Addictions Exam: Textbook Readings Flashcards
seven dimension of addiction:
- substance use
- problems
- physical adaptation
- behavioral dependence
- cognitive impairment
- medical harm
- motivation for change
A first dimension to consider is the extent and pattern of the person’s use of psychoactive substances. This is most often described in terms of _____, ____, and _____.
quantity, frequency, and variability
Psychoactive drugs can also have _____ or ______ effects on cognitive functioning, adaptive abilities, and intelligence.
acute or chronic
Routes of adminstration fall into four major categories, all of which begin with “in”: (1) ______ (2)______, (3) ______, and (4) _______.
ingestion, inhalation, intranasal, and injection
pharmokinetics
the more or less predictable way a drug moves through and is eliminated by the body
Once a drug enters the bloodstream it is circulated throughout the body within about _____
a minute
A ________of drugs is the ratio of a lethal dose (LD-50, or the dose level that is lethal for 50% of humans) to the usual effective dose (ED) that produces desired effects in 50% of people (ED-50). The greater the ratio of LD-50 to ED-50, the wider the margin of safety. This same ratio is also called the __________
safety index, therapeutic window
six myths about AA:
- it is a disease model only view of addiction
- medication is discouraged
- it’s only for religious people
- believes only people who have been through addiction can help those with an addiction
- its always good to push clients to go to AA, even if they are against it.
- AA is not based in science
Studies have found that AA attendance per se did not predict posttreatment abstinence, whereas AA ______ did.
involvement
four recommendations for facilitating mutual self-help group attendance:
- encourage clients to begin attending while in individual treatment and not just at the end of treatment
- encourage clients to sample different groups to find the right one.
- use the three-strike approach to encourage clients to attend
- get clients directly in touch with group sponsors over the phone in session
5 AA secular alternatives
- women for sobriety
- self-management and recovery training (SMART)
- secular organizations for sobriety (SOS)
- moderation management
- life-ring secular recovery
hypotheses regarding co-occurring conditions:
- self medication
- common genetic vulnerability
- neurocognitive factors
- developmental factors
- environmental factors
The idea behind the ________ model of co-occurring conditions is that those who differ in the severity of their addiction and psychiatric disorders have different treatment needs and may require different treatment settings.
quadrant
The ______ criteria include five different contexts for withdrawal management.
ASAM
five contexts of ASAM withdrawal management (WM) criteria:
level 1, 2, 3.2, 3.7, & 4
• Level _____: Ambulatory withdrawal management with _________.
2, extended on-site monitoring
• Level _______: Clinically managed _______ withdrawal management.
3.2, residential
• Level ____ : Medically ______ inpatient withdrawal management.
3.7, monitored
• Level 3.7: Medically _______ inpatient withdrawal management.
3.7, monitored
• Level 4: Medically ________ inpatient withdrawal management.
4, managed
six clinical dimensions of ASAM standards
- acute intoxication or withdrawal potential
- biomedical conditions/complications
- emotional/behavioral/cognitive complications
- readiness to change
- relapse potential
- recovery/living environment
CIWA-Ar
clinical institute withdrawal assessment for alcohol scale- revised
There are two broad models for stabilization in withdrawal management: a _____ model and a ______model.
social, medical
There are various stage models of treatment for addiction, and we think in terms of four phases: _____, _____, _____, and _____.
palliative care, stabilization, rehabilitation, and maintenance
In project MATCH, as predicted, more ____ clients fared best with motivational enhancement therapy.
angry
In project MATCH, clients whose social networks supported continued _____ rather than _______ fared best in the long run with twelve-step facilitated treatment
drinking, abstinence
In project Match, clients with less concomitant _______ fared better in TSF than in CBT.
psychopathology
In sum, scientific evidence for the validity of ASAM’s placement criteria is _______ thus far.
weak
The logic of stepped care is to offer the least _______and ________ level of care that is likely to help.
intensive, intrusive
Kaslow and colleagues (2011) discuss several principles of systems theory that are integral to family therapy. Four of these principles are:
wholeness, anamorphosis, homeostasis, and circular causality
As a principle of systems theory, _______ means that families are organized wholes with interdependent components, and that the whole is greater than the sum of its parts.
wholeness
_________ is an evolutionary concept referring to the complex changes that occur in the family unit’s composition and function over time
Anamorphosis
_________ is a regulatory function that seeks equilibrium or stability in patterns of family member interactions, patterns that often are not amenable or responsive to change.
Homeostasis
The principle that patterns of interaction are bidirectional, reciprocal, and circular, rather than linear, is referred to as ________ causality.
circular
McCrady, Ladd, and Hallgren (2012) identify three models that dominate contemporary family addiction treatment: ________, _________, and __________.
family disease models, family systems models, and behavioral models.
In the family disease model of addiction, ___________ is considered an unhealthy relationship pattern, whereas ________ is a common behavior arising from it.
codependency, enabling
From their systematic analysis of the literature on codependency, Dear, Roberts, and Lange (2005) identified four key features of it: excessive external ______, self-_____ behavior, difficulty experiencing ________, and _______ behavior
focus, -sacrificing, emotions, controlling
Calderwood and Rajesparam (2014) encourage practitioners to use the phrase “people in a relationship with someone with an addiction” rather than the term codependent, and Van Wormer and Davis (2013) recommend the terms ______ or _________. These references are consistent with Miller and colleagues’ (2011) stress-coping hypothesis and the stress– strain– coping– support model
survivor, caring family member
Black (1982) proposed three roles that children of an alcoholic parent adopt: the very ______ child (often the oldest or only child); the ______ (follows directions, adapts to circumstances of the day); and the ______ (the family comforter, tries to make others in the home feel better, feels responsible for the pain of others).
responsible, adjuster, placater
Wegscheider-Cruse (1989) later developed five family roles:
the enabler, hero, scapegoat, lost child, and mascot.
From a family systems perspective, the chemically dependent member is not diseased; he or she is playing a _____
role
The second role is the ______ or simply the ______. Van Wormer and Davis (2013) use the less pejorative term, family manager
chief enabler, enabler
The role of the _________ is usually adopted by the oldest child. References to this role include the parental child, the superstar, and the goody two shoes
family hero
The _________ role often is adopted by the second oldest child. The scapegoat can be viewed as the reverse image of family hero (Wegscheider-Cruse, 1989). This child does very little right and is quite rebellious.
scapegoat
The_______ may be a middle child but may also be the youngest. The chief characteristic of this child is his or her objective to avoid conflict at all costs. These children maintain balance in the family by simply disappearing;
lost child
The last commonly described role is the _____ or the family clown
mascot
Two rules often found in families where problematic alcohol use is present are that (1) ______ can only be expressed when the alcoholic is drinking and (2) _____ and ______ can only be expressed when one or both partners has been drinking
anger, affection, intimacy
In the behavioral model, behaviors of family members serve a purpose, whether or not they are aware of it; there is a payoff to __________, not just to an individual.
the family system
There are quite a few family therapy models, several of which Kaslow and colleagues (2011) have reviewed. Among them are __________ and __________ family models that emphasize past rather than present interactions and intrapsychic more so than interpersonal dimensions.
psychodynamically informed and intergenerational-contextual family models
________ and ___________ family models define dysfunctional systems as those that have prevented members from fulfilling their personal growth.
Experiential and humanistic
The _______ family model considers the metacommunication strategies, symbolic communication patterns, or rituals used among members, and how these covert, nonverbal messages (e.g., shoulder shrugs, isolating behavior) exaggerate or change the meaning of verbal communication.
strategic
In the _______ family model, the focus is on the organizational structure of relationships and the source, function, and manifestation of power in the family unit. Concepts such as boundaries, hierarchy, alignment (e.g., who spends time with whom), and coalitions are integral to this model.
structural
The focus of _________ is on inappropriate family alliances, excessively rigid or permeable boundaries between family members, and the identification of individual family members (often the adolescent) as the source of familial dysfunction. What is referred to as the principle of _________ assumes that for every action by a family member, there is a corresponding reaction from the rest of the family
brief strategic family therapy, complementarity
Strategies used in brief strategic family therapy are categorized as
joining, tracking and diagnostic enactment, and restructuring
________ is described as “an integrative ecological model that combines a family systems view of family functioning with behavioral techniques and a multi-systemic emphasis”
Functional family therapy
The rates of successful engagement of adolescents in _________ are reported to be between 78 and 89%, considerably higher than engagement rates for other treatments that service youth
Functional family therapy
Three of the primary functions of relationships and their corresponding payoffs in functional family therapy are (1) ______ (to increase closeness and contact), (2) ______ (to increase distance and independence), and (3) _______.
merging, separating, midpointing
The social ecological theory proposes that human development and behavior can be fully understood only from the perspective of the natural settings in which human development and behavior occur. This is known as ___________
ecological validity
Henggeler (2011) listed five key components of ______ that help explain its effectiveness: (1) providing treatment services in the home, at school, and in other community locations; (2) scheduling appointments at the family’s convenience, including evening and weekend hours; (3) offering 24-hour per-day, 7-day-per-week availability of therapists to address crises that might interfere with the success of treatment; (4) maintaining caseloads of four to six families per therapist on an MST team so that intensive services can be modified to accommodate family needs; and (5) including two to four full-time therapists on each MST team so that there is continuity of treatment
multisystemic therapy
