Co-Occurring Disorders Midterm

impact of parental substance use on children - parenting

A parent's substance use disorder may affect his or her ability to function effectively in a parental role. Ineffective or inconsistent parenting can be due to the following: a. Physical or mental impairments caused by alcohol or other drugs b. Reduced capacity to respond to a child's cues and needs c. Difficulties regulating emotions and controlling anger and impulsivity d. Disruptions in healthy parent-child attachment e. Spending limited funds on alcohol and drugs rather than food or other household needs f. Spending time seeking out, manufacturing, or using alcohol or other drugs g. Incarceration, which can result in inadequate or inappropriate supervision for children h. Estrangement from family and other social supports

impact of parental substance use on children - child and adolescent development

Children and youth of parents who use or abuse substances and have parenting difficulties have an increased chance of experiencing a variety of negative outcomes: a. Poor cognitive, social, and emotional development b. Depression, anxiety, and other trauma and mental health symptoms c. Physical and health issues d. Substance use problems

assessment - assessment for COD disorders

Consists of gathering key information and engaging in a process with the client that enables the counselor to understand the client's readiness for change, problem areas, COD diagnosis(es), disabilities, and strengths. An assessment typically involves a clinical examination of the functioning and well-being of the client.

assessment - screening for COD disorders

Formal process of testing to determine whether a client does or does not warrant further attention at the current time in regard to a particular disorder and, the possibility of a co-occurring substance use or mental disorder.

children of parents with substance use disorders

Many families receiving child welfare services are affected by parental substance use. About 12% of children live with a parent who is dependent/abuses alcohol or other drugs. Based on data from 2002 to 2007, the National Survey on Drug Use and Health reported that 8.3 million children lived with at least one substance abusing parent. These children are at increased risk for maltreatment and entering the child welfare system.

role of co-occurring issues

Many parents with substance abuse problems also experience social isolation, poverty, unstable housing, and domestic violence. These co-occurring issues may contribute to both the substance use and the child maltreatment. Evidence increasingly points to a critical role of stress and reactions within the brain to stress, which can lead to both drug-seeking activity and inappropriate care-giving.

parental substance abuse as a risk factor for maltreatment and child welfare involvement

Parental substance abuse is recognized as a risk factor for child maltreatment and child welfare involvement. Research shows that children with parents who abuse alcohol or drugs are more likely to experience abuse or neglect than children in other households. One longitudinal study identified parental substance abuse as one of five key factors that predicted a report to child protective services for abuse or neglect. Parental substance abuse is frequently reported as a reason for removal, particularly in combination with neglect. For almost 31% of all children placed in foster care in 2012, parental alcohol or drug use was the documented reason for removal.

impact of parental substance use on children - prenatal and infant development

The effects of parental substance use disorders on a child can begin before the child is born. Maternal drug and alcohol use during pregnancy have been associated with premature birth, low birth weight, slowed growth, and a variety of physical, emotional, behavioral, and cognitive problems.

assessment - assessment process

a. Detailed chronological history of past mental health symptoms, diagnosis, treatment, and impairment, particularly before the onset of substance abuse, and during periods of extended abstinence. b. Obtain a more detailed description of current strengths, supports, limitations, skill deficits, and cultural barriers related to following the recommended treatment regimen for any disorder. c. Determine stage of change for each problem, and identify external contingencies.

remission

absence of impairment due to substance use or mental health disorder

mental health disorders

characterized by: (1) nature and severity of symptoms, (2) duration of symptoms, and (3) extent to which symptoms interfere with ability to carry out daily routine activities

serious emotional disturbances (SED)

children with a SED are defined as "persons from birth to 18 years of age who currently or at any time during the past year, have had a diagnosable mental, behavioral, or emotional disorder to meet DSM criteria"

integrated screening

determination that a person has a co-occurring substance use or mental health disorder

recovery

gaining information, increasing self-awareness, developing skills for sober living, and following a program of change

integrated assessment

gathering information and engaging in a process with the client that enables provider to establish their presence or absence of co-occurring disorders

category I

less severe mental disorder/less severe substance disorder

category III

less severe mental disorder/more severe substance disorder

substance abuse

maladaptive pattern of substance use manifested by recurrent and significant adverse consequences related to the repeated use of substances

substance dependence

more serious than abuse and includes such features such as increased tolerance of substance, resulting in the need for ever-greater amounts of the substance to achieve the intended effect

category II

more severe mental disorder/less severe substance disorder

category IV

more severe mental disorder/more severe substance disorder

serious mental illness (SMI)

persons age 18 and over who currently or during past year have had diagnosable mental, behavioral, or emotional disorders to meet DSM criteria, resulting in impairment which substantially interferes with or limits one or more major life activities

substance-induced disorders

present as a wide variety of symptoms that are characteristic of other mental health disorders such as delirium, psychosis, mood disturbance, etc.; must be evidence of substance intoxication or withdrawal, maladaptive behavior, and temporal relationship between symptoms and substance use must be present

co-occurring disorders (COD)

refers to co-occurring substance-related and mental health disorders; some clients' mental health and substance abuse problems, at any point in time, may not fully meet criteria for DSM diagnosis

relapse

return to active substance use in a person with a diagnosed substance use disorders or the return of disabling psychiatric symptoms after a period of remission related to a nonaddictive mental health disorder

integrated interventions

specific treatment strategies or therapeutic techniques in which interventions for all COD diagnoses or symptoms are combined in a single contact or a series of contact over time