: Tobacco and smoking cessation. Tawain J Psychiatry (Taipei) 2019; 33: 125-34.  Back to cited text no. 2
Goldberg SB, Tucker RP, Greene PA, et al.: Mindfulness-based interventions for psychiatric disorders: a systematic review and meta-analysis. Clin Psychol Rev 2018; 59: 52-60.  Back to cited text no. 3
Lundahl B, Droubay BA, Burke B, et al.: Motivational interviewing adherence tools: a scoping review investigating content validity. Patient Educ Couns 2019; 102: 2145-55.  Back to cited text no. 4
Chambers R, Gullone E, Aen NB: Mindful emotion regulation: an integrative view. Clin Psychol Rev 2009; 29: 560-72.  Back to cited text no. 5
Walsh R: Lifestyle and mental health. Am Psychol 2011; 66: 579-92.  Back to cited text no. 6
Howell AJ, Passmore HA, Holder MD: Implicit theories of well-being predict well-being and the endorsement of therapeutic lifestyle changes. J Happ Stud 2016; 17: 2347-63.  Back to cited text no. 7


  [Table 1]


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