Addiction treatment Final - study guide
Legal and ethical issues for social workers dealing with those clients that are addicted
-Involuntary commitment -following code of ethics -Duel or multiple relationships in addiction field
ASAM Levels of Care- Outlines treatment as a continuum
0.5: Early Intervention I: Outpatient Services II: Intensive Outpatient Services/Partial Hospitalizaiton III: Residential/Inpatient Services IV: Medically Managed Intensive Inpatient Services
Traditional treatment system for people with drug/alcohol addiction
1. Detoxification 2. Acute hospitalization 3. Residential programs 4. Outpatient services 5. Transitional sober living environments
Three basic tenets of recovery management
1. Emphasis is on CHOICE of treatment-respects individual right to manage one's own destiny and to take responsibility for one's own actions. 2. Providing OPTIONS- it does not help to have the right to choose without having options 3. Pay attention to the READINESS Of the clients and-or a client systems to make changes in the areas they have chosen
Smart recovery primary goals
1. To help individuals gain independence from addictive behavior (thru abstinence) 2. To teach people how to enhance and maintain motivation to abstain, cope with a urges, manage thoughts, feelings and behaviors, and balance momentary and enduring satisfactions. Uses CBT, communication skills, anger management skills and stress management techniques
What percent of children live with at least one parent who is Dependent on her has abused alcohol or drugs?
12%
Harm reduction psychotherapy
A collection of clinical principles that guide the practitioner on how to view the consumer, how to create the helping relationship, and how to select various interventions.
SBRIT model
A comprehensive, integrated, public health approach to the delivery of early intervention and treatment services for persons with addiction and or mental health problems
Women for Sobriety (WFS)
A program that addresses the unique issues for women that might be barriers to their recovery, such as lack of staff esteem, depression and feelings of guilt. POWER OF POSITIVE THINKING is the center of the program.
AUDIT
A simple ONE question screen for men/women to rule out alcohol/drug problems
Techniques/strategies of cognitive behavioral therapy
ABC's of emotions model Heavy reliance on educational Cheerios and standardized approaches
prenatal substance abuse
AMA and American Academy of pediatrics say that education prevention and treatment are the best ways to address this issue. And they know that criminalization may scare women away from getting the treatment they need.
Traditional US approach to drug policy
Abstinence only and a criminal approach to addiction
Gamblers Anonymous (GA)
An organization of inspirational group therapy, modeled after Alcoholics Anonymous (AA), for individuals who desire to, but cannot, stop gambling.
Recovery capital
Another way to describe clients strengths (including the skills, resources and strengths that client brings to the recovery process) Focusing on this is designed to capture the positive measure of personal and social resources
Family Adaptation
Are useful way to see the family's response to a members distractive and addictive behaviors
Screening
Can point you in the right direction
SMART Recovery (Self-Management and Recovery Training)
Cognitive behavioral alternative to the spiritual focus of 12 step programs. Addiction is viewed more as a maladaptive behavior than a disease and could arise from substance use
Styles of family adaptation
Coping, blaming, joining, critical. Families may adapt to the social isolation and continual stress of the progressing addiction, or members may regroup and form a reconstituted family without the addicted member
Assessment
Defines the nature of the problem and assists in Developing specific treatment recommendations for addressing the problem
Co-occurring disorders
Disorders that occur at the same time as the psychiatric disorder and may be associated with the disorder.
Lesbians and substance misuse
Face same health issues as hetero women-but the risk of self harm and depression may be higher among those not open about their sexual orientation and who lacks support. Chemical dependence is high within this group.
Preventative resource
Family. A system of both risk and resilience
Recovery Management
Focuses on addiction as a chronic disorder needing long-term support-clients are recognized as having the right to self manage the recovery process
Most recent change to DSM in 2013
Gambling is included in the substance-related and addiction disorder section because of the overlap in terms of etiology, biology, comorbidity and treatment
Gender (like race and class) is a what? And how is it learned?
Gender is a social construct that is learned early and throughout our lives
Strength-based assessment rest on what?
HOPE
Choice
Hallmark of strength-based interventions
Motivational Interviewing (MI)
Is a client centered, directive method for enhancing intrinsic motivation to change by exploring in resolving ambivalence A humanistic, client-centered, psychosocial, directive counseling approach that was developed by William R. Miller and Stephen Rollnick in the early 1980s.
CAGE
Is a screening for alcohol problems-optimal for screening WOMEN
The Lie/Bet Questionnaire
Is a valid and reliable tool for ruling out gambling disorders. These two questions differentiate between disordered and non-problem gambling and tell the clinician to further assess what is needed
cognitive-behavioral therapy (CBT)
Is based on the idea that maladaptive thinking and bad habits are the mechanisms that both cause problems and keep them going
Harm Reduction Model
It chooses to minimize harmful effects of drugs/alcohol use rather than ignore or penalize the user
What type of process is family adaptation?
It is an ACTIVE process of self change, environmental change, or both, not a mirror adjustment to circumstances
Techniques of solution focused therapy
Miracle question - Helpful in supporting hope that things can be different in spite of past attempts to change Asking for EXCEPTIONS to the problem (Helps clients remember times when problems could have happened but didn't SCALING ??s -Assess clients level of hope, confidence, sadness, how much change has occurred etc. COPING ??s -Are used to bring out survival strategies of people who have managed in spite of addiction
resilience
More than just the ability of an individual family member to recover-rather it involves protective factors within the entire family system/dynamics
OARS
Open-ended questions Affirmations Reflective listening Summaries
Trans-theoretical Model of Change
Provides a framework to explain how people acquire and maintain healthy behavior. Behavior change is built on readiness for change. People progress through behavior changes at varying rates.
Family illness
Refers to the fact that the addicted family is malfunctioning. It does NOT mean that the addiction stems from family dynamics but rather, that this dysfunction in 1 or more members affects family dynamics
Four tenets of cognitive Behavioral therapy
Reinforcement Modeling Condition responding Cognitive factors
Cognitive behavioral therapy is foundation of RP
Relapse prevention
SBRIT
S- Screening B- Brief R- Referral I- Intervention T- Treatment
Strengths Perspective
Seeks to identify, use, build, and reinforce the abilities and strengths that people have in contrast to the pathological perspective, which focuses on their deficiencies
Components of Recovery
Self-direction Individualized and person-centered Empowerment Holistic Nonlinear Strengths Based Peer Support Respect Responsibility Hope
History of mutual help groups
Self-help groups fill in gaps to deal with almost every human problem. AAA, online support groups (offering accessibility, convenience, anonymity) Cost-effective due to rising healthcare costs are and attics off and being in dire financial circumstances
Solution Focused Therapy
Solving the problem is more important than finding and elaborating on the root cause of the problem and that the clients had the ability within themselves and/or the social system to bring about change
SASSI
Substance Abuse Subtle Screening Inventory ***STEALTH Assessment. T/F questions on side one did not ask about direct drug/alcohol use side to does this minimizes client defensiveness
Gender sensitive care
Taking gender and sexual orientation into account by knowledge Ing the different experiences, inequalities, and needs of each person
What is the only state to criminalize drug use during pregnancy?
Tennessee
Guiding principle of strength-based practice
That clients are in charge of setting their own goals and deciding how they will achieve them
HALLMARK of Harm Reduction practice
That professionals respect the clients self determination about how to engage or whether to engage and offered services
Formal diagnosis
The process of determining if the client's problems or symptoms meet the specific DSM criteria for a disorder. Made by MD,NP, licensed psychologist or LMSW
Diagnosing
The process that determines if a person meets certain predetermined criteria for substance abuse, dependence, or pathological gambling. The DSM Is used for diagnosing patients
Most essential clinical skill
The quality of empathy
Gay males and substance misuse
The use of drugs in the gay community doubles the likelihood that gay men will engage in unprotected sex. This is the gateway to many health problems, STDs, HIV/AIDS. Being gay and not open about sexual orientation may lead to self hatred, suicidal ideation, being bullied or abused, and heavy use of alcohol or other drugs. You need to this population compared to heterosexual man is that heavy alcohol consumption and associated problems continue across the lifespan rather than diminished with age.
Gendered behavior's
These are taught and reinforced by others
Most common approach to diagnosing
Through clinical interview with client-comparing symptoms and behaviors to DSM
Typical approach to relapse prevention
To analyze the factors that increase the risk for relapse and then develop plans to avoid such situations
Family Interventions
To be effective, need to be culturally sensitive to diverse family forms as well as geared toward the family stage of awareness of a problem in the family is willingness to do something about it
TWEAK
Tolerance Worry Eye-opener Amnesia Kut down Also used to screen women for alcofil problem s
No wrong door-right door
What seems like not so good of a choice (Children in foster care) becomes the right choice to get treatment and needed help
Violence and trauma
When under the influence of alcohol or drugs, the capacity to be violent towards others and to be the victim of that violence, is shared by the male and female gender alike. Women are far more likely than men to be subjected to violence and murder by a person with whom they have an intimate relationship.. Violets can also be related to war and military service.
Shame factor
Women's seen as caretakers-if they are addicts they are not seen this way. Men-are seen as though they have failed in their gender roles by not supporting their family
Alcoholics Anonymous (AA)
a self-help organization that provides support and guidance for people with alcohol use disorder Key components-12 steps
drug courts
specialized courts that impose drug testing and counseling requirements on substance abusers and monitor their progress instead of sending them immediately to jail or prison
relapse prevention
the treatment approach that uses functional analysis to identify the antecedents and consequences of drug use and then develops alternative cognitive and behavioral skills to reduce the risk of future drug use
group therapy
therapy conducted with groups rather than individuals, permitting therapeutic benefits from group interaction Cost effective Helps people learn from other people's experiences Can be beneficial for those who have become isolated from family/friends due to addiction
Mental Health Courts
use judges who have special training and can use non adversarial procedures to mandate treatment and rehabilitation if the individual is found guilty rather than incarceration
Trans-theoretical Model of Change
• Pre-contemplation no interest in change, no desire for information • Contemplation Beginning to believe a change is needed • Preparation needs to assist in planning for change • Action actually making changes, ID barriers and facilitate change Maintenance- sustaining over time Notes: First step is to identify risk factors. Relapse- some clients go back to step 1 or 2. They view it as a learning process.