Final Substance Abuse and Addiction MM 640

The first step of the 12 steps of Alcoholics Anonymous (AA) begins with

"We admitted we were powerless over alcohol"

What are 3 core elements of Motivational Interviewing ?

1. A particular kind of conversation about change (counseling, therapy, consultation, method of communication) 2. Collaborative 3. Evocative

Aversion treatment derives from which school?

Classical conditioning/behaviorism

What is supporting self-efficacy ?

Clients have within themselves the capabilities to change successfully. Self efficacy is a clients belief that change is possible. Counselors support self efficacy by focusing on previous successes and highlighting skills and strengths the client already has.

SMART Recovery is drawn from the principles of

Cognitive Behavioral Therapy

Which Stage of Change in the Transtheoretical model typically includes a Cost-Benefit analysis ?

Contemplation stage

What are the 4 principles of Motivational Interviewing?

Express Empathy Support Self- efficacy Roll with Resistance Develop Discrepancy

Which of the following is not an important social factor in the biopsychosocial model that impacts the course of a person's addiction problems and recovery?

intelligence

Of all the sexual minorities, which group is the most subject to violent assault and employment discrimination?

transgendered pesons

According to the DSM-5 what phrase replaces the word dependence?

use disorder

What are issues for African Americans?

14% of population Substance abuse and addiction rate is 8% 24% report binge drinking 9% illicit drug use 44% of inmates sentenced for illicit drug involvement Gambling- those who gamble high substance addiction rate 45% of new HIV cases are African American

What are cultural issue for Latinos?

17% of California population 58% in US are Mexicans Substance abuse for Hispanics 10% Increase in treatment for meth use. 21% of Latinos smoke High rate of gambling problems, HIV/AIDS major problem High rate of poverty, few have health insurance. Highest drop out rate of highschool drop-out rate. Puerto Ricans have highest poverty rate.

What are cultural issues for American Indians and Alaskan Natives?

2% of US Population. Historical trauma from displacement. Racism and wrongfully accused of neglectful parenting. High rate of substance abuse or dependence. 18 % drug use, 22% binge drinking 41% cigarette use High poverty, alcohol use

What is a requirement to join Gambler's Anonymous ?

A desire to stop gambling.

What is Rolling with Resistance?

Resistance is seen as a difference in the clients view of the problem and solution and that of the clinician. Client experiences this as their freedom or autonomy being impinged upon. The resistance is based on the clients ambivalence about change. Counselors avoid a negative interaction by not confronting the client and instead rolling with it. Actions and statements that demonstrate resistance remain unchallenged especially early in the relationship. Dancing with the client. Counselors avoid the "righting reflex".

What is Motivational Interviewing ?

William R. Miller 1983 developed this technique from his experiences in the treatment of problem drinkers. Definition "a collaborative, person-centered of guiding to elicit and strengthen motivation for change" Supports change in a manner congruent with the person's own values and concerns. Focuses on exploring and resolving ambivalence and centers on motivational processes within the individual that facilitate change.

The most commonly used substance by persons with severe mental illness is

alcohol

Which of the following is not a screen for alcohol problems?

20 questions

What are cultural issues for Asians?

6% of the US Population Immigration Stress Japanese Americans drink more than Chinese Americans Cambodians and Hmong Chinese war trauma, poverty Emotional shaming

Results from the National Survey on Drug Use and Health (SAMHSA, 2010) indicate that among persons aged 12 or older, the rate of substance abuse was highest among?

American Indians and Alaska Natives

How do you express empathy?

Empathy is seeing the world through the client's eyes, thinking about things as the client feels them, sharing in the client's experiences. Clients are heard and understood. Relies on the client's experiencing the counselor as able to see the world as the client sees it.

What is the Preparation stage?

In this stage the client is ready to take some type of change geared towards action within the next month (4 weeks). The plan of action to follow can involve joining a gym, consulting a counselor, talking to their physician. These people are candidates for action-oriented programs. People are preparing for action.

What is the Pre-Contemplation stage?

It is the first stage. This is usually where the person is in denial and not ready to change yet. Sometimes seen as resistance, unmotivated, or unready for help. Not able to see the consequences of their actions, uninformed or under informed.

Which family made their money through selling illicit alcohol directly to people at the highest levels of organized crime?

Kennedy

Which one of these is not a depressant?

Nicotine

How do you Develop Discrepancy?

Occurs between a perceived mismatch between current circumstances/behavior and their values and future goals. Counselors help clients become aware of how current behaviors may lead them away from rather than towards their goals.

What is the Collaborative aspect of Motivational Interviewing?

Partnerships between the therapist and the client. Focus is on mutual understanding. Contrast to the therapist assuming "Expert" role and confronting the client and imposing their perspective on the client's substance use behavior.

What is the Action stage?

People are implementing the plan. This can appear to be a reduction of a substance such as reduction in number of cigarettes, switching to low-tar and low-nicotine , reduction of amount of drinks per week. Switching from one type of alcohol to another such as hard liquor to beer. It is unique to each individual.

What is the Termination phase?

People in this stage have no desire to return to their previous behaviors. This stage is rarely reached.

A recommended way to build trust with gay and lesbian clients (according to the text) is to?

Post a Safe Zone symbol on a pink triangle on the office door

What are the 6 stages The Transtheoretical Model (DiClemente & Prochaska , 1985) of change aka The Stages of Change?

Pre-contemplation (denial) Contemplation (ambivalence) Preparation Action Maintenance Termination (Relapse)

Treatment issues African Americans

Recovery includes family support and spirituality Twice as many are in poverty as whites Higher social class a protective factor Almost half of advertising budget targets blacks Treatment barriers- paperwork for Medicaid, waiting period, wanting to conceal problem

Treatment issues for Latinos

Spanish/bilingual counselors Second generation women have more addiction problems Male/female role differentiation Need for GED programs, job assistance, training programs, and housing assistance.

What is the Contemplation stage?

The person is past denial at this point. Their is an intention to change a behavior/idea/thought/belief in the next six months. A cost-benefit analysis can create a sense of ambivalence if the pro's and cons are equal in weight.

What is the Maintenance phase?

This stage can involve (relapse and recycling) . People are implementing the action plan and making modifications to prevent relapse. Data and research has shown this stage can last from 6 months to 5 years. The risk of relapse drops significantly after the 5 year mark.

Motivational interviewing was developed by __________ as he demonstrated his motivational techniques to Norwegian student interns.

William Miller

Which of the following is not a technique for enhancing motivation?

break through denial

The prefrontal cortex of the brain reaches full maturity soon after age:

mid-20's

A recent change in emergency room admissions concerns related to what overdoses?

prescription drug misuse

The highest percentage of teenagers who actually attempt or commit suicide are those struggling with?

sexual orientation issues

According to the text, the following behaviors can become addictive except for

studying