Addictions Final Fall 2019

What is a mental status exam?

A structured assessment of the patient's behavioral and cognitive functioning

Multicausal models

- addiction is not caused by a single factor Syndrome model of addiction - suggests that the current research pertaining to excessive eating, gamling, sexual behaviors, shopping, substance abuse, and so on doest not adequately capture the origin, nature, and processes of addiction Integral model - examines substance abuse etiology and treatment from a four-quadrant perspective adapted from the work of Ken Wilbur and incorporates concepts from integrative medicine and transpersonal psychology

Culture-specific models

- possibilities inherent in promoting stereotypes and overgeneralizing about the characteristics of those who "seem" to fit the specific culture under consideration (France, Italy, Catholic) Subcultural models - factors related to age, gender, ethnicity, SES, religion, and family background can create different patterns within specific cultural groups

Supracultural models

-(Bales) cultures that create guilt, suppress aggression and sexual tension, and that support the use of alcohol to relieve those tensions will probably have high rates of alcoholism; cultures collective attitude toward alcohol use could influence the rate of alcoholism (Bacon) high rates of alcoholism were likely to exist in cultures that combine a lack of indulgence toward children with demanding attitudes toward achievement and negative attitudes toward dependent behavior in adults

At least 2 functions and characteristics of Children of Alcoholics (COAs)

-Children of Alcoholics have elevated risks of impulsivity, conduct disorders, alexithymia, depression, and anxiety. -COAs are at an elevated risk of alcoholism. -Their home env. Is one in which they do not have control

At least three ethical and legal issues with groups

-Competence of leader -Confidentiality -Informed consent

Two types of counselors in the addiction field

-Counselors in recovery -Counselors who have never used

Secondary strategies that prevention programs may be categorized

-Designed for individuals whom have already began to exhibit problematic behaviors and symptoms -Halt the behavior before it reaches levels of severity, or before symptoms get worse. -"Some secondary programs can be described as a harm reduction model." -Example: responsible drinking (in hindsight rather than abstinence)

In counseling persons with addiction problems and disabilities, counselors must have a clear understanding of the client's psychosocial history and presenting problems. What are at least 2 basic questions you should ask to help identify areas in which the client may have disabilities, impairments, and functional limitations?

-Do you feel you have a disability, or has anyone ever told you that you have one? Have you ever had to stay in a hospital overnight, or gone to an emergency room for any reason? -Do you take any kind of medication (prescription and over-the-counter)? -Were you ever diagnosed with a disability?

Examples of Self-care

-Don't take work home -Ask for help -Adjust schedule -Do something physical -Water, water, water and healthy diet as well as healthy sleep patterns -Continuing education

Give at least two examples of environmental interventions, emotional interventions, cognitive interventions, and physical interventions that target triggers?

-Environmental interventions -Thoroughly clean their living space, one area or room at a time, to reinforce a sense of control over personal or local environment -Avoiding certain places, such as neighborhoods where crack or meth house is located, and frequent nonhigh-risk locations, such as community centers or AA/NA meetings -Emotional interventions -Stay with the feeling verbalizing out loud the list of things accomplished to stay sober Self-soothing - focusing on one of the five senses at a time, pausing to fully attend to, experience, or soak in the natural or nonsubstance-induces sensation in order to withstand an urge or a craving to use -Cognitive interventions -Review a written plan detailing alternative preparations and strategies to keep from using -Teach the client to confront the problem with comebacks and question the evidence regarding the seemingly infinite benefits of substance use, as well as the seemingly infinite detriments or negative assumptions about sobriety -Physical interventions -Engage in physical exercise, talk with someone such as an AA sponsor, sing, snap a rubber band on the wrist -Remind clients of the "insanity" of their active using days, recalling seemingly irrelevant decisions mad and the negative physical consequences of their using

Four pillars that guide the philosophy and subsequent counseling actions of MI

-Expressing empathy: demonstrates that the counselor unconditionally accepts the client -Developing discrepancy: requires active listening from the counselor; cognitive dissonance -Rolling with resistance: counselor must not argue for change, instead view resistance as a signal the session should go in a different direction -Support self-efficacy: important for clients to believe they have personal choice and control

Family Models

-Family members are influential in motivation the addict to get sober or in preventing the addict from making serious changes -Behavioral models - make excuses for family members; unable to relate to a family member who is "under the influence" -Family systems - focuses on the way roles in families interrelate Family disease - entire family has disorder/disease and all must enter counseling for improvement to occur within the addicted family member

4 stages that counselors may use to assess sexual identity stage for client seeking treatment

-Identification (lesbian, gay, bisexual, and identifying one's attraction to the same sex) -Cognitive changes (accessing community resources and activities in the LGB community) -Acceptance (giving oneself permission to be LGB) -Action (sharing about one's LGB identity with family, friends, and others, and embracing ones' sexual identity)

Temperance Movement

-Initial goal was the replacement of excessive drinking with more moderate and socially approved levels of drinking -6 artisans and working men started the Washingtonian Total Abstinence Society (1840) & were key in shaping future self-help groups -Women's Christian Temperance Movement and the mobilization of efforts to close down saloons (late 1800's)

What are the assumptions of cognitive behavioral approaches?

-Involves complex cognitive and behavioral processes -Is largely learned -Can be modified, particularly by means of CB counseling -Is to teach coping skills to resist substance use and to reduce problems associated with substance abuse and dependence -requires comprehensive case conceptualization that serves as the basis for selecting specific CB techniques -is a warm, supportive, collaborative counseling relationship

Tertiary strategies that prevention programs may be categorized

-Juvenile Drug Court (JDC) is an example of a tertiary program -Diverting drug offenders and substance abusers to treatment, and rehabilitation recovery programs, in opposition to criminal charges and jail time. -Examples: JDC, mandated counseling programs, or relapse prevention programs.

Difference between lapse and relapse

-Lapse: a technical or modest breach of agreed treatment goals, which allows for learning and therefore eventual achievement of the ultimate aims and objectives of treatment -A moment of poor judgement but learn from mistake and keeping recovery and treatment a priority -Relapse: a more serious violation of treatment goals, or a more minor violations in which such learning is not evident -When a single glass of wine turns into denial of addiction and abandoning recovery

Concerns about counselors who have never been users

-May unconsciously stigmatize these clients by making assumptions based on media images and stereotypes -Possible negative feelings toward the client which can result in consequences of loss of capacity for empathy as well as possible early client termination

Discuss briefly drugs used in treating opioid dependence. What is this treatment an example of (discussed in Chapter 8)?

-Methadone, buprenorphine, naltrexone -Harm reduction

Two signs of gambling addiction

-Need to gamble with increasing amounts of money in order to achieve the desired excitement -Lies to conceal the extent of involvement with gambling -Relies on others to provide money to relieve desperate financial situations

What are at least 3 ways addictions counselors can advocate for LGBTQ people?

-Post a list of LGBTQ-friendly 12-step meeting in the local, regional, and national area -Ensure that all paperwork is LGBTQ-inclusive and free of heterosexist language and includes transgender as a gender box or allows clients to write in their gender as opposed to checking a box -Train fellow counselors and staff on LGBTQ culture to ensure an LGBTQ-friendly environment at all levels of treatment -Constantly monitor one's level of awareness, knowledge, and skills in working with LGBTQ people living with addiction in order to increase one's competence with these issues.

Three points to remember about human assessment measures

-Protect client welfare and information -Be competent to use assessment -Recognize uniqueness and diversity -Be watchful of stereotypes -Use proper instrument appropriately -Keep empathic connection alive -Use multiple methods -Continue to reassess over time

Four central concepts essential for client or clinician behavior change:

-Stages of change (precontemplation, contemplation, preparation, action, and maintenance, and ***relapse) -Processes of change (cognitive, behavioral, and affective activities that facilitate change) -Self-Efficacy (client's/clinician's confidence in making changes) -Decisional Balance (advantages and disadvantages of change)

Three categories of assessment interviews

-Structured: optimize reliability and validity, with the intent of limiting assessor bias; rigid, may need training, and can compromise rapport -Semi-structured: provide a framework for addictions counselors to use while still allowing a detail-oriented clinician to pursue areas of important client information and disclosure not addressed by a structured assessment tool -Unstructured: allows the client to more freely share experience & allows the clinician to divert and probe into areas that arise during the interview; builds rapport

Primary strategies that prevention programs may be categorized

-Targets the existence of problem behaviors before symptoms began to occur. Participants within an "at-risk" category or vulnerable population. -Purpose: Diminish the problem before it begins. -Examples: elementary students (D.A.R.E) program, health and wellness (courses in high school that provide knowledge of the effects of substances on the human body) etc.

Comorbidity

-The co-occurrence of two or more disorders in a single individual (substance abuse accompanied by anxiety and mood disorders) -NIDA suggests that there are various factors that impace the pervasiveness of comorbidity among substance users, such as gender, type of disorder, and mental illness -Various types of mental health disorders may prove to be a predictor for the onset and development of substance abuse or addiction

Reasons many freshmen use alcohol and drugs

-The effects of substance abuse is usually initiated during childhood and adolescence. -"Many freshmen use alcohol and drugs to reduce their social anxiety, to fit in socially, and for a major part of their recreational activities."

What is the informed eclecticism model?

-There is no single superior approach to treatment for all individuals -Treatment programs and systems should be constructed with a variety of approaches that have been shown to be effective -Different types of individuals respond best to different treatment approaches. Miller & Hester strongly emphasize tailoring or customizing treatment to the unique needs and strengths of each individual client, thereby increasing treatment effectiveness and efficiency. Implicit in this model is the need for all helping professionals in the addictions field to be familiar with a multiplicity of interventions so as to select from and offer the most appropriate type and level or care to those needing and deserving quality service.

What are three types of therapeutic relationships in client-counselor collaboration?

-Visitor-type: when the client believes there in not a problem and the counselor agrees, validates, or "goes along with" this perceptions, while at the same time offering to help the client in ways the clients may be able to determine -Complainant-type: problem recognition and a shared understanding of the nature of the problem, with the focus being on how the client can transition to seeing him/herself as part of the solution -Customer-type: involves joint construction of a solution plan or path that the client is able and willing to participate in and even take the lead on

What are some examples of Harm Reduction?

-Warm turkey approach: includes sobriety sampling, whereby the client attempts to abstain for a period of time, on an experimental basis. -Tapering down: the amount and frequency of consumption is gradually decreased. -Trial moderation: a negotiated period of time when the client is allowed to try limiting his/her intake. This takes place after a period of sobriety with the support of a counselor or concerned significant other, and usually applies to alcohol use only.

Sociocultural Models

-a person's likelihood of using drugs are influenced by the sociocultural system surrounding the individual - observations of the differences and similarities between cultural groups and subgroups; the social context of drug use strongly influences drug definitions, drug effect, drug-related behavior, and the drug experience;

Biological Models

-addicts are predisposed to develop dependence of drugs -Genetic models :strong statistical associations between genetic factors and alcohol abuse: ex - adopted children closely resemble their biological parents than adoptive parents when it comes to alcohol use, alcoholic rates are higher in monozygotic twin pairs than dizygotic pairs, children of alcoholics are 7x more likely to be alcoholic -Neurobiological models: neurotransmitters in the brain that serve as the chemical messengers of our brain; affects limbic system; dopamine is key in activity

Prochaska and Diclemente's Theoretical Model of Change

-leading approach for explaining and interventing across a variety of health-related behaviors such as smoking cessation, alcohol abuse, dieting, and substance abuse -use to assess an addiction counselor's rediness for change in terms of adapting new treatment protocols

Philosophical foundations of Addictions Counseling

1. Hope 2. Strength-based approaches 3. Whole Person approach 4. Motivation 5. Client Collaboration 6. Multidisciplinary approach 7. Advocacy

At least 2 steps of the 12 steps of AA

1. We admitted we were powerless over alcohol—that our lives had become unmanageable. 2. Came to believe that a Power greater than ourselves could restore us to sanity. 3. Made a decision to turn our will and our lives over to the care of God as we understood Him. 4. Made a searching and fearless moral inventory of ourselves. 5. Admitted to God, to ourselves, and to another human being the exact nature of our wrongs. 6. Were entirely ready to have God remove all these defects of character. 7. Humbly asked Him to remove our shortcomings. 8. Made a list of all persons we had harmed, and became willing to make amends to them all. 9. Made direct amends to such people wherever possible, except when to do so would injure them or others. 10. Continued to take personal inventory and when we were wrong promptly admitted it. 11. Sought through prayer and meditation to improve our conscious contact with God, as we understood Him, praying only for knowledge of His will for us and the power to carry that out. 12. Having had a spiritual awakening as the result of these Steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.

Similar to the diagnostic process of substance addiction, diagnosis of a process addiction is based on five criteria:

1. loss of willpower 2. harmful consequences 3. unmanageable lifestyle 4. tolerance or escalation of use 5. withdrawal symptoms upon quitting

Minimum age of client for AUI

16

By what ratio men outnumber women in addictions treatment?

4 to 1

As many as what percent of women with drug abuse and dependence problems report being sexually abused at least once in their lifetime?

90%

Define absorption, distribution, biotransformation, and elimination.

Absorption: aspirin into the body from the swallowed tablet Distribution: aspirin throughout the body Biotransformation: aspirin into by-products (i.e. metabolites) Elimination: waste by-products

What core factors contribute to the desire to produce pleasure and reduce painful (a)ffects?

Agonist, antagonist, neurotransmitter, receptor, and reuptake

Discuss the ASAM levels of care

American Society of Addiction Medicine's (ASAM) levels of care are listed below: Level 0.5 Early interventions Intervention services are provided for clients at risk or those who might have a substance-related problem. Level I Outpatient Treatment Consists of nonresidential services, which are organized and can be delivered in a variety of settings. Level II Intensive Outpatient or Partial Hospitalization This is usually in an outpatient setting and can be delivered before or after work and school, during weekdays, or on weekends. Level III Residential or Inpatient Is a 24-hour residential (live in) setting in which services are provided by mental health professionals and addiction treatment counselors. Level IV Medically Managed Inpatient Care Is designed to provide 24-hour medically managed evaluation and treatment.

What are some of the observations noted on a mental status exam?

Appearance General behavior Attitude Speech Affect Mood Attention Form of thought Content of thought Perception Memory Orientation Intellectual functioning Insight Judgment Reading and writing

Categories of resistant behavior

Arguing - client may appear hostile and argumentative Interrupting - client takes on defensive manner and may talk over the counselor or cut the counselor off Negating - client appears to be unwilling to acknowledge that there is a problem and/or appears to be resistant to taking responsibility for the problems Ignoring - client is not actively engaging in the helping conversation

Five techniques to use early and often in MI

Ask open-ended questions Reflective listening Affirmation Summarization Eliciting change talk

Men who abuse cocaine are more likely to be diagnosed with what disorder?

Attention deficit hyperactivity disorder

What medication was the first pharmacotherapy available for alcohol addiction?

Aversion Treatment, First-Line: Disulfiram (Antabuse)

What is BASICS?

BASICS is a two-session program offered on college campus that is intended to raise awareness of drinking behaviors and to encourage a consideration of behavior change by providing feedback in a nonjudgmental manner. It has been proven effective at decreasing alcohol use and its consequences at 6-month follow-up, especially for male students.

Stimulants

Cocaine, amphetamine, methamphetamine

What are some common relapse precursors for LGBTQ clients?

Coming-out issues, experience of shame, low self-esteem, internalize homonegativity and/or transnegativity, verbal and physical attacks, grief and loss due to HIV/AIDS, learning about HIV status, and social situations where AODs are present

To the members of NA, it is not the specific chemical that is the problem, but what?

Common disease of addiction

CRAFT

Community Reinforcement and Family Training: based on the principles of CRA but it is designed for and targets the friends and family members of the person with the substance use problem, specifically the person who refuses to enter treatment. Rather than working directly with the person with substance use problems, it enlists the assistance of a concerned significant other, such as a parent or spouse, by training the CSO to interact with his/her loved one in new and more constructive ways. It is describes as a rigorous treatment package.

What is an example discussed in the textbook of an intervention with no proven track record or with a poor track record, or one that is potentially harmful?

D.A.R.E

"Unlike many other people with disabilities, people who are ____ often do not identify with a medical model of disability and instead embrace a cultural model that emphasizes their abilities within the ____ community and their own language and values."

Deaf; deaf

Stages in addicted family systems

Denial Home treatment Chaos Control:

What are exceptions that facilitate change?

Exceptions refer to occasions when the problem is not a problem or times when the problem could have happened. The past Recent nonproblem occurrences Recurrent exceptions Occasions in the future when the client can imagine the problem no longer existing or being influential

Major cause of death ranking in the U.S.

Excessive drinking

True or False: Latinos have the highest rate of alcohol related deaths. Native Americans have the highest rate of alcohol related deaths.

FALSE

What is a criticism journal?

Family members keep track of every critical and fearful thought they have about the addict and the process of recovery. Family members can keep the journal until the end of counseling, at which they can look back and see what changed.

By how many times does Alcohol dependence increase the risk of death in women?

Five times

Disadvantages of groups

Group conflict is a disadvantage of group therapy for treatment of addictions. Leaders should consider the implications of resistance and conflict on a macro and micro level. Also hostile behavior can be a conflict that occasionally occurs.

At least 3 risk factors for persons with disabilities

Health and Medical Psychological Interpersonal and Social

What are the steps in entering an inpatient facility?

In the initial phase, a client will most likely meet with a clinician, one who will be in charge of the treatment program. Next is a quick medical evaluation, followed by more introductions and being escorted to a dorm room. In the active phase a client will have access to and utilize various treatment modalities and services. Sleeping is scheduled and relationships are forbidden. The final phase is where one would create an aftercare program of options for release.

What is the FRAMES perspective of brief interventions?

Intended to fulfill the primary purpose of brief interventions: to enhance a person's own resources for change by activating his/her own self-regulatory processes.

Two characteristics of comorbidity

Involve mental and emotional disorders that coincide with substance use disorders.

How many prisoners meet the DSM criteria for substance abuse?

It is estimated that 1.7 million (about two-thirds) prisoners meet the DSM criteria for substance abuse

Discuss Mindfulness-Based Relapse Prevention.

It is intended to promote increased awareness of triggers for substance use, habitual patterns of using, and "automatic" reactions that seem to control a person's daily living. It is an aftercare program for persons who have completed out-patient or in-patient treatment for substance use disorders. It takes place in 2-hour weekly group sessions over an 8-week period and offers instruction on mindfulness skills, and times is allotted for practicing theses skills when urges, cravings, and other triggers to use arise. Clients are encouraged to adopt mindfulness as a recovery lifestyle.

Hallucinogens

LSD, Mescaline, psilocybin (mushrooms)

Most often selected screening instruments in assessing substance abuse

MAST, The CAGE, and SASSI-3

At least 2 coping strategies

Meditation and deep breathing exercises Cognitive coping strategies, such as mindfulness and self-talk

One alternative model

Osborn Argues that disease concept model and states that those with alcohol use disorders can be best served by matching treatment to individual client needs and that brief interventions that target specific symptoms are just as effective as more intensive and long-term treatment.

Control

Other family members identify the problem as an addiction, and control is often attempted through divorce, separation, or total emotional isolation. The family then becomes ensnared in a cycle of helplessness and futile attempts to control the addict's behavior.

In what ways does diversity impact pharmacotherapy? What are some cautions that clinicians should be aware of?

Pupil dilation (Caucasians most responsive); Enzyme [CYP 2D6] (19% of Sans Bushmen) Given the existence of wide ethnic variations in the impact of medications, consideration of the interplay between ethnicity and pharmacotherapy represents best practice for the professional counselor. Indiscriminate application of ethnic differences can be considered practicing racialized medicine.

Discuss the RDAP program

RDAP or Residential Drug Abuse Program uses cognitive behavior therapy as its primary approach. Inmates live in a modified environment, separated from the general population. Inmates experience half a day of treatment programs and either a half day of school or vocational training. The program generally is 9 months in length.

What qualities should increase while gathering information for assessment?

Reliability, validity, relevancy

What instrument does addictions counselors view as the most important and most frequently used?

Sassi-3

When is a second-line agent used?

Second-line agent is typically given to a patient when a first-line agent isn't sufficient. It is a proven medication typically given to a patient when a first-line agent: 1) does not work, 2) has too many side effects, or 3) stops working. Some second-line agents are Baclofen (Lioresal) and Carbamazepine.

What are SIDs?

Seemingly irrelevant decisions Decisions an individual makes that may seem irrelevant at the time, but very often can lead to a relapse Ex: choosing a route that would lead past drug house; hanging out with old friends and having "just one drink"

In reference to addiction pharmacotherapy, what are the main neurotransmitters of interest?

Serotonin (5HT), dopamine (DA), norepinephrine (NA)

What theoretical orientation has been regarded as the "counseling of hope"?

Solution-focused counseling

Limitations and strengths of assessments

Some of the strengths of using assessments are adequate reliability and validity. And some of the limitations are that some are time consuming, some requires more training, and may not be suitable for all clients.

True or False: Contrary to popular belief, substance use and abuse is not an equal opportunity phenomenon.

TRUE

Which SASSI-3 scales do not contribute to the scoring system? Why?

The FAM and COR. The FAM measure traits present in persons who focus on others' problems rather than their own and who may lack assertiveness .The COR scale contains items frequently endorsed by persons with a criminal history.

Which scale of the Minnesota Multiphasic Personality Inventory -2 is helpful in identifying the potential for drug or alcohol abuse in a patient/client?

The MacAndrew Alcoholism Scale

What is considered the gold standard of alcohol abuse screening?

The Michigan Alcoholism Screening Test (MAST)

What is SBIRT?

The Screening, Brief Intervention, and Referral to Treatment is a three step assessment tool using SASSI, DAST, and MAST in emergency room settings to quickly establish the best form of care for patients that show signs of substance use and behavioral disorders.

Chaos:

The addiction is so out of control that it can no longer be hidden. Other family members spin out of control, conflicts and confrontations escalate without resolution, and consequences for family members become more pronounced. This is the stage i which partners and/or children may experience serious emotional or physical problems, and threats of divorce or separation are made but not completed.

Denial

The family begins to hide the abuse from each other and everyone else, offering other explanations for the addict's behavior and isolating themselves from people who may suspect the addiction.

Why is group counseling considered the approach of choice when treating addiction?

The influence of group members who have similar experiences is helpful in breaking down the denial frequently associated with addiction. Group therapy affords an opportunity to interact with others, promoting effective social skills and self-disclosure; explore new behaviors in a safe environment; and emotionally invest in others in education about addiction.

The peak ages for alcohol abuse

The peak ages for alcohol abuse are between 18 and 29 years old

Etiology

The study of causation or origination of a disease or medical condition.

Discuss the "Trying on for Size" approach.

There is not a one-size fits all approach that can be used in addictions counseling. There is no single best approach for everyone as different individuals respond to different approaches. Therefore, treatment systems should include a variety of effective approaches. Innovative practices, such as certain evidence-based practices, are adopted and then implemented by substance abuse counselors.

Multidisciplinary Treatment Team

These teams typically include mental health counselors and substance use disorder treatment counselors, case managers, nursing staff, and psychiatric consultants.

What is the basic goal of a self-help group; the functions of the leader; examples of a self-help group?

These voluntary groups have members that share a common problem and meet for the purpose of exchanging social support. Most are self-governing, with members rather than mental health professionals determining activities. Examples of self-help groups are AA or NA.

Alcohol

This was a vague question, so I'm not really sure the information that is wanted. The pages listed are crammed with information about alcohol.

5 categories of chemical substances

Tobacco Alcohol Opiods Stimulants Hallucinogens

Who created MI

William Miller

e Minnesota model of treatment provided the backbone for addictions counseling, however, which group of people does not particularly meet the needs of?

Women

Juveniles in the Juvenile Drug Court Diversionary program receive close supervision by ______ and periodic ______.

a parole officer; drug testing

Disease Model

addictive disease is chronic and incurable (E.M. Jellinek& Benjamin Rush)

Process addiction

an addiction to behavior, process, or addiction. sex, gambling, internet gaming, technology, work, compulsive buying, food addiction and disordered eating

Learning models

assumes that alcohol/drug use results in a decrease in uncomfortable psychological states such as anxiety, stress, or tension, thus providing positive reinforcement to its user; dependency usually develops

Home treatment:

attempts by family members to get the addict to stop using, usually by controlling her or his behavior. Family roles may undergo significant shifts as children try to care for parents, coalitions are formed, and other members' problems are neglected in order to keep the emphasis on the addict.

Moral Model

based on beliefs and judgments of what is right and wrong, acceptable or unacceptable; emphasis on "punishment"; use of religious intervention; sinfulness inherent in human nature

Out of every 10 ex-felons, how many are unemployed?

between 5 and 7

Neurotransmitters

chemicals released by nerve cells at synapses that influence the activity of other cells; play critical roles in transmitting information between neurons through specialized gaps

Tobacco

cigarettes, cigars, smokeless tobacco such as snuff, chew, spit tobacco

Definition of MI

client-centered, directive method for enhancing intrinsic motivation to change by exploring and resolving ambivalence. It is primarily as a communication style that helps to facilitate change when clients are ambivalent about changing their behaviors and used as a collaborative tool between the client and the counselor that promotes self-efficacy and views resistance as part of the change cycle rather than as a personality defect or symptom of pathology.

CRA

community reinforcement approach: a comprehensive biopsychosocial approach to the treatment of substance use disorders based on the premise that one's environment or community plays a critical role in reinforcing one's recovery efforts. It enlists community reinforcers to support change in an individual's substance use.

Improving the relationships between clients and _______ is the core of improving treatment outcomes.

counselors

Public Health Model

emphasis on promoting health behaviors (Paul Lemkau)

Alcohol

found in liquor, beer, and wine

Homoprejudice:

hatred and fear of LGBT community

Transprejudice:

hatred and fear of individuals with nontraditional gender expression

Opoids

heroin, opium

Heterosexism:

ideological system that assumes that all individuals are heterosexual, and it is "normal"

Dopamine

important neurotransmitter involved in pleasurable sensations

Psychodynamic models

links addiction to ego deficiencies, inadequate parenting, attachment disorders, hostility, homosexuality, masturbation, etc; difficulties linked to early childhood development are not specific to alcoholism/addiction, but are reported by non addicted adults with a variety of other psychological problems Personality theory modes - certain personality traits predispose the individual to drug use

Moral Model

looks at how drugs affect a person's mind and emotions

As of July 2010, the Native American population was estimated at just over 3 _________________.

million people

Counselors who increase their ____________________________ will better understand how their own personal dimensions affect their perception and understanding of their clients.

multicultural competence

Cognitive-behavioral models

self-exploration, religious insights, altering moods, escape from boredom/despair, and enhancement of creativity, performance, sensory experience, pleasure; dependency is related to the reinforcement the person perceives

Developmental Model

understand factors that increase or decrease risks for individuals to use/misuse drugs; prenatal through early childhood, middle childhood, adolescene, late adolescence/early childhood, adulthood