Download ADC or LCDC TX Exam Comprehensive Study Guide 2024: Substance Abuse and Dependence and more Exams Career Counseling in PDF only on Docsity!
ADC or LCDC TX Exam Comprehensive
Study Guide 2024
A method of reinforcing therapeutic alliance & spirit of collaboration between the PT & counselor: - ✔✔setting mutually-established goals A mental status exam includes: - ✔✔ Appearance Speech Thought Process The provision of info concerning alcohol/drug abuse & the available srvcs & resources: - ✔✔client education When should significant others should be involved in the treatment process? - ✔✔From the clients first contact with the treatment center 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. 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. A cognitive-based therapy, developed by Ellis, designed to confront a PT's irrational thinking - ✔✔Rational-Emotive Therapy A "release of information" must include: name, address, DOB & _____? - ✔✔The purpose of the release of information When a client discloses suicidal thougths, the counselor's first step is to: - ✔✔Assess the degree of risk
When conducting an assessment what is the counselor's primary focus? - ✔✔Identifying the clients problems and needs, strengths and weaknessess. The BEST indicator if an individual is physically dependent upon alcohol or another drug is: - ✔✔The presence of withdrawal symptoms. Guilt and ___ are painful emotions that are part of grieving. - ✔✔Anger Despite vast personality differences, virtually all substance abusers experience: - ✔✔remorse, self-hatred and shame 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 Self report screening instrument consists of 4 Y/N questions. Requires aprox 1 min to complete - ✔✔CAGE questionnaire Drug Offender Profile Evaluation/Refferal Strategies - ✔✔D.O.P.E.R.S. Michigan Alcoholism Screening Test - ✔✔MAST Self Administered Alcoholism Screening Test - ✔✔SAAST Short Michigan Alcoholism Screening Test - ✔✔SMAST Substance Abuse Subtle Screening Inventory - Adult or Adolescent Version - ✔✔SASSI Addiction Severity Index - ✔✔ASI
(SCM) Getting ready to change - ✔✔Preparation (SCM) Changing behavior - ✔✔Action SCM) Maintaining the behavior change - ✔✔Maintenance (SCM) Returning to older behaviors and abandoning the new changes - ✔✔relapse The Stages of Change Model was originally developed in the late 1970's and early 1980's by... - ✔✔James Prochaska, Carlo DiClemente Bio-psychosocial perspective - ✔✔This recognizes that there are biological, psychological and social causes of substance abuse and dependence. 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. 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. Assessment Instruments - ✔✔These aid in the identification of, and treatment planning for substance related disorders.
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. Screening Instrument - ✔✔This distinguishes individuals who do not have a disorder from those who might have one. - ✔✔ CAGE - ✔✔4 questions - Yes to 1 indicates possibility of alcohol dependence. Cut down? Annoyed by criticism of drinking behavior? Guilty about drinking? Eye-opener? DAST - ✔✔Drug Abuse Screening Test (adapted from MAST) used to detect abuse or dependence on drugs other than alcohol. MAST - ✔✔Michigan Alcoholism Screening Test - yes or no to 25 questions. 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. 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. SASSI-A2 - ✔✔Substance Abuse Subtle Screening Inventory for Adolescents ages 12 to 18. 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.
The Strong Interest Inventory - ✔✔A vocational interest scale that compares clients' interests to those of people who are happy in different occupations. MMPI- 2 - ✔✔The Minnesorta Multiphasic Personality Inventory contaings several clinical scales that detect pathology including the MacAndrew Alcoholism Scale. 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. 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. 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. Biomarkers - ✔✔Measuring these physiological markers at intervals throughout treatment may provide early identification of relapse. EMIT - ✔✔Enzyme Multiplied Immunoassay Test - this urine testing kit uses antibodies that react to the presence of a drug or its metabolites. GGT - ✔✔Gamma-glutamyltransferase - indicates prolonged, rather than episodic drinking. ASAT - ✔✔Aspartate aminotransferase - screens for heavy drinking. ALAT - ✔✔Alanine aminotransferase - screens for heavy drinking.
CDT - ✔✔Carbohydrate Deficient Transferrin - sensitive enough to pick up moderate drinking over a peoiod of a few weeks. 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. FTQ - ✔✔Family Tree Questionnaire helps clients report information about the incidence of alcohol problems in their blood relatives. Genogram - ✔✔A pictorial representation of family structure, using a least three generations and a standard set of symbols. DSM-IV-TR - ✔✔Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (APA, 2000). Axis I - ✔✔Contains 16 categories of clinical disorders, one of which is Substance Related Disorders. 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. Substance Use Disorders - ✔✔This sub-category of Substance Related Disorders includes both Substance Abuse and Substance Dependence. 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. Axis II - ✔✔This axis of the DSM IV- TR includes the personality disorders as well as mental retardation.
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. Physiological Dependence - ✔✔Indicated by whether tolerance and withdrawal are present. 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. 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. 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. 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. Affect - ✔✔The external expression of an internal emotional state. Mood - ✔✔A sustained emotion. Changes less frequently than affect.
Delusions - ✔✔False beliefs that are maintained despite proof against their truth. Hallucinations - ✔✔Perceiving something in the absence of a sensory input. May be auditory, visual, olfactory, gustatory or tactile. Illusions - ✔✔Misperceptions of actual sensory input. 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. 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." 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". 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. AUDIT - ✔✔world health organization, over 8 suggests harmful consumption, looks at frequency - ✔✔ DAST - ✔✔drug dependence other than alc...lifetime severity
Axis II - ✔✔personality disorder Axis II Cluster A - ✔✔odd...eccentric...suspicious Axis II Cluster B - ✔✔dramatic...emotional..impulsive...lack empathy Axis III Cluster C - ✔✔Fearful...anxious...perfectionist Axis III - ✔✔medical 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 - ✔✔ Mood - ✔✔sustained emotion that colors the perception of the world Dellusions - ✔✔continued belief of something even when proof against it....false belief based on faulty external reality Hallucinations - ✔✔sensory perception of reality occuring without external stimuli Illusions - ✔✔misperception about a real external stimuli...rustling leafs... Assesment - ✔✔gathering info about pt in order to make informed diagnostic impression
Empathy - ✔✔ability to perceive pt emotions and see their world thru their eyes concreteness - ✔✔relates vague aspect to concrete terms...helps with coping skills paraphrasing - ✔✔picking out emotions and repeating them back with added clarity...builds trust and reduces resistance Reflection - ✔✔restates content that produces emotions, counselor stays neutral simplifying - ✔✔reflection, removes confusion, avoids convoluted explanations so they can solve problem in here and now Probing - ✔✔open ended questions help clarify and move to new understanding Reframing - ✔✔offers new perspective to situation exploring alternatives - ✔✔examine various options to pt Person Centered Theory - ✔✔Carl Rogers Person Centered - ✔✔Here and now...people are resourceful and capable of solving own problems and are trustworthy Person Centered - ✔✔3 characteristics; unconditional positve regard, genuiness and accurate empathy Person Centered - ✔✔in addictions counseling; builds rapport and T.R to help pt recover Reality Therapy - ✔✔William Glasser
Cognitive behavior - ✔✔Aaron Beck Cognitive behavior - ✔✔focus on here and now, pt with emotional probls have faulty thinking or incorrect info Cognitive behavior - ✔✔cognitive distortions - over generalization, minimization, personalizing events, polarized thinking Cognitive behavior - Techniques - ✔✔challenge faulty thoughts, ask where did evidence come from, instill hope, Socratic Brief Therapy - ✔✔time limited, structured, directed at specific goal Brief Therapy - ✔✔uses motivation to change behavior, avoid getting ahead of pt, understands stages to help clinican Brief Therapy - ✔✔reduces pt risk of harm from controlled substance use, specific goals for consumption pattern, key is to extract single behavior change process Brief Therapy - ✔✔Five Stages Brief Therapy - Precontemplation - ✔✔user not considering change, or acknowledge problem exists Brief Therapy - contemplation - ✔✔acknowledges problem, ambivalent about change Brief Therapy - determination - ✔✔begins once user decides to change - plan of action Brief Therapy - action - ✔✔putting plan into action, uses new behav, not yet stable
Brief Therapy - maintenance - ✔✔establishes new behav on long term basis Constructivism - ✔✔George Kelly 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. Constructivism - ✔✔focus current problem,then patterns...attention given to background and early attachment Constructivism - ✔✔view people in positive optimistic terms, proactive, goal driven, operate according to the knowledge they posses 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. Feminist therapy - ✔✔Helen Deutsch and Karen Horney Feminist therapy - ✔✔Give women view of social position and sense of community with new power, possibilities and overriding binding stigmas 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 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
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 Components - ✔✔members contribute, observe peers, model behavir, shared norms and values, structure, and relationships Case Mgt - Assessment - ✔✔identify pt strength, weakness and needs Case Mgt - Planning - ✔✔negotiate what pt wants, develop plan for achieving it Case Mgt - linking system - ✔✔help pt obtain required services by referring to services for formal/informal care Case Mgt - advocacy - ✔✔intercede on behalf of pt to obtain needed resources Case Mgt - monitoring - ✔✔evaluate progress continuously and take action if needed Case Mgt - Brokerage- - ✔✔id pt needs help access resources, no advocacy but when pt needs access to resources Case Mgt - Assertive community - ✔✔frequent long term contact with pt in natural setting, focus on practical problems of daily living 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 Level I Treatment - ✔✔outpatient Level 2 treatment - ✔✔intensive outpatient/partical hospitalization
Level 3 - ✔✔residential or inpatient Level 4 - ✔✔medically managed intensive inpatient Aftercare - ✔✔called continuing care, follows discharge, case mgr helps transition, and take responsibility for their lives Disengagement - ✔✔takes place over time, discuss what has been learned in treatment Community resources - ✔✔coordination variety of resources, counselor should be familiar with resources Advocacy coordination in case mgt - ✔✔involves coordinating with family, community agencies, legal system and legislative bodies Culturally sensitive case mgt - ✔✔pt should be linked to services whose values are consistent with their own Case mgt with women - ✔✔reluctant to seek treatment without encouragement, medical, mental health and family counseling see more women case mgt with adolescents - ✔✔encouraging family involvement, provide support, track relapse episodes, connect with school, work and community resources Evaluate case mgt effectiveness - ✔✔track through interviews, professionals, self report, arrests.. 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
