13. Specialist Interventions Flashcards

Question

what are examples of nicotine replacements?

Answer 1

Patches Once-daily application, socially acceptable, easy to use, steady and reliable dose Gum Best for smokers heavily dependant on Nicotine Poor compliance Inhalers Plastic tube with inhalable nicotine All are more effective with counselling

Answer 2

Random or intermittent urine drug screening to identify drug used recently Timing varies between drugs – depends on pharmacokinetics May aid in relapse prevention Best if voluntary decision by person Helps to demonstrate adherence? False positives/negatives Danger in shifting to less easily detectable drugs, masking agents etc… Focus can become on ‘beating’ the screen rather than treatment goals

Answer 3

If abstinence not a goal – harm minimisation approach Requires high motivation Difficult for long-standing addiction Environmental factors often key to success - Strong social supports required

Answer 4

Self-monitoring Develop limits and rules around consumption Devise strategies for high risk situations Use rewards to maintain changes to behaviour

Answer 5

``` Plan drinking Consume drinks with less alcohol Avoid cocktails and punches Start with non-alcoholic drink Every second drink non-alcoholic ```

Answer 6

Non-drug using social support – usually run by peers in recovery Widely available Easy to set up and run – no/low cost 12 Step programs most common

Answer 7

Strong ‘spiritual’ based philosophy Require abstinence as a goal peer facilitated treatment

Answer 8

Step 1 - We admitted we were powerless over our addiction - that our lives had become unmanageable Step 2 - Came to believe that a Power greater than ourselves could restore us to sanity Step 3 - Made a decision to turn our will and our lives over to the care of God as we understood God Step 4 - Made a searching and fearless moral inventory of ourselves Step 5 - Admitted to God, to ourselves and to another human being the exact nature of our wrongs Step 6 - Were entirely ready to have God remove all these defects of character Step 7 - Humbly asked God to remove our shortcomings Step 8 - Made a list of all persons we had harmed, and became willing to make amends to them all Step 9 - Made direct amends to such people wherever possible, except when to do so would injure them or others Step 10 - Continued to take personal inventory and when we were wrong promptly admitted it Step 11 - Sought through prayer and meditation to improve our conscious contact with God as we understood God, praying only for knowledge of God's will for us and the power to carry that out Step 12 - Having had a spiritual awakening as the result of these steps, we tried to carry this message to other addicts, and to practice these principles in all our affairs

Answer 9

1-5 sessions with follow-up and self-help material Very focussed interventions - e.g. decision making, problem solving, goal setting, relapse prevention Useful for pre-contemplators, less severe/complicated Substance Use Disorder, and primary care settings Results often as good or better than longer therapy in these contexts

Answer 10

Deficient social skills - | Leads to poor adjustment and dysfunction and thus use Substance abuse as a coping strategy

Answer 11

training in areas of deficiency - teaching new social skills group therapy can be a good setting for this

Answer 12

Assertiveness training, anger management, relaxation training, modelling, role playing etc…

Answer 13

May be a longer-term intervention Focus on dysfunctional cognitions Behaviours that maintain alcohol and other drug use Skills training In addition to treatments for any mental health comorbidities

Answer 14

Change to social groups, cued associations, “seemingly irrelevant decisions”

Answer 15

Generates and disseminates drug-related resources to the community Prevention and intervention strategies Can raise awareness of drug issues Useful if linked to the development of more comprehensive strategies for the community

Answer 16

Recognises role of social disadvantage in substance abuse problems If successful, are strong protective factors against drug misuse Opportunities to develop skills and social networks outside the drug using lifestyle Can improve self-worth and self-esteem Introduces alternatives and healthy lifestyle

Answer 17

``` Focus on treating the ‘family’ Better treatment outcomes Family members need to agree to be involved Confidentiality issues Multiple needs need to be managed ```

Answer 18

Can improve compliance with treatment and earlier engagement | Can alleviate distress for significant others

Answer 19

``` Single point of contact with health and social services Client driven Advocacy Community based Flexible and culturally sensitive Link clients with appropriate services Monitor clients’ progress in treatment ```

Answer 20

Medium to long-term residential programs Public & Private options - Private usually shorter stay – a few weeks, Public – a few months Generally require abstinence as a goal Facilitate access to medical services, education, employment, skills training, and community supports Usually promote participation in daily running of program – ‘Therapeutic Community’ Tend to be group therapy based Staged reintegration programs - Half-way and 3/4 (less structured) houses

Answer 21

No two people are the same Different problems require different types or combinations of interventions at different levels - Although there are specific interventions that may work best for specific populations Job of clinician/case manager is to work out which option is best for the client, in collaboration with the client

Answer 22

combinations of treatment and intervention options. i.e. drug intervention, indivudal intervention and environment interventions drug - maintenance therapy individual - CBT Environment - family therapy

Answer 23

Goal is to place client into least intensive treatment that will most likely facilitate treatment goals