LCDC TX Exam
Double-Consciousness for a minority client means
"How I see myself" and " How I see whites"
The Stages of Change :
1) pre-contemplation 2) contemplation 3) preparation 4) action 5) maintenance 6) relapse
Myers Briggs
1-16 personality...no pathology
12 Core Functions
1. Screening 2. Intake 3. Orientation 4. Assessment 5. Treatment Planning 6. Counseling 7. Case Management 8. Crisis Intervention 9. Client Education 10. Referral 11. Reports & Record Keeping 12. Consultation
Beck depression
21 item...depression symptoms for 2 weeks...29-63 depression
Adolescent Drinking Index
24 item paper and pencil self report rating scale intended to measure the severity of drinking. 5 min. completion time. Need 5th grade reading level.
Person Centered
3 characteristics; unconditional positve regard, genuiness and accurate empathy
CAGE
4 questions - Yes to 1 indicates possibility of alcohol dependence. Cut down? Annoyed by criticism of drinking behavior? Guilty about drinking? Eye-opener?
The Controlled Substances Act created how many Schedules of drugs?
5 Schedules (I through V)
Mesolimbic dopamine sys
A central group of structures is common to the actions of all drugs / pleasure pathway in the brain
substance abuse
A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by at least one of the four following criteria occurring within a 12 month period: There is recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home; there is recurrent substance use in situations in which it is physically hazardous; there are recurrent substance-related legal problems; and/or there is continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance. Additionally, if symptoms have ever met the criteria for substance dependence, substance abuse cannot be diagnosed for that class or substance.
Substance Abuse
A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by at least one of the four following criteria occurring within a 12- month period: recurrent substance use resulting in a failure to fulfill major obligations at home, school or work, recurrent substance use in situations in which it is physically hazardous, recurrent substance use legal problems, and continued substance use despite having persistent or recurring problems caused or exacerbated by the effects of the substance.
Substance Dependence
A maladaptive pattern of substance use, leading to clinically significant impairment or distress, as manifested by 3 or more of the following 7 criteria: tolerance, withdrawal, increased dose or dosing for longer periods of time, attempts to cut down unsuccessfully, time spent obtaining, using, recovering from use, important social, occupational and recreational activities given up or reduced because of use, physical or psychological problems caused or exacerbated by continued use.
Norepinephrine
A neurotransmitter involved in arousal, as well as in learning and mood regulation
Genogram
A pictorial representation of family structure, using a least three generations and a standard set of symbols.
SOCRATES
A readiness-to-change scale that stands for Stages Of Change Readiness And Treatment Eagerness Scale.
URICA
A readiness-to-change scale that stands for the University of Rhode Island Change Assessment.
The Mental Status Exam
A series of observations about a client's appearance, behavior, attention, mood, affect, perceptual and thought processes, judgement, and memory at a given point in time. Includes observations of a client's orientation to time, place and person.
Mood
A sustained emotion. Changes less frequently than affect.
The Strong Interest Inventory
A vocational interest scale that compares clients' interests to those of people who are happy in different occupations.
Rational Emotive
A-B-C; activating event, belief about, and consequences
Regarding a "seropositive" result, the person has?
AIDS
Addiction Severity Index
ASI
Cognitive behavior
Aaron Beck
Acculturation
Accommodation to rules & expectations of the majority culture without entirely giving up cultural identity.
Excitatory neurotransmitter released by axons
Acetylcholine
Frequent client reaction during the termination phase of counseling
Acting out behavior
(SCM) Changing behavior
Action
Changing behavior
Action
Case Management
Activities intended to bring services, agencies, resources, or people together within a planned framework of action toward the achievement of established goals. It may involve liaison activities and collateral contacts.
Assimilation
Adaptation to a new culture by taking on a new identity and abandoning the old cultural identity.
Intake
Administrative and initial assessment procedures for admission to a program.
Step 5
Admit to God, ourselves and others the nature of our wrongs, allows the release of neg behav and wrong doings
Generativity vs Stagnation
Adults need to create or nurture things that will outlast them, often by having children or creating a positive change that benefits other people. Success leads to feelings of usefulness and accomplishment, while failure results in shallow involvement in the world.
ALAT
Alanine aminotransferase - screens for heavy drinking.
Rational Emotive
Albert Ellis
Seconal taken with what drug will lead to a "potentiation"effect
Alcohol
AUDIT
Alcohol Use Disorders Identification Test. The 10 items on this instrument developed by the WHO ask about frequency of drinking, alcohol dependence, and problems caused by alcohol. Scores range from 0 to 40 with a score of 8 or higher indicating the likelihood of harmful alcohol consumption
RAPS-4 (Rapid Alcohol Problems Screen)
An answer of yes to one or more questions indcates the possibility of alcohol dependence during the past year. The questions have to do with remorse, amnesia, performance of life duties, and starting the day with alcohol.
CAGE
An answer of yes to one or more questions indicates the possibility of alcohol dependence.
Guilt and ___ are painful emotions that are part of grieving.
Anger
Schedule I Drugs
Any drug included here has a high level of abuse/dependence. Also, there is no accepted medical use. (Examples: Heroin, LSD and Marijuana)
A mental status exam includes:
Appearance Speech Thought Process
ASAT
Aspartate aminotransferase - screens for heavy drinking.
PT discloses suicidal thoughts, counselor's first step?
Assess the degree of risk
When a client discloses suicidal thougths, the counselor's first step is to:
Assess the degree of risk
The essential first step in determining the possible causes of addiction for the person and the most appropriate modality for his needs.
Assessment
Five Critical Components of Effective Treatment
Assessment, Patient-treatment matching, Comprehensive services, Relapse prevention and Accountability of the treatment program
Process of termination should be discussed
At the onset of treatment
Active listening
Attending to verbal/nonverbal aspects of communication, counselor remains neutral. Encourages trust and self-disclosure.
Psychosocial Stage: Early Childhood (2 to 3 years)
Autonomy vs Shame and Doubt
Fundamental Ethical Principles
Autonomy: Respect the client's independence and self-determination. Nonmaleficence: Do not harm the client Beneficence: Provide benefit for the client Justice: Be fair to the client Fidelity: Be faithful to the client Veracity: Be truthful with the client
Cluster A
Axis II disorders that feature odd, eccentric, isolative, or suspicious behavior. They include Paranoid, Schizoid, and Schizotypal personality disorders.
Cluster B
Axis II disorders that often co-occur with substance abuse and dependence, and are characterized by dramatic, emotional, erratic, or impulsive behavior, or a reduced capacity for empathy. They include Antisocial Personality Disorder, BPD, Histrionic Personality Disorder and Narcissistic Personality Disorder.
One of the best safeguards against differential power
Be alert to and understand the power relationship
Which cultural group has traditionally been the subject of a matriarchal family structure?
Blacks
Antagonist
Blocks the receptor and prevents activation by neurotransmitters or other drugs (Ex Naltrexone)
Maslows Hierarchy of Needs
Bottom to Top: Physiological (breathing, food, water, sex, sleep, homeostasis, excretion) Safety (security of body, employment, resources, morality, the family, health, property) Love/Belonging (Friendship, family, sexual intimacy) Esteem (self-esteem, confidence, achievement, respect of others, respect by others) Self-Actualization (morality, creativity, spontaneity, problem solving, lack of prejudice, acceptance of facts).
Three major structures of the nervous system
Brain, spinal cord and peripheral nerves
Bi-polar mood disorder is distinguished from major depression
By at least one episode of mania
Self report screening instrument consists of 4 Y/N questions. Requires aprox 1 min to complete
CAGE questionnaire
Axis I, IV and V
CASACs are responible for these three axes on the Written Assessment Summary. Other axes can be written up as "deferred" or list symptoms eg. deferred, reports frequent headaches.
CNS
CNS - Body's coordinating center for mechanical and chemical actions, brain and spinal cord
During a session you notice that the client is getting progressively more agitated. You suspect potential violence unless something is done immediately. Best course of action:
Call for assistance
CDT
Carbohydrate Deficient Transferrin - sensitive enough to pick up moderate drinking over a peoiod of a few weeks.
Person Centered Theory
Carl Rogers
Two major parts of the nervous system
Central and peripheral nervous systems
Reports and Record Keeping
Charting the results of the assessment and treatment plan; writing reports, progress notes, discharge summaries, and other client-related data.
Trust vs Mistrust
Children develop a sense of trust when caregivers provide reliability, care, and affection. A lack of this will lead to mistrust.
Initiative vs Guilt
Children need to begin asserting control and power over the environment. Success in this stage leads to a sense of purpose. Children who try to exert too much power experience disapproval, resulting in a sense of guilt.
Industry vs Inferiority
Children need to cope with new social and academic demands. Success leads to a sense of competence, while a failure results in feelings of inferiority.
Structural famly therapy - Clear boundaries
Clear but firm boundaries
Provision of information concerning alcohol and other drug abuse and the available services and resources
Client Education
Drug misuse
Combining alcohol with other depressant drugs
Goal Statement
Component of a MTP that should be acceptable to the client and answers the question, "What is necessary to remedy the problem?" Should be stated positively - eg. "Client will maintain abstinence," rather than, "Client will not drink."
Problem Statement
Component of a MTP that should be stated in client's words whenever possible. Answers the question, "Why are you here?" Include statement of problem and evidence for it.
Objectives
Component of a MTP that states specific things the client will do to meet the goal. Stated in behavioral terms, and are observable, realistic, time specific, appropriate to the level of treatment and measurable.
Strategies
Component of a MTP that states what the counselor will do to help meet the client's objectives. Includes the theoretical model to be used, (eg. reality therapy) and the specific techniques to be employed (eg. assertiveness training or refusal skills training). These are sometimes also called "Interventions".
Somatic system
Comprised of the cranial and spinal nerves which connect the CNS to the skin and the skeletal muscles
Must always be considered when consulting with out-of -agency professionals
Confidentiality
Immediacy
Consists of dealing openly with issues that are present in the clinical relationship.
Re-framing
Consists of offering a different perspective on a situation the client is facing.
Your dually-diagnosed client, stabilized on medication for his psychiatric disorder, decides he wants to quit smoking. You should:
Consult with his physician regarding nicotine/medication interaction
A dually-diagnosed PT, stablized on meds for his psychatric D/O, wants to quit smoking. You should:
Consult with his physician regarding nicotine/medication interaction.
Step 10
Cont to take personal inventory and when we were wrong promptly admit it...promote support of sobriey and continue chane, helps recognize dont have to slip back into old habits
Axis I
Contains 16 categories of clinical disorders, one of which is Substance Related Disorders.
Axis III of the DSM-IV-TR?
Contains 16 general medical conditions that are potentially relevant to the understanding or management of the client's diagnosed disorder.
Axis IV
Contains nine psychosocial and environmental problems that may affect the client's diagnosis, treatment, and prognosis. (Examples: Homeless, Money problems, Access to healthcare, Transportation)
Axis II of the DSM-IV-TR?
Contains personality disorders as well as mental retardation.
(SCM) Acknowledging that there is a problem but not yet ready or sure of wanting to make a change
Contemplation
Acknowledging that there is a problem but not yet ready or sure of wanting to make a change
Contemplation
2nd or transition stage of group development involves
Control issues
What should occur after a PT is considered appropriate and eligible for treatment?
Counselor should provide the PT with an overview describing the goals, objectives, rules and obligations of the program
Style of counseling in which a counselor is aware of his/her fears and dislikes for a minority culture but hides those fears beneath the surface of counseling
Covert (Hidden) Prejudice
Drug Offender Profile Evaluation/Refferal Strategies
D.O.P.E.R.S.
The "businessman's lunch" is a term used for
DMT
Diagnostic and Statistical Manual of Mental Disorders
DSM
Prohibtion caused _________________to occur.
Decreased number of deaths associated with alcoholism
Withdrawal
Defined by either the characteristic withdrawal syndrome for the substance or the same or a closely related substance being taken to relieve or avoid withdrawal symptoms.
The following AIDS associated illness that may be less recognized in substance abusers is
Dementia
Process of Addiction: Stage Three
Dependency/Addiction
Orientation
Describing to the client the general nature and goals of the program; the rules governing client conduct and infractions that can lead to disciplinary action or discharge from the program, the hours during which services are available; the treatment costs that are to be borne by the client, if any; and the client's rights.
DSM-IV-TR
Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (APA, 2000).
Chronis and relapsing nature
Disorder of addiction
" primum non nocere"
Do no Harm
Destructive & rigid family rules which contribute to the low self-esteem of CoA's. -Claudia Black
Don't Talk, Don't Trust, Don't Feel.
Neurotransmitter found in the brain associated with movement and pleasure
Dopamine
DAST
Drug Abuse Screening Test (adapted from MAST) used to detect abuse or dependence on drugs other than alcohol.
DAST
Drug Abuse Screening Test, adapted from the MAST, this self-report instrument is used to detect abuse of or dependence on drugs other than alcohol. It provides a measure of lifetime problem severity.
Schedule V Drugs
Drugs in this category are considered to be at low risk for either physical dependence or psychological dependence. Again, there are currently accepted indications for medical use. (Examples: Medical mixtures using small amounts of opium or codeine)
Schedule IV Drugs
Drugs in this category are considered to be at low risk for physical dependence but moderate risk for psychological dependence. There are currently accepted indications for medical use. (Examples: Xanax, Ambien, Brabital, and Chloral hydrate)
Schedule III Drugs
Drugs in this category are considered to be at moderate risk or low risk for physical dependence but at high risk for psychological dependence. There are currently reasons for medical use. (Examples: Anabolic steroids, most barbiturates, and ketamine)
Psychosocial Stage: Maturity (65 to death)
Ego Integrity vs Despair
EMIT
Enzyme Multiplied Immunoassay Test - this urine testing kit uses antibodies that react to the presence of a drug or its metabolites.
The following naturally occurring substance is not classified as a stimulant
Ergot
6 Stages of Counseling
Evaluation, Feedback, Counseling, Agreement, Changing Behavior and Termination
Process of Addiction: Stage One
Experimental and Social Use of Drugs and Alcohol
Adapted Short Michigan Alcoholism Screening Test for Fathers
F-SMAST
Frequent mistake that begining counselors make with clients
Failure to openly discuss each others expectations
T or F: According to the American Society of Addiction Medicine(ASAM), detoxification services are one of the five categories of primary treatment.
False
T or F: Betel Nut has effects similar to that of cocaine.
False
T or F: Hallucinogens are associated with physical withdrawal.
False
Delusions
False beliefs that are maintained despite proof against their truth.
FTQ
Family Tree Questionnaire helps clients report information about the incidence of alcohol problems in their blood relatives.
Axis III Cluster C
Fearful...anxious...perfectionist
Brief Therapy
Five Stages
Stress inoculation
Focuses primarily on increasing coping skills
Tuckman's 5 Stages of Group Therapy
Forming, Storming, Norming, Performing, Adjourning
when should significant others be involved in the treatment process
From first contact with treatment center
When should significant others should be involved in the treatment process?
From the clients first contact with the treatment center
Global Appraisal of Individual Needs
GAIN
GGT
Gamma-glutamyltransferase - indicates prolonged, rather than episodic drinking.
Psychosocial Stage: Middle Adulthood (40 to 65)
Generativity vs Stagnation
Constructivism
George Kelly
Feminist therapy
Give women view of social position and sense of community with new power, possibilities and overriding binding stigmas
Clarifying
Grasps the message at both feeling and thinking levels; helping members sort out conflicting and confused feelings and thoughts.
Human Immunodeficiency Virus
HIV
Feminist therapy
Helen Deutsch and Karen Horney
Rational Emotive
Help pt confront irrational beliefs through gathering evidence...pt becomes aware of automatic thought process
Reality Therapy
Help pt in here and now...frustrated with psychoanalysis
Person Centered
Here and now...people are resourceful and capable of solving own problems and are trustworthy
Step 7
Humbly ask him to remove short comings, admits to fear of repeated unhealthy behav
Injected
IV - few seconds to minutes
Referral
Identification of client's needs that cannot be met by the counselor or agency and assisting the client to use the support systems and community resources available.
When conducting an assessment what is the counselor's primary focus?
Identifying the clients problems and needs, strengths and weaknessess.
When conducting an assessment, what is the counselor's primary focus?
Identifying the clients problems, needs, strengths and weaknesses
Duty to Warn
If a client threatens to harm another person who is reasonably identifiable, the counselor has a duty to warn the appropriate authorities of that threat. Texas counselors do not have a duty to warn the intended victim, but the authorities.
Pattern of drinking accurately associated with the term "alcoholism"
Inability to control the amount one drinks
Paraphrasing
Includes therapeutic qualities of empathy and warmth. Paraphrasing refers to a counselor's verbal response that rephrases the essence of the client's message. It allows the client to hear what he or she has just said, either in parroted form or with added clarity. The interactive process can increase trust and can reduce resistance.
Psychosocial Stage: Adolescence (12 to 18 years)
Indentity vs Role Confusion
Physiological Dependence
Indicated by whether tolerance and withdrawal are present.
Traditional
Individuals are defined as carriers of the community ethos. They neither overtly accept nor reject their ethnic identity. Traditional persons have most of their emotional, spiritual, and, to some degree, educational needs met through their ethnic community and have limited contact with the dominant culture or any outside communities.
Culturally Immersed
Individuals have rejected mainstream culture, and their emotional and spiritual needs are met exclusively in their ethnic community or in the gay community.
Bicultural/Multicultural
Individuals that are proud of their cultures and can function in, fulfill their needs through, and be proud of the dominant culture. Their emotional, educational, economic, and spiritual needs are usually fulfilled in a diverse, integrated living environment that honors two (or more) cultures.
Psychosocial Stage: School Age (6 to 11 years)
Industry vs Inferiority
Psychosocial Stage: Preschool (3 to 5 years)
Initiative vs Guilt
Antidipsotropic
Intended therapeutic effect is to reduce or prevent alcoholic drinking.
Psychosocial Stage: Young Adulthood (19 to 40 years)
Intimacy vs Isolation
Erickson's developmental theory- ____ should be accomplished in adulthood is
Intimacy vs. Isolation
Probing
Involves asking open-ended questions to clarify information and to help the client toward a new understand.
Simplifying
Involves the reflection and restatement of what the client said. It removes confusion, avoids intellectualizations, and convoluted explanations, and can help the client stay focused on concerns, feelings, and problems in the here and now.
Confrontation
Involves the use of a statement or question to raise some discrepancy within the client
The Stages of Change Model was originally developed in the late 1970's and early 1980's by...
James Prochaska, Carlo DiClemente
The Stages of Change Model was originally developed in the late 1970's and early 1980's by ________and __________ at the University of Rhode Island when they were studying how smokers were able to give up their habits or addiction.
James Prochaska; Carlo DiClemente
What popular street drug that includes the main ingredient Cathonine?
KHAT
Michigan Alcoholism Screening Test
MAST
Minnesota Multiphasic Personality Inventory
MMPI
Minnosota Substance Abuse Problems Scale
MSAPS
MMPI
MacAndrews alc scale
Step 4
Made a searching and fearless moral inventory of self, provokes indiv to look closer at basic errors in perceptin, begains teaching about responsibility
Maintenance
Maintaining the behavior change
SCM) Maintaining the behavior change
Maintenance
Personality Disorders
Maladaptive ways of perceiving, thinking and relating
Biomarkers
Measuring these physiological markers at intervals throughout treatment may provide early identification of relapse.
3 Stages of Drug/Alcohol Counseling
Medical, Psychosocial and Aftercare
MAST
Michigan Alcoholism Screening Test - yes or no to 25 questions.
MAST
Michigan Alcoholism Screening Test. This instrument requires yes/no answers to 25 questions. Scores indicate the absence of alcohol dependence (0 to 3), possible substance dependence (4), or likely alcohol dependence (5 or higher). A brief MAST (10 items) and a 13-item Short MAST (SMAST) are available, as is a Geriatric MAST (MAST-G)
Agonist
Mimic the action of the endogenous (naturally occurring) neurotransmitters, same or a stronger affinity than the neurotransmitter itself (Ex Methadone)
Illusions
Misperceptions of actual sensory input.
Most important criteria for client inclusion in group counseling
Motivation
Common error counselors make when conducting an assessment?
Moving too quickly from data collection to treatment planning
Progress Notes
Must include interpretations of progress with reference to directly observed behaviors
Autonomic System
Nerves connect the CNS to the various body organs; including heart, stomach, intestines and various glands
When an electrical impulse reaches the end of an axon; tiny saclike structures known as synaptic knobs manufacture chemicals called ___________.
Neurotransmitter
OCDS
Obsessive Compulsive Drinking Scale
Reflecting
Occurs when the counselor restates content that had generated emotion from the client--it is a reflection of feeling. Reflection of feeling captures and expresses to the client the core of what he or she is feeling. It allows the client to be aware of his or her own expressed emotions and how the counselor understood his or her emotional message. The counselor should be careful not to interpret the client's feelings. The counselor remains neutral and nonjudgmental by not offering opinions, judgments, or advice.
Ego Integrity vs Despair
Older adults need to look back on life and feel a sense of fulfillment. Success at this stage leads to feelings of wisdom, while failure results in regret, bitterness, and despair.
Assessment
Ongoing process by which a counselor/program identifies and evaluates an individual's strengths, weaknesses, problems and needs for the development of the treatment plan.
___ withdrawal - pupils dilated, gooseflesh, lacrimation, muscle jerks, flu syndrome, vomiting, diarrhea, nervousness, yawning, severe anxiety
Opiod
Name the Routes of Administration for Substances
Oral, Injection, Inhalation, Transdermal, Buccal Administration (mucous membranes in the mouth), Rectum
Rational Recovery
Organization founded as an alternative to programs with spiritual overtones, whose publications called" The Small Book".
Potential pitfall for new counselors
Over-identification with clients
Restating
Paraphrasing what has said to clarify. Don't just repeat word for word what the client is saying.
Hallucinations
Perceiving something in the absence of a sensory input. May be auditory, visual, olfactory, gustatory or tactile.
Special study of where and how drugs act in the human body
Pharmacodynamic
(SCM) Not yeat acknowledging that there is a problem behavoir that needs to be changed
Pre-Contemplation
Not yet acknowledging that there is a problem behavior that needs to be changed.
Pre-contemplation
Stages of Change
Pre-contemplation, Contemplation, Preparation, Action, Maintenance, Relapse
Transtheoretical model of Change
Precontemplation (Not ready) , Contemplation (Getting Ready), Preparation (Ready), Action, Maintenance
(SCM) Getting ready to change
Preparation
Getting ready to change
Preparation
The following is the best indicator if an individual is physically dependent upon alcohol or another drug.
Presence of withdrawal symptoms
Process of Addiction: Stage Two
Problem Use or Abuse
What are the 4 main components to a treatment plan?
Problems, Goals, Objectives, Strategies
Concreteness
Process by which the counselor relates the vague aspects of the client in direct expression of feelings and experiences in specific concrete terms to assist the client to develop more functional coping skills.
Primary purpose of professional standards of practice
Provide recognition of demonstrated competency in addictions counseling
Client Education
Provision of information to individuals and groups concerning alcohol and other drug abuse and the available services and resources.
Psychotropic Medications
Psychiatric medications that treat mental disorders.
RAPS4
Rapid Alcohol Problems Screen. An answer of yes to one or more questions indicated the possibility of alcohol dependence during the past year. The questions have to do with remorse, amnesia, performance of life duties, and starting the day with alcohol.
A cognitive-based therapy, developed by Ellis, designed to confront a PT's irrational thinking
Rational-Emotive Therapy
Attending
Refers to ways in which the clinician demonstrates that she/he is listening to the client through the use of cues
Consultation
Relating with counselors and other professionals in regard to client treatment (services) to assure comprehensive quality care for the client.
After a counselor has made a summary statement, the most important thing the counselor should do is ______________.
Remain quiet for a time to allow the client to consider the summarized material
RAPS4
Remorse, amnesia, personal respon, start day with drink...alc dependence
Self Administered Alcoholism Screening Test
SAAST
Substance Abuse Subtle Screening Inventory - Adult or Adolescent Version
SASSI
Substance Abuse Subtle Screening Invnetory for Adolescents
SASSI-A
Short Michigan Alcoholism Screening Test
SMAST
Structural famly therapy - present & past
Salvador Minuchin- modify the present, past changed by interventions. Three subsystems of nuclear family - parent subsystem, sibling, sibling/parent
You are having difficultiy with a client early on in the case. The BEST thing for you to do is:
Seek out supervision with a colleage or supervisor
You are having difficulty with a client early in the case
Seek out supervision/consultation
CAGE questionaire
Self report screening instrument consisting of 4 yes or no questions. Requires approx. 1 min to complete
Primary purpose of a professional code of ethics
Serve as a guideline helping clients while behaving in a fair way to colleagues
SADD
Short Alcohol Dependence Data
Positive reinforcement
Something specifically designed to increase the occurrence of a particular behavior
What does SOAP mean in reference to note taking?
Subjective, Objective, Assessment, Plan
SASSI-A2
Substance Abuse Subtle Screening Inventory for Adolescents ages 12 to 18.
SASSI
Substance Abuse Subtle Screening Inventory. This brief self report is designed to identify individuals with a high probability of having a substance related disorder. A version is designed for adolescent, the SASSI-A2 is for clients 12 to 18.
SDSS
Substance Dependence Severity Scale
Difference between, Autonomy vs Shame and Doubt
Success lead to feelings of autonomy, failure results in feelings of shame and doubt.
Goal of an effective aftercare program
Support gains made in treatment
Readiness To Change Questionnair
TRCQ
Identity vs Role Confusion
Teens need to develop a sense of self and personal identity. Success leads to an ability to stay true to yourself, while failure leads to role confusion and a weak sense of self.
The Interpersonal style in which a member of a minority group has pride in his/her racial identity; it's history and cultural traditions and yet is comfortable in operating in the world is known as:
The Bi-cltural Interpersonal Style
MMPI-2
The Minnesorta Multiphasic Personality Inventory contaings several clinical scales that detect pathology including the MacAndrew Alcoholism Scale.
Empathy
The ability to perceive another person's experience and communicate that perception back to the person.
Affect
The external expression of an internal emotional state.
The BEST indicator if an individual is physically dependent upon alcohol or another drug is:
The presence of withdrawal symptoms.
Screening
The process by which a client is determined appropriate and eligible for admission to a particular program.
Treatment Planning
The process in which the counselor and the client identify and rank problems needing resolution, establish agreed upon immediate and long-term goals, and decide on the treatment methods and resources to be used.
Polysubstance Dependence
The proper diagnosis for a client who has repeatedly taken at least three groups of substances, and who meets creiteria for dependence for the substances as a group, but not for the substances individually.
A "release of information" must include: name, address, DOB & _____?
The purpose of the release of information
Counseling
The utilization of special skills to assist individuals, families, or groups in achieving objectives through exploration of a problem and its ramifications; examination of attitudes and feelings; consideration of alternative solutions; and decision making.
The NIDA-financed Drug Abuse reporting Program found that: (having to do with therapeutic communities)
Therapeutic communities do reduce drug use relative to untreated clients or those who are simply detoxified and released.
Substance Induced Disorders
These Axis I disorders are a sub-category of Substance Related Disorders and can include Substance Intoxication and Substance Withdrawal, Substance induced delirium, persisting dementia, persisting amnesic disorder, psychotic disorder, mood disorder, anxiety disorder, sexual dysfunction disorder, and sleep disorder.
Cluster C
These Axis II personality disorders feature anxious, fearful, and perfectionistic behavior. They are the Avoidant, Dependent, and Obsessive-Compulsive personality disorders.
Assessment Instruments
These aid in the identification of, and treatment planning for substance related disorders.
Schedule II Drugs
These drugs are essentially similar to those in Schedule I. There is evidence of the potential for abuse/dependence. The distinguishing feature in Schedule II is that there is accepted medical use. There are restrictions on manufacture and distribution via production quotas and import/export controls. Prescriptions are non-refillable. (Examples: Methadone, Morphine, Methamphetamine, Ritalin, Adderall and Cocaine)
Biological factors
These include brain chemistry problems, which may be genetic, making some people particularly vulnerable to addiction to certain drugs once they try them.
Psychological factors
These include cognitive styles, personality traits, and early developmental experiences that may contribute to a client's causes of substance abuse and dependence.
Social factors
These include poverty, oppression, poorly developed social skills, and family dysfunction that may contribute to a client's causes of substance abuse and dependence.
Axis V
This axis of the DSM IV -TR is the Global Assessment of Functioning (GAF) scale, which assigns a number from 1 to 100 to the counselor's judgement of the client's overall level of psychological, social and occupational functioning.
Axis II
This axis of the DSM IV- TR includes the personality disorders as well as mental retardation.
SASSI (Substance Abuse Subtle Screening Inventory)
This brief self-report is designed to identify individuals with a high probability of having a substance related disorder.
Substance Related Disorders
This category of clinical disorders in Axis I of the DSM IV-TR includes both Substance Use Disorders and Substance Induced Disorders.
Dually-Diagnosed
This client has one or more other psychiatric disorders along with substance abuse or substance dependence. Also known as co-occurring disorders. All disorders should be treated concurrently and aggressively.
DIS-IV (Diagnostic Interview Schedule - Alcohol Module)
This diagnostic instrument asks 28 questions that permit diagnosis of alcohol abuse or dependence.
ADS (Alcohol Dependence Scale)
This diagnostic instrument is a 25-item instrument that provides a quantitative measure of the severity of alcohol dependence.
ICS (Impaired Control Scale)
This diagnostic instrument is a pencil and paper self-administered insturment that measures clients' attempts to control drinking during the last 6 months and their perception of their ability to control it now.
Screening Instrument
This distinguishes individuals who do not have a disorder from those who might have one.
TWEAK
This five-item instrument was designed to screen for harmful drinking in pregnant women. The items have to do with tolerance, worry of close friends and relatives, using alcohol as an eye opener, amnesia (blackouts), and felt need to cut down on drinking.
CBI (Coping Behaviors Index)
This instrument measures factors related to relapse risk: positive thinking, negative thinking, avoidance/distraction, and seeking social supports.
TLFB (Time Line Follow Back Procedure)
This is a Comprehensive Measure of Drinking which makes connections between significant events in the client's life and alcohol/drug use patterns and intensity, for the past year.
MBTI (The Myers-Briggs Type Indicator)
This is a personality inventory that looks at clients' preferred ways of being in the world and assigns them to 1 of 16 personality types. Frequently used in vocational and relationship counseling.
WAIS-III (Wechsler Adult Intelligence Scale)
This is a popular intelligence test.
ASI (Addiction Severity Index)
This is a semi-structured interview with seven subscales addressing problems in the areas of family/social status, medical status, employment and support, drug use, alcohol use, legal status, and psychiatric status. It is useful for treatment planning and outcome evaluation with adult clients.
Motivational interviewing
This is a style of interacting with clents, used not only for assessment, but for all phases of treatment, that is particularly helpful for reducing defensiveness and encouraging therapeutic collaboration between the counselor and client. Uses the interpersonal process to enhance clients' motivation to change, and encourages clients to move on to the next stage of readiness for change.
Antisocial Personality Disorder
This personality disorder features a pervasive pattern of disregard for and violation of the rights of others.
Histrionic Personality Disorder
This personality disorder features a pervasive pattern of excessive emotionality and attention seeking, often with provocative dress.
Narcissistic Personality Disorder
This personality disorder features a pervasive pattern of grandiosity, need for admiration, and lack of empathy.
Borderline Personality Disorder
This personality disorder features a pervasive pattern of instability in interpersonal relationships, self-image, affect, and control over inpulses. Features may include frantic attempts to avoid real or imagined abandonment, impulsivity in at least two areas that are self-damaging, chronic feelings of emptiness.
Bio-psychosocial perspective
This recognizes that there are biological, psychological and social causes of substance abuse and dependence.
Reliability
This refers to the consistency with which an assessment instrument measures.
Validity
This refers to what an assessment instrument measures and how it is used.
AUI (Alcohol Use Inventory)
This self-report inventory is in multiple-choice format, for ages 16 and up. It is based on the multiple condition theory, which takes into account individuals' different styles of drinking, perceptions of alcohol's benefits and consequences, and how they want to deal with drinking problems.
Substance Use Disorders
This sub-category of Substance Related Disorders includes both Substance Abuse and Substance Dependence.
Crisis Intervention
Those services which respond to an alcohol and/or other drug abuser's needs during acute emotional and/or physical distress.
One of the earliest models for case management services in the criminal justice system was created in 1972, when the White House launched a demonstration program known as
Treatment Alternatives to Street Crimes (TASC)
T or F: Alcohol accounts for one half of the ten leading causes of death in the Native American population
True
T or F: Guilt and anger are painful emotions that are part of grieving
True
Tor F: Counselors should visit facilities to which they frequently make referrals.
True
Psychosocial Stage: Infancy (Birth to 18 months)
Trust vs Mistrust:
Summarizing
Tying together of the main points, themes, and issues presented by clients during part or all of a session.
Specifiers
Used for Substance Dependence Diagnosis, these 6 categories are: Early full remission, early partial remission, sustained full remission, sustained partial remission, on agonist therapy, in a controlled environment.
The Beck Depression Inventory II
Used to track changing levels of depression over the course of treatment for clients age 13 and over. Individuals rate themselves on 21 groups of statements that tap the affective, behavioral, cognitive, and physiological symptoms of depression for the 2 weeks prior to testing.
Human Validation process
Virginia Satir - assisting individuals in transforming family rules and messages (specifically abut individuation and communication) to be more acceptable and flexible, allowing for change, enhance and validate self-esteem; family rules; sculpting; nurturing triads; congruence & openness in communication; family mapping & chronologies Therapist is the role model, facilitator, resource person and investigator
WAIS
Weschler...intelligence tet
Self-disclosure
When the clinician shares something about him/herself for the benefit of the client.
Reality Therapy
William Glasser
Exploring Alternatives
Working with the client to examine various options
Intimacy vs Isolation
Young adults need to form intimate, loving relationships with other people. Success leads to strong relationships, while failure results in loneliness and isolation.
`
`
Heroin, a chemically altered form of morphine, was originally introduced as
a cure for morphine addiction.
Cross dependence
a person who is physically dep to one drug, lessens or prevents W/D symptoms by using other drugs with similar classification
Step 2
a power greater than ourselves can restor sanity..indiv recognizes insanity of and moves toward higher power
Empathy
ability to perceive pt emotions and see their world thru their eyes
AVE
abstinence violation effect - tendency for some to use substances problematically when they believe abstinence is too difficult, happens when person attempts to abstain and then faces conflict and guilt
Reality Therapy
accepts no excuses..holds pt accountable..allows for natural consequences...no enabling
Brief Therapy - contemplation
acknowledges problem, ambivalent about change
Chronic use
acute pancreatitis, inflammation of panreas, blocking of duct causing digestive juices to produce fat and then injury through attempts to digest
Step 1
admit powerlessness and lives unmanageble
Endocrine system
affect pituitary gland, liver damage, production of, reception of and metabolizing of hormones may be affected by alco
Dependence
after using drugs, indiv finds difficult or impossible to control use, dependenc or addiction usually involves tolerance or W/D
Case Mgt - strengths based
aggressive outreach, helps pt develop goal, advocates, and view community as resources not a barrier, this is an alternative to disease concept
AHMD
alco heart muscle disease - serious condition where heart does not pump amt of blood needed for demands of body
Stimulants produce
alertness, well being, euphoria, increased engry,anxiety, medical prob, cardiac, cns, respiratory and potential death
SASSI
allows diagnosis of cohabitating disorders...self report
Tolerance
altered physiolocal state develops after repeated drug use and body becomes accustomed and adapts to presence of drug, evidenced by drug having less of an effect in same dose
Black out
amnesia like state, appear to be functioning normally but have no memory of what went on
Effective dose
amt of drug necessary to get desired effect in about 50% of those who use
Potency
amt of drug needed to produce desired effect
Dose
amt of drug taken at any particular time
Aldehyde dehydrogenase
an enzyme that is involved in metabolizing alcohol
If one drug, such as a barbiturate tends to reduce the effectiveness of an oral contraceptive, the drug interaction would be most accurately described as _________.
antagonistic
ADH
antidireutic hormone - can inhibit production and output of ADH by pituitary region of brain, causing kidneys to reasbsorb less water, and produce more urine
Trazadone is an ______________.
antidpressant
Serotonin
anxiety, depression and aggressiveness Affects mood, hunger, sleep, and arousal
Alcohol W/D
anxiety, hyper arousal, elevated vitals, sweating, shakes, altered perceptin, visual/tactile hallucinations and illusions/swizures, possible death if combined with alco or barbituate
Drug
any substance, after enters body changes either the structure or function of body
A person wants to accept a party invitation because he is very social but is concerned because there will be a lot of drinking and he is a member od AA. He is experiencing
approach-avoidance conflict
Acetylcholine
arousal reactions or inhibitory factors
Substance abuse effects on musculoskeletal system
arthritis, gouty arthiritis
A counselor can avoid professional burnout by
attending to health through adequate sleep, an exercise program and proper diet.
The first barbiturate produced in 1903 was called
barbital
Brief Therapy - determination
begins once user decides to change - plan of action
Therapeutic community
believes substance abuse is whole person; self help proess of incremental learning; changes in behavior, values and attitudes
VTA
bentral tegmental area and nucleus accumbens of brain make up leasure center, responsible for reward sys for all drugs
Valium, Halcion and Xanax are _________________.
bezodiazepines
Biological view of addiction
biogenetic factors cause behavioral and psychological change; internal, not environmental causes
CDT
blood biomarker...detects long term drinking
Induced disorder
brought on or worsened by substance
The method by which disulfiram (antibuse) act to deter the consumption of alcohol is
by decreasing the body's ability to break down poisonous metabolites of alcohol.
Aftercare
called continuing care, follows discharge, case mgr helps transition, and take responsibility for their lives
Identification
can be self id, court order, probation
Ketamine
can be snorted or injected, frightening experience of complete sensory detachment, paranoia, boredom, explained near death experiences
Rehab/tx program
can range from providing duc, intensive outpatient, inpatient residential prog
Marijuana is a unique compound which contains over 200 chemicals, one particular chemical is the main psychoactive chemical that makes marijuana "go". The name of the psychoactive compound is
cannabinol
Cognitive behavior - Techniques
challenge faulty thoughts, ask where did evidence come from, instill hope, Socratic
Reality Therapy techniques
challenge inappropriate beh, focus on strengths, discourages excses, help pt achieve goal, find constructive way to meet goals
Hallucinogens
change sensory perceptino and alter reality; hallicunations naturally occuring and synthetically prepared drugs
Neurotransmitters
chemical messengers
Intervention - choose team
choose team gather data, make list of incidents, describe incident, no anger or accusations
Addiction is a __________ disorder that is prone to relapse, even after significant periods of recovery.
chronic
White blood cells
chronic alc use reduces white blood cells, negatively affects immune sys, increases chances of infection
The provision of info concerning alcohol/drug abuse & the available srvcs & resources:
client education
Constructivism
clinican does not direct or pursuade, they use elaboration and metaphors to advance the process, serve as co-investigators helping pt construct rewarding way of being and coping.
Cognitive behavior
cognitive distortions - over generalization, minimization, personalizing events, polarized thinking
Alcohol decreases resistance to HIV infection by
compromising T-cell functions
An irresistible impulse
compulsion
One of the counselor's task is to guide the client in relating and communicating in specific terms, rather than in general or abstract terms. This characteristic or ability is called
concreteness.
Dellusions
continued belief of something even when proof against it....false belief based on faulty external reality
Pulmonary defense
contrubtue to chronic obsturction in airflow, bronchospasm, affects asthma lung cancer high long term drinkers, smokers and increases risk of TB
Community resources
coordination variety of resources, counselor should be familiar with resources
CBI
coping behav inventory...relapse, social supports, attitude and avoidance
Criminal view of addiction defines drug use as a ___________.
criminal behavior.
Moderate alc
decrease risk of gallstones, harms liver, acute fatty liver is fat deposits, build up in liver cells, is reversable if stopped
Stimulant W/D
depression with suicidal thoughts, excessive need for sleep, fatigue, increased appetite, drug craving, not life threathening but suicide potential high
Rational Emotive - techniques
detect irrational beliefs through words (ought, should, must and always)...when is that not true...homework given
The primary purpose of the screening process is to
determine one's appropriateness and eligibility for admission
Intervention - steps
determine steps that will be taken if person does not seek help
The initial stage of crisis intervention involves
determining the problem.
Metalbolic process that changes alcohol to the compound acetaldehyde
detoxification
Skin
dilates vessels of skin, jaundice, itching, changes in hair distribution, skin infections because liver dysfunciton
Amphetamine
direct the release of dopamine and norepinephrine and blocks reuptake creating euphoric effect
PT is unhappy with the way treatment is progressing, counselor should __?
discuss these concerns with the client and make necessary changes in treatment goals.
Therapeutic index
dose determined to be safe for use and desired effect of drug, determined by dividing the lethal dose by effective dose
Lethal dose
dose of drug results in death
Axis II Cluster B
dramatic...emotional..impulsive...lack empathy
DAST
drug dependence other than alc...lifetime severity
Denial
early when occasional excessive drinking are explained as isolated event
Mental status exam does not assess: a) education level b) appearance c)speech d) thought process
education level
case mgt with adolescents
encouraging family involvement, provide support, track relapse episodes, connect with school, work and community resources
potentiation
enhancement of one agent by another so that the combined effect is greater than the sum of the effects of each one alone
Structural famly therapy - diffuse boundaries
enmeshment, everyone in everyone elses business, distinctions not present between subsystems
Several experts believe that burn-out occurs in stages. The first stage is______________.
enthusiasm
During the screening process, a critical task that the counselor has to do is to
establish rapport with the client.
Brief Therapy - maintenance
establishes new behav on long term basis
Case Mgt - monitoring
evaluate progress continuously and take action if needed
exploring alternatives
examine various options to pt
Comprehensive client documentation
facilitates communication and enhances accountability
Disorganization/chaos
family operations have broken down, partner has to deal with critical situations
Structural famly therapy - present & past
family supported but nurtured, balance between autonomy and connectedness; freedom to indivuate
While the overall national suicide rate has increased slightly but consistently in recent years, disproportionate increase have occurred among
females and the young
Intervention - treatment
find out about treatment, cost and info
Constructivism
focus current problem,then patterns...attention given to background and early attachment
Cognitive behavior
focus on here and now, pt with emotional probls have faulty thinking or incorrect info
Tertiary prevention
focus on stopping progressive damage of drug use, incorporates group intervention to get people into treatment, residential ther communities, promotes healthire life style
In a crisis interview with a client, you are most concerned with
focusing questions about the present situation and the clients means of coping with the stress.
A relatively mild psychedelic substance which is chemically similar to LSD is
found in morning glory seeds.
Case Mgt - Assertive community
frequent long term contact with pt in natural setting, focus on practical problems of daily living
Assesment
gathering info about pt in order to make informed diagnostic impression
Intervention - rehearse
go over each item on list, determine order to read list, allows you to find out team members individual emotions
Max effect
greatest response from drug no matter the dose given or taken
THC can produce
hallucinations and analgesia
DOM, MDA and MDMA are ?
hallucinogen amphetamines
Step 12
having had spiritual awakening as result of steps, this step vital to maintain sobriety, sharing steps with others
Seasonal alcohol arrhythmias
healy alcohol consumption assoc with holidays, subsides in few days
Alcoholic hepatitis
heavy or extnded bout of alco, inflammation of liver, metablilism is disrupted, jaundice, may be reversible with medical intervention
Family Systems Theory
help addicts decrease anxiety by getting family members to focus on their own recovery, Families are systems of interconnected ad interdependent individuals, a system of interacting parts
Case Mgt - linking system
help pt obtain required services by referring to services for formal/informal care
Schedule I
high level of abuse/dep, no accepted medical, heroin, lsd, marijuana
Tendency of the family to try and maintain balance
homeostasis
Reality Therapy
humans have 2 basic needs; love and feel worthwhile
Part of the brain that controls heart rate, hunger, body weight and arterial blood pressure
hypothalamus
Case Mgt - Brokerage-
id pt needs help access resources, no advocacy but when pt needs access to resources
Case Mgt - Assessment
identify pt strength, weakness and needs
Relapse prevention efforts are aimed at
identifying high risk situations and learning alternative coping skills.
Person Centered
in addictions counseling; builds rapport and T.R to help pt recover
Medicine
includes drugs used to prevent, treatment, diagnose illness/relieve pain
Stabilization
includes need for detox at a medical facility
While taking an alcohol drug history, a good clue to alcohol dependence is _________________.
increased tolerance and withdrawal symptoms when abstinence is attempted
Cross tolerance
increased tolerance to effects of another drug in same class
Respiratory sys decrease
increases respirations when low to moderate doses are used, larger or toxic amts
behavioral view
influence both positive and negative reinforcement as casual factor for cont drug use; positve reinforcement reinforces the cont use because of pleasure pathway, reinforcement pleasure thru effects on GABA neurotransmitters
Inhalation
inhaled into lungs, immediately or few sec
Snorted
inhaled into nose absorbed through mucus membrances
Anemia
insufficeient function of red blood cells, affects nutrient levels, buildup of toxins reduces red blood cells production, those that are produced are defective and can cause bleeding from ulcers
Primary prevention
intended for young with no experience, promotes abstinence, develops refusal skills, promote viable alternatives
Level 2 treatment
intensive outpatient/partical hospitalization
Abuse
intentional use of drug other than intended, to achiee altered state of consciousness, leads to mental, phyusical, emotional or social impariment of using, family or society
Case Mgt - advocacy
intercede on behalf of pt to obtain needed resources
Advocacy coordination in case mgt
involves coordinating with family, community agencies, legal system and legislative bodies
Internal signs of alc
irritation causes inflammation, abdominal pain, bleeding esophagus and stomach
Reverse tolerance
kindling efect - indiv can become more senstive to drugs rather than less sensitive
Rational Emotive - irrational thoughts
lead to self criticism, isolation, self abuse, not striving for potential and drug use
Rational Emotive
learn irrational thoughts as a child that can lead to self destructive behavior...disturbances come from faulty beliefs of everyone should love you
Half life
length of time drug remains in body and continues to affect user
After absorption and distribution of a drug, it is metabolized by the ___________.
liver
Metabolic tolerance
liver adapts to presence of drug over time and produces mre enzyme to break down drug
Schedule IV
low physical dep, moderate psychologcal dep, xanax, barbitatues, chloral hydrate
Schedule V
low risk for either; medical mixture of opium or codeine
Step 3
made decision to turn lives over to God, enables indiv to go to life preserver, begins search for own direction
Step 9
made direct aments, concerded effort to clean up situations and wrong doings
Step 8
made list of person harmed and make amends
Substance abuse
maladaptive patter of abuse...1 of 4 criteria..failure to meet life duties. cant quit, legal problems, continues regardless of danger
Substance dependence
maladaptive pattern...3 of 7 criteria..cutting back, cont use despite prob, tolerance, gives up activities
Cannabinoids
mari, hashish, thc, well being, relaxed, euphoria, etachment, altered level of consciuonsess, altered sense of time
According to the most recent National Survey on Drug Abuse and Health the specific drugs that had the highest levels of past years dependence or abuse in 2009 were
marijuana, pain relievers and cocaine
Axis III
medical
3 Stages of effective treatment
medical/physical interventions, psychosocial rehabilitation and aftercare
Level 4
medically managed intensive inpatient
Components
members contribute, observe peers, model behavir, shared norms and values, structure, and relationships
Effective communication occurs in group when
message senders use "I" messages.
Threshold dose
minimal dose - smallest amt of drug to produce detectable response
Illusions
misperception about a real external stimuli...rustling leafs...
Schedule III
moderate to low physical dep, high psychological dep, medical uses; steriords, barbituates, ketamine
Effective case management for persons in need of multiple services requires
monitoring, feedback and evaluation of services.
Axis I
mood disorders
Oral
mouth or swallowed - 15 min
Amphetamines were first used clinically to treat?
narcolepsy
Codiene, morphine and opium fall under what drug classification
narcotics
MDMA
nausea, clenching of jaw, blurred vision, painic attacks, confusion, depression, paranoid psychosis, increased temp, cardiac arrest
Case Mgt - Planning
negotiate what pt wants, develop plan for achieving it
Pharmacodynamic tolerance
nerve cells become less sensitive to effects of drug over time
Functional and structural unit of the nervous system
neuron
The ___________is the basic unit of the nervous system.
neuron
Dopamine
neurotransmitter associated with movement, attention and learning and the brain's pleasure and reward system.
A counselor best communicates a non judgmental attitude by ______________
non-verbal behavior
Treatment recovery continuum
nonuse, moderate and non problematic use, heavy and non problematic use, heavey use with moderal life, heavy use with seirous life prob, depen/addiction with life and health prob
Neurotransmitter associated with arousal and mood
norepinephrine
Moderate mgt
not intended for alcoholic, but prblem drinkers, abstinence is not primary goals but guidelines and limits for moderate drinking, promotes early self recognition of risky drinking behav
Before therapy or counseling begins, clients may be given information about the treatment they will receive, as will as possible risks involved. this process is called
obtaining informed consent for treatment.
Synergistic interactions
occur two or more drugs used same time, results are greater than the sum of the actions of the drugs used
Antagonistic interactions
occur when two or more drugs used same time, results are less than the sum of the acitons of the drug or they cancel the effects of each other
Axis II Cluster A
odd...eccentric...suspicious
Reframing
offers new perspective to situation
Client files should be readily accessible to?
only those persons directly involved in providing clinical services.
Probing
open ended questions help clarify and move to new understanding
The description of the Clients Rights typically occurs during the
orientation.
Level I Treatment
outpatient
Metabolic process that leads to the formation of water and carbon dioxide by process of chemically heating acetic acid
oxidation
LSD side effects
panic attacks, increased blood pressure, heart palpitations, tremors, nausea, muscle weakness, increased temp,
The primary factor in the development of young people's attitude toward drugs is
parental role models
Reorganization in spite of prob
partner takes charge redirecting main focus from user to maintain life
Rational Emotive
people born with both rational and irrational beliefs
Constructivism
people have system of constructs and symbols that reflect themselves in their world. Problem is discrepancy between people capacity and current demands of environment.
Cirrhosis
permanent, widespread destruction of liver cells, progress can slow with cessation
Axis II
personality disorder
MMPI
personality inventory...detects pathology
Which two basic categories have treatment approaches evolved?
pharmacological and behavioral modalities
paraphrasing
picking out emotions and repeating them back with added clarity...builds trust and reduces resistance
If an anti-ulcer medicine tends to increase blood alcohol levels and thus makes drinkers more intoxicated, this type of drug interaction would be best described as _____________.
potentiating
Benzodiazepines include the ability to_?
produce severe, even fatal, withdrawal.
Secular org for sobriety SOS
promotes one day at a time toward sobriety, non religious, sobriety being the priority in addict life
The focus of intervention in the criminal justice system is first to
protect the health, safety and welfare of the public.
Negative reinforcement
provides escape from neg feelings, also called tension reduction, self medication; avoiding unpleasant w/d symptoms
PCP
psychotic reactions, bizarre behavior, ourbursts of hostility and violence, impending death
Culturally sensitive case mgt
pt should be linked to services whose values are consistent with their own
" Release of Information" form must include client's name, address, date of birth and ________________.
purpose for release
Brief Therapy - action
putting plan into action, uses new behav, not yet stable
Relapse prevention
recovery and relapse are ongoing, not one event, should id individual triggers and plan to confront as they occur, should be part of pt aftercare
Dr. Sigmund Frued unsuccessfully used cocaine to
reduce the severity of withdrawal symptoms of morphine addicts.
Brief Therapy
reduces pt risk of harm from controlled substance use, specific goals for consumption pattern, key is to extract single behavior change process
simplifying
reflection, removes confusion, avoids convoluted explanations so they can solve problem in here and now
Reality therapy
rejects medical mode, emphasis on responsibility, no transference and encourages counselor to be himself
(SCM) Returning to older behaviors and abandoning the new changes
relapse
Gaba
relates to inhibitory factors and slows communication
concreteness
relates vague aspect to concrete terms...helps with coping skills
Case mgt with women
reluctant to seek treatment without encouragement, medical, mental health and family counseling see more women
Despite Vast personality differences, virtually all substance abusers experience
remorse, self-hatred and shame
Despite vast personality differences, virtually all substance abusers experience:
remorse, self-hatred and shame
Level 3
residential or inpatient
Reflection
restates content that produces emotions, counselor stays neutral
Relapse
returning to older behaviors and abandoning the new changes
The measurement of progress toward treatment goals id best assessed by
reviewing documentation in progress notes.
The intake process involves________________.
screening
The intake process is usually an extension of the
screening.
Secondary prevention
seeks to stop experimental, incorporates intervention, education, skills to avoid future use, instead of jail use treatment
Rational recovery
self help based on RET, self reliance, non-spiritual, AVRT addictive coice recognition technique
To assist them in handling termination issues, effective counselors use appropriate levels
self- disclosure
Heroin is an example of a ___________.
semi-synthetic narcotic
Hallucinations
sensory perception of reality occuring without external stimuli
Three stages of the process of stimulus and response
sensory reception, interconnection and motor response
Family reorganization
seperation occurs and family without user
Neurotransmitter associated with regulation of sensory perception, sleep and body temp and its alterations in functioning have been found to be related to mental illness and certain drug hallucinations
serotonin
A method of reinforcing therapeutic alliance & spirit of collaboration between the PT & counselor:
setting mutually-established goals
Major method of reinforcing the therapeutic alliance and spirit of collaboration between the client and the counselor
setting mutually-established goals
Depressants
slow CNS, decreases alertness and judgment, binds to GABA inhibitor receptors
Effects
slowed reaction time, altered perception, panic, anxiety, dizziness, increased respiration, heart rate and body temp, red eyes, mild dilation of pupils, tremors, decreased coordination, anxiety, probl with memory and possible hallucinations
Meth
smoke, immediate intense rush lasts few min
Cocaine
snorting - 20 to 30 min, remains brain 2/3 days, affects dopamine, norepinephrine and serotonin; blocks reuptake of dopamine increasing amt and prolonging the dopamine effect
Two subdivisions of the peripheral nervous system
somatic and autonomic systems
Schedule II
some medical use, restrictions of manufaucturing, prescriptions not refillable
Step 11
sought through prayer and meditation to improve our conscious contact with God
The metabolic effects of alcohol and other drugs alter the individual's chemistry because psychoactive drugs mimic, displace, block or deplete_________________.
specific chemical messengers between nerve cells in the brain
Abuse potential
speed of action and how long lasts/ and social factors
Physical dep
state of functional adaptation to drug in which presence of foreigh chemical becomes normal and absence of drug would present abnormal state
The nervous system is comprised of the specialized structures that control and coordinate all body activities through the process of _______________ and ____________.
stimulus; response
Sociocultural view of substance disorders
stressful socioeconomic conditions, cultural differences in drinking patterns can enhane or reduce risk; social pressure, attitudes and cultural norms all influence
LSD
structured like serotonin and binds to receptors
sub abuse disorder
substance abuse and dependence
Mood
sustained emotion that colors the perception of the world
When alcohol and barbiturates are taken together, what pharmacological affect are they likely to have?
synergistic
Hallucinogens work on the brain by interfering with various neurotransmitters, causing an overlap of the senses to occur.
synesthesia
You have assessed your client and determined that he is a problem drinker. He insists that the reason he drinks is because of his wife's behavior. You intial objective is to help him?
take responsibility for his behavior
Disengagement
takes place over time, discuss what has been learned in treatment
Intoxication
temporary change caused by significant amt of drug affecting emotional, cognitive or psychomotor functioning
Pointing out parallels between a client's interpersonal relationships and client/counselor interaction serves to focus awareness on
the "here and now".
The best indicator if an individual is physically dependent upon alcohol or another drug is
the presence of withdrawal symptoms
Barbiturates can be sub-classified into group by__________.
the speed of the onset and duration of the effects
NIDA- financed drug abuse reporting program found ( having to do with therapeutic communities)
therapeutic communities do reduce drug use relative to untreated clients or those who are simply detoxified and released
Social learning model
therp communities based on social learning model, goal is to learn to be different by participating in community that operates by different rules; commonly used for judicial treatment
Therapeutic communities differ from Synanon because
these communities try to return clients to society.
Brief Therapy
time limited, structured, directed at specific goal
The goal of AL-ANON is
to provide a fellowship and support for individuals in relationships with Alcoholics.
Stimulants
tolerance and dependence, snxiety, confusion, social w/d, weight loss, psychosis, potential death, ireversable prob with CNS
Structural famly therapy - Rigid boundaries
too much distance between family members, children fight for boundaries, negotiate for themselves without parental protection
Evaluate case mgt effectiveness
track through interviews, professionals, self report, arrests..
All of the following are benzodiazepines except: a)valium b)halcion c)trazodone d)xanax
trazodone
The medical view of addiction understands that addicted persons have a ________________.
treatable disease
The identification and ranking of problems needing resolution is
treatment planning.
Misuse
unintentional or inappropriate use of drug for what other than intended
EMT
urine tests, tests metabolites/drugs, heroin, marij, pcp, cocaine
TWEAK
use/abuse during pregnancy
Brief Therapy - Precontemplation
user not considering change, or acknowledge problem exists
Attempts to eliminate
users partner realizes usage not normal and pressures him to quit/cut back
Brief Therapy
uses motivation to change behavior, avoid getting ahead of pt, understands stages to help clinican
Constructivism
view people in positive optimistic terms, proactive, goal driven, operate according to the knowledge they posses
Step 6
we entirely ready to have God remove all defects of character, this step let go
Physical signs of alcohol dependence
weakened overall appearance, hyper pigmented, jaundice skin, ataxia, unstady gate
Additive Effect
when two or more drugs used same time result are equal to the sum of the actions of the drugs used
Behavioral tolerance
when, after peiro of time repeated drug use the user is able to modify their behav in hopes that others wont notice intoxication a form of diminishing effect that takes place because the user becomes accustomed to the effects of a given drug and how to act under its influence
Intervention - organizer
witnessed the addiction firsthand and aware of consequences
AUDIT
world health organization, over 8 suggests harmful consumption, looks at frequency
