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.