Study Guide-Finals

What % engaged in treatment after the Johnson Institute Intervention? CRAFT?

25-30(quarter) Johnson, 68(more than half) CRAFT

When the person who is substance dependent refuses treatment, how effective are Al-anon referral, AFT and Coping Skills Therapy, as compared to a wait list control group?

All produce improvements in family members' emotional distress and coping that are greater than in a wait-list control group

What is joining? Restructuring? Contracting? Enactment, and reframing? How might you mark boundaries? Be able to identify examples of these.

All these are treatments of Family systems approach, joining builds rapport with family, promotes alliance, therapist express understanding of each family member's feelings and views. Restructuring is challenging the family's homeostasis through modifications in the family's bonding, in this, Contracting is an agreement to work on agreed-upon issues,Enactment involves having family members describe recurring behavioral sequences to each other, Reframing involves helping family members to understand the inter-relatedness of their behaviors and to see and understand how the substance use, Restructuring consists of shifting family interaction patterns and establishing new, healthier behaviors (e.g., changing seating arrangements to strengthen the role of parents in the family. Therapist marks boundaries by clearly delineating individual and subsystem boundaries. For example, to strengthen and protect the parental subsystem from intrusion by children and other adults, the therapist might conduct some parent-only sessions.

What is social network therapy approach?

Approach to substance abuse treatment in which the therapist enlists the help of selected family members and friends to provide ongoing support for the substance abuser.

Looking at Table 10.1, which types of interventions have the strongest support and for which types of clients?

Clients resisted to get help=CRAFT best support, and clients who want help=Ecological approach best support

How is substance use maintained?

Cognitive- behavioral- systemic model of maintenance emphasizes the role of family interaction patterns and problems as both antecedents and consequences of alcohol use.

Which of these treatments is associated with less drinking and lower levels of violence?

Coping skills therapy

What are the assumptions of cognitive- behavioral- systemic model?

External antecedents to drinking relates to alcohol consumption, through repeated associations with reinforcement or anticipation of reinforcement; (2) cognitive and affective events relates to external antecedents and drinking; (3) drinking is maintained by physiological, psychological, and/ or interpersonal consequences; and (4) drinkers reciprocal interactions+environment=repetitive behavioral patterns

How are family interaction patterns related to substance use?

Family interactions maintain drinking both directly and indirectly, both intentionally and without the family's awareness of the process.

According to the text, in what situation is stress the highest for families?(pg. 257)

Family member refuse help because don't feel have problem.

What are the assumptions of Al-Anon? What are people "powerless" over in this 12 step program?

Family members detach in a loving way, accept that they are powerless to control the substance abuser, and seek support from other members of the Al-Anon program.

What is ecological approach?

Interventions that focus on assessing and changing multiple system influences that affect the substance abuser,include intrapersonal variables, the interpersonal system of the family and larger social network, and the extrapersonal system, such as the school and community at large.

How frequent is violence in substance abusing couples?

One-half

What are familial antecedents of substance use?

Partner withdrawal(cause more stress), negative interactions, nagging or demanding, family member drinking

Be aware of the techniques discussed in BCT.

Recovery Contract that includes a "trust discussion" in which the substance abuser states his or her intent not to drink or use drugs that day, series of behavioral assignments to increase positive feelings, shared activities, and constructive communication. "Catch Your Partner Doing Something Nice, caring day, shared reward activities, continuing recovery plan"

What are the different family-based conceptualizations of substance use?

The family disease approach views alcoholism and other drug abuse as an illness of the family, suffered by both addict and family(codependency).The family systems approach applies the principles of general systems theory to families, with particular attention paid to ways in which families maintain a dynamic balance between substance use and family functioning and whose interactional behavior is organized around alcohol or drug use. Behavioral approaches assume that family interactions serve to reinforce alcohol- and drug-using behavior. Social network therapy involves the patient's social network in treatment to support the patient's recovery. Ecological approaches assume that substance abuse results from many sources of influence from the multiple systems in the substance abuser's life.

What is the Johnson Institute Intervention? What is ARISE? What is CRAFT? Which of these has the most empirical support?

They all are family-based intervention methods for substance abuser resisting help.Johnson- therapist helps family plan and conduct surprise family confrontation meeting called an intervention. ARISE- a relational intervention sequence for engagement is a 3-step model starting with low-pressure methods and ending with Johnson if needed. CRAFT- Community reinforcement and family training, teach family to use positive reinforcement and negative consequences to discourage substance use and encourage treatment. CRAFT has most evidence

How many consequences of use are there and what are they?

Two, positive and negative, positive are getting care while intoxicated, short-term increase positive interactions, short-term regulate of negative affect, negative are domestic violence, distress, deficit in problem solving and communicating.