Addictions Midterm
Number of meetings new AA members should go to in 90 days
90
Men
...are more likely to report current illicit drug use, twice as likely to use marijuana, more likely to be pathological gamblers, and more likely to report current alcohol use than women
___million Americans participate in a mutual help group a year and ___ million have at some point in their life
10, 25
In 2004, women comprised what percent of the membership of AA?
35%
The percentage of persons who are severely mentally ill that can drink alcohol or use drugs at a moderate level without consequences is
5%
"No wrong door"
Integrated treatment practices
Mood disorders
Major depression, hypomania, and dysthymia
Groups that have specialized AA meetings
Veterans, Native Americans, elders, men/women, gay/lesbian
Bulimics tend to share the following characteristics:
a likely history of childhood sexual abuse, a tendency to abuse alcohol, the tendency to have overweight family members.
29. AA could be considered ________, where identity transformation can take place because of finding personal meaning in the stories of other members.
a narrative community
criteria listed in DSM for pathological gambling
a preoccupation with gambling, a need to gamble with increasing amounts of money, and gambling from stress
1. Typical signs of internet addiction include:
a preoccupation with the internet, jeopardized relationships, lying behavior
Counseling LGBT
accept the labels they give themselves, don't pathologize boundaries, may be reluctant to include other family members, shouldn't be encouraged to come out when they aren't ready
Eating disorders, gambling, shopping and other behavioral addictions
are compulsive and obsessive and involve euphoria that is not induced artificially by a drug
Transgendered persons
are the most subject to violent assault and employment discrimination.
2. The preferred treatment for eating disorders in the book is
combo of pharmaceutical and cognitive interventions
According to van Wormer, The purpose of managed care is not to manage care, but to manage
costs
only requirement for AA membership
desire to stop drinking
Criticisms of AA
disempowering for women, not Christian enough (addiction not seen as sin), too Christian, too white, substitute addiction, run by non-professionals
12 step treatment models
encourage compliance, follow highly directive models
"4-R's" when treating anorexia
relabel, reattribute, refocus, revalue
What percent of those with eating disorders misuse alcohol and other drugs?
50 %
What percent of web users develop serious problems with their web use?
6%
Rates of women seeking help for gambling is increasing.
67.8% of females with gambling problems were late onset.
9. By 1990, what percentage of those ever treated for alcoholism had attended at least one AA meeting?
70%
Civil asset forfeitures
80% of people who have property forfeited are not charged with a crime
What % of pop (12+) needed treatment for an illicit drug/alcohol use
9.5
Most commonly used substance by person with mental illness
Alcohol (then marijuana, then cocaine)
95% of treatment programs in the US were basing their programs on what?
Alcoholics Anonymous
Gambling
Costs $6.7 per year
Wegscheider's Role Theory
Dependent: gripped by contradictions. Selfishly preoccupied, all or nothing, tendency to escape the scene. Family manager: sober partner of addict, over functions to compensate for the addict, plagued by guilt/shame Hero: often the first born, high achieving, constantly seeking approval, inclined to suffer from low self-esteem, feels loved for actions rather than who they are, perfectionistic Scapegoat: everyone loves to blame this child, experiments early with drugs Lost: excellent escape mechanism, lives in a fantasy world Mascot: the clown, comic relief, often hyperactive
During the precontemplation phase of a family with an addicted member, families are often:
Either enmeshed (spouses are estranged and children are clinging to one of the parents) isolated (lack all cohesion, all members are alone), and the goal is to move them towards being healthy (touching but boundaries not overlapping).
One of the most common errors of pathological gamblers:
False belief that luck has to do with anything
Counseling Latino Families
Family prioritized over the individual. Can be very successful. Be personable, subtlely look for emotions, homework may not work, disease model may be effective, use fundamental spiritual precepts to inspire hope
Classic family systems approach
Patient is viewed solely within the context of the family, where the symptoms or problems presumably evolved
concepts derived from Bill Wilson
Powerlessness, carrying the message to other persons, and seeking divine guidance
AA meetings
Stress the voluntary nature and are run by recovered individuals
What's been the effect of welfare reform on women?
TANF encourages states to deny cash assistance/food stamps to women with recent drug felony convictions. Single moms and women in public assistance prenatal clinics carry the brunt. TANF also promotes routine drug testing and abstinence contracts.
The first of the 12 Steps of AA begins:
We admitted we were powerless over alcohol
case management
an approach designed to help mentally ill persons in trouble with the law stay out of jail by diverting them into treatment
Reason persons with coexisting disorders might use a substance
loneliness, anxiety, insomnia
a self-help group for people who want to drink moderately and prevent serious drinking problems
moderation management
Counseling African Americans
need to be familiar with complex interactions, strengths, and problems of extended families. Larger network of family. connection between family and therapist is the most important part!
Children who later became compulsive gamblers/other addicts had personalities characterized by
negativity, nervousness, anger and a tendency to worry/feel victimized
Collaborative case management
offering a menu of support systems and services
2. According to the National Council Study, the suicide rate is highest among:
pathological gamblers
Pathological gamblers exhibit complex impairments in decision making associated with the:
prefrontal cortex of brain
Research indicates that the transition from separate to integrated treatment for co-occurring disorders that:
stable remission rates more than double
Risk factors for eating disorders amongst girls
stress and trauma, susceptibility to media ads and images, substance misuse.
Counseling Asian Families
therapy doesn't breach gender roles/boundaries in generations, first appt made with father, sensitive to privacy, may not move forward regularly
primary challenge in eating disorders treatment compared to other substance a use treatment is that
treatment protocols that involve a commitment to abstinence do not apply
AA as practiced in the community is considered to be compatible with harm reduction because the program is:
voluntary
True statements concerning clients with schizophrenia
what looks like resistance or denial may in reality be a manifestation of negative symptoms of schizophrenia; clients with a co-occuring mental disorders involving psychosis have a higher risk for self-destructive and violent behaviors; clients with co-occuring mental disorders involving psychosis are particularly vulnerable to homelessness, housing instability, victimization, poor nutrition, and inadequate financial resources.