PSY460 Final

Cultural Competence

Having cultural knowledge, awareness, sensitivity, skills and understanding of ethical principles.

Define Cultural Competence:

Having cultural knowledge, awareness, sensitivity, skills, and understanding of ethical principles.

The National Institute on Drug Abuse published a booklet in 2012 called "Principles of Drug Addiction Treatment: A Research-Based Guide", this guide has ____ principles? A. 15 B. 10 C. 13 D. 20

C. 13

An 18-year-old female who received a DUI last month drives to a party on Saturday and has four martinis. This would be an example of: A. Use B. Misuse C. Abuse D. Dependence

C. Abuse

All of the following are MATs (medically assisted treatments) for opiate use except: A. Suboxone B. Methadone C. Carmadone D. Vivitrol

C. Carmadone

The process of motivating a person to actively involve him/herself in treatment is called: A. Intervention B. Motivational Interviewing C. Client engagement D. Client participation

C. Client engagement

Screening is all of the following except: A. A brief procedure use to identify individuals with possible problems B. Use prior to a thorough assessment because of timing and cost C. The same as a basic assessment D. A procedure use to identify people at risk for developing AOD problems.

C. The same as a basic assessment

Name a common drug in the drug classification of CNS Stimulants:

Cocaine

Misuse

Continued use after NEGATIVE consequences Ex: Hangover

Difference between moral and sociocultural/psychological models is that the later models focus on external factors including:

Cultural, family, peers, and NOT VOCATION

"I need to do something about my cocaine use" is indicative of which stage of change? A. Action B. Contemplation C. Goal identification D. Determination

D. Determination

In situations where state and federal laws regarding confidentiality of AOD patient information are in conflict, mental health professionals should: A. Follow federal laws B. Follow state laws C. Use professional judgement D. Follow federal law, unless state law is more restrictive

D. Follow federal law, unless state law is more restrictive

CNS depressants: A. Increase respiration, heart rate, motor activity, and alertness B. Produce an altered state of consciousness C. Have similar effects to caffeine D. Reduce the overall functioning of the CNS to induce sedation, drowsiness, or coma

D. Reduce the overall functioning of the CNS to induce sedation, drowsiness, or coma

In the assessment process, mental health professionals should always consider the possibility of alcohol or other drug problems because: A. Clients tend to minimize their use B. Denial is a common defense mechanism used by alcoholics and addicts C. The coexistence of alcohol and other drug problems and other mental disorders is common D. The *prevalence* of AOD problems is so great

D. The PREVALENCE of AOD problems is so great

In motivational Interviewing, what is the purpose of eliciting change talk? A. To enhance client self-esteem B. To make explicit the problems, concerns, and intentions of clients C. To facilitate the development of the core conditions for therapeutic growth D. To help clients resolve their ambivalence

D. To help clients resolve their ambivalence

Minimization

Glossing over a problem and acting as though it's not a significant problem

What is the main difference between HIPAA and 42 CFR?

HIPAA is for generalized medical information and 42 CFR is drug and alcohol related.

Drugs that induce a dreamy, relaxed state and, in some people, intense feelings of pleasure are:

Opiates

Give one example from your chapter on an instance where HIPAA applies.

PHI- Personal Health Information (EX: Name, Address)

Withdrawal

Physical/psychological effects that occur when a dependent individual discontinues use

The disease model of addiction describes alcoholism in which way

Progressive, irreversible, chronic, incurable

MI (Motivational Interviewing)

Provides a therapeutic environment in clients feel comfortable being honest about difficulties. Such comfort is often lacking during confrontational approaches

Acculturation

Refers to the changes that can occur when an individual from one culture engages with another culture 1. integration 2. Assimiliation 3. Separation 4. Marginalization

Denial

Refusing to acknowledge or believe an obvious truth

Sociocultural model, addiction is:

Related to cultural, religions, family, and peer variables

Reverse tolerance

Smaller quantities are needed to produce the same effect

Abuse

The CONTINUED use of substance in spite of adverse consequences

Use

The consumption of drugs/alcohol with NO negative consequences

BI (Brief Interventions) Who should get a BI

Those who may be sub-diagnostic but have moderate risk for problems. BI can also work for those who meet diagnostic criteria as well SOC model and MI form basis for BIs

Cross-tolerance

tolerance to other drugs from the same pharmacological group

Define Dependence:

A recurrent or ongoing need to use

Emphasizing Personal choice and control:

" Only you can make decisions for yourself."

Through of someone who believes in Disease model of addiction

"That addict just needs to go to NA"

Reframing:

( after client relays an angry story of mother being upset with drug use) "Your mother is scared and really cares about you."

SMS's

- Cognitive (Problem recognition): In what ways has marijuana been a problem for you? -Affective (concern statements): What worries your family about your use? -Behavioral (intentions to act): What do you think has to happen?

How does MI resolve ambivalence

- Empathy - D-Balance - Avoid "traps" (Confront, question and answer, expert trap, labeling trap, premature focus trap) -Open-ended Qs -Reflective Listening -Affirmatations -Being supportive -Strategic Summaries -Elicit Self-Motivational Statements -SMS's (Reasons for change come form the client)

How do you know when client is ready to change?

- Lack of resistance -Fewer questions regarding the problem - Asks questions re change

"Resistance" or Counter SMS's Process shared BY client and therapist

-Arguing -Interrupting -Denying -Ignoring

When opiates are combined with _____ the risk for overdose increases:

Benzodiazepines

Cultural-centered counseling

-helping with the accuracy for conflict management -Providing common ground for conflict management -Increasing Identity -Increasing health through biodiversity -Protection from culture encapsuation** -Helping the future global village survive -Increasing social justice right thinking that is both linear and nonlinear -Helping people to learn about culture, shock spirituality, political pluralism, and good psychology

Four general principles of MI

1. Ambivalence (Mixed feelings) 2. Elicit change talk 3. Client resistance and counselor behavior 4. Transition from Resistance to Change

5 Basic Steps to BIs

1. Built Rapport- define purpose of discussion, get client permission to proceed 2. Evaluate- is this a light, moderate, or at risk user 3. Feedback-this is an interactive discussion-provide info- than "What do you make of that?" 4. Explore possibility of setting goals: "Im wondering where this leaves you now? what might you do with this info? what has to change? 5. Summary, closure, agreement on "plan" Follow-up may be scheduled

When opiates are combined with ____ the risk for overdose increases

Benzos

Stages of Change

1. Precontemplation- Don't know there is a problem TASK= provide information, raise awareness 2. Contemplation- considers that perhaps there is a problem, unsure regarding changing it or not TASK= Tip the balance towards change 3. Determination- looking for viable change plan TASK= Develop strategies that are acceptable, accessible and effective 4. Action- Acting to being about change TASK= Monitor plans and alter as needed, maintain motivation 5. Maintenance- changes resulting from action stage are kept, person continues working to keep change in place TASK= monitor situation for risk of relapse, learn new skills as needed to keep changes in place 6. Relapse- client goes back to using substance bc they don't have the skills they need to maintain the behavior change

Deal with counter SMS's via Reflective Listening

1. Simple - "you're scared" 2. Amplified - " Your mother is worried for absolutely no reason whatsoever" 3. Double-sided - " So whereas LSD opened a lot of doors for you, now you are starting to wonder if it's a bad example for your child" 4. Shift-focus - "Whoa you're way ahead of me here, before talking about your giving up smoking, it sounds like you may be more concerned about losing your friends right now" 5. Agree with a twist - (after client states that child and husband are on her case for drinking and therapist could't possible understand the stress) "I agree, substance use can be a family problem, not just one person's issue"

Heroin was synthesized as a derivative of morphine in ____. (complete the year)

1898

How many models of addiction are there?

5

There are ____ basic steps involved in a brief intervention

5

Addiction

A COMPULSION to use regardless of negative consequences

Dependence

A RECURRENT or ongoing need to use -two types 1. Psychological 2. Physical

The earliest reference to opium was in: A. 540AD B. 3400BC C. 1980 D. None of the above

A. 540 AD

Which of the following is NOT one of the general principles of motivational interviewing? A. Confront resistance B. Develop discrepancy C. Support self-efficacy D. express empathy

A. Confront resistance

Examples of Hallucinogens include all the following EXPECT: A. Heroin B. LSD C. PCP D. Psilocybin

A. Heroin

Treatment strategies and techniques include ___ A. Individual, group and family counseling; support groups; lifestyle changes; education; and aftercare B. ONLY AA and NA meetings C. ONLY outpatient intensive treatment programs D. None of the above

A. Individual, group and family counseling; support groups; lifestyle changes; education; and aftercare

Treatment must be designed _______ and must consider diversity issues A. Individually B. For the family C. worldwide D. None of the above

A. Individually

___ is a state of being under the influence of alcohol or other drugs so that thinking, feeling, and/or behavior are affected. A. Intoxication B. Tolerance C. Dependence D. Withdrawal

A. Intoxication

Social risk factors can involve: A. Peer groups, families, and communities B. Peer groups, families, and churches C. Peer groups, siblings, and communities D. None of the Above

A. Peer groups, families, and communities

What is a draw back to the use of self-report inventories in assessing AOD problems? A. The nature of a self-report instrument includes the potential for collecting false information B. Self-report inventories generally have less than adequate reliability C. Self-report inventories can only be administered by psychologists D. Self-report inventories are expensive since computer scoring is required

A. The nature of a self-report instrument includes the potential for collecting false information

Projection

Accusing someone else of the thoughts and behaviors you want to hide

What percent of people with a substance abuse disorder actually receive treatment? A. 50% B. 10% C. 35% D. 5%

B. 10%

Morphine was isolated from opium in what century? A. 1700's B. 1800's C. 1900's D. 2000's

B. 1800's

Following are the routes of misuse and abuse seen today for prescription opioids, except: A. Chewing B. Absorption through skin C. Snorting D. Injecting

B. Absorption through the skin

42 Code of Federal Regulations, Part 2 deals with: A. Ethical mandated for AOD treatment providers B. Confidentiality in AOD treatment programs C. Patient rights in AOD treatment programs D. The maintenance of patients' records and treatment plans

B. Confidentiality in AOD treatment programs

Which of the following is NOT one of the 4 key concepts in the use of defense mechanisms: A. Denial B. Exaggeration C. Minimization D. Rationalization

B. Exaggeration

Without sensitivity to cultural differences, providers will: A. Likely be effective from the outset because of the core conditions B. Likely be ineffective from outset because attempts to assess alcohol and drug involvement will be met with therapeutic resistances's C. Likely be effective because mental health professionals understand cultural sensitivty D. Both A and C

B. Likely be ineffective from the outset because attempts to assess alcohol and drug involvement will be met with therapeutic resistance's

All of the following are types of resistance except: A. Arguing B. Nodding C. Denying D. Interrupting

B. Nodding

According to research, persons with disabilities misuse drugs because: A. They see is modeled by others B. of psychological trauma and social distance from the community C. Their family member influence use D. There is no research on this problem

B. Of psychological trauma and social distance from the community

"You think I have a drinking problem? Why, I never thought that. I'll think about it" is indicative of while stage of change? A. Reframing B. Precontemplation C. Contemplation D. Reconsideration

B. Precontemplation

Which of the following is NOT an exception to the General Rule regarding disclosure: A. Disclosure to a Qualified Services Organization Agreement B. The use of Alcohol to other drugs by a pregnant woman C. A court order D. Crimes committed against program staff

B. The use of Alcohol to other drugs by a pregnant woman

Rationalization

Explaining feelings or behaviors in a way that makes them seem reasonable

Assessment and diagnosis are essentially the same.

False

CNS Depressants can be used in the treatment of Attention Deficit Disorder (ADD)

False

Ethical standards can differ from State to State but are the same for all types of therapeutic work.

False

Our beliefs and preconceived notions do not affect our work with clients that use AOD's

False

Percodan is made up of oxycodone and Percocet.

False

Treatment of AOD doesn't differ much between models

False

Cultural encapsulation

Lack of understanding, ignorance of another's cultural background and the influence this background has on one's current view of the world

Name an example of a treatment approach:

Motivational Interviewing

Intervention

Moving from problem identification to treatment. It's done to the client

Name two specific ways that we are combating opiate overdose deaths discussed in the Powerpoint slides:

Narcan, MAT, Prescription Drug Monitoring

Tolerance

Need MORE of drug to get the desired effect

According to the moral model, addiction is a consequence of personal choice

True

Anyone working in or for a facility that offers AOD diagnosis, treatment, or referral and receives federal funding is covered by 42 CFR.

True

Clients with a substance use disorder or other mental disorders have been a focus of attention due to large numbers of individuals with "co-occurring" disorders

True

Generally a client should be placed in the treatment setting with the least amount of restrictions, the highest probability of success, and considering the factors determined through the initial assessment.

True

Health Professionals should always consider the possibility of alcohol or other drug problems due to the prevalence in society

True

In motivational interviewing, client resistance can be seen as a counselor skill problem.

True

Much of the language used to describe AOD is taken from the moral model

True

Narcan is available to friends and family members as well as medical professionals.

True

Opiates are drugs that induce a dreamy, relaxed state and, in some people, intense feelings of pleasure

True

The Stage of change model and MI form basis for Brief Interventions

True

The active ingredient in cannabinols is delta-9-tetrahydrocannabinol (THC)

True

The difference between engagement and intervention is the involvement of the client.

True

The elderly population in America account for one-fourth of all drugs prescribed

True

The withdrawal of CNS Depressants can be medically dangerous

True

Cultural enagement

active involvement in treatment

With regard to the identification of an addictive personality, research shoes that:

addicts have as many different types of personalities as non-addicts

Proponents of the disease concept believe that research on alcoholic's control over drinking shows that:

alcoholics cannot predict the situations in which will lose control over their use.

Confrontation

generally no emotional support for it. why use it when other more pleasant methods with empirical support work?