Addictions Exam: Textbook Readings

Question 1

seven dimension of addiction:

Answer 1

• substance use
• problems
• physical adaptation
• behavioral dependence
• cognitive impairment
• medical harm
• motivation for change

Question 2

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 _____.

Answer 2

quantity, frequency, and variability

Question 3

Psychoactive drugs can also have _____ or ______ effects on cognitive functioning, adaptive abilities, and intelligence.

Answer 3

acute or chronic

Question 4

Routes of adminstration fall into four major categories, all of which begin with “in”: (1) ______ (2)______, (3) ______, and (4) _______.

Answer 4

ingestion, inhalation, intranasal, and injection

Question 5

pharmokinetics

Answer 5

the more or less predictable way a drug moves through and is eliminated by the body

Question 6

Once a drug enters the bloodstream it is circulated throughout the body within about _____

Answer 6

a minute

Question 7

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 __________

Answer 7

safety index, therapeutic window

Question 8

six myths about AA:

Answer 8

1. it is a disease model only view of addiction
2. medication is discouraged
3. it’s only for religious people
4. believes only people who have been through addiction can help those with an addiction
5. its always good to push clients to go to AA, even if they are against it.
6. AA is not based in science

Question 9

Studies have found that AA attendance per se did not predict posttreatment abstinence, whereas AA ______ did.

Answer 9

involvement

Question 10

four recommendations for facilitating mutual self-help group attendance:

Answer 10

1. encourage clients to begin attending while in individual treatment and not just at the end of treatment
2. encourage clients to sample different groups to find the right one.
3. use the three-strike approach to encourage clients to attend
4. get clients directly in touch with group sponsors over the phone in session

Question 11

5 AA secular alternatives

Answer 11

• women for sobriety
• self-management and recovery training (SMART)
• secular organizations for sobriety (SOS)
• moderation management
• life-ring secular recovery

Question 12

hypotheses regarding co-occurring conditions:

Answer 12

• self medication
• common genetic vulnerability
• neurocognitive factors
• developmental factors
• environmental factors

Question 13

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.

Answer 13

quadrant

Question 14

The ______ criteria include five different contexts for withdrawal management.

Answer 14

ASAM

Question 15

five contexts of ASAM withdrawal management (WM) criteria:

Answer 15

level 1, 2, 3.2, 3.7, & 4

Question 16

• Level _____: Ambulatory withdrawal management with _________.

Answer 16

2, extended on-site monitoring

Question 17

• Level _______: Clinically managed _______ withdrawal management.

Answer 17

3.2, residential

Question 18

• Level ____ : Medically ______ inpatient withdrawal management.

Answer 18

3.7, monitored

Question 19

• Level 3.7: Medically _______ inpatient withdrawal management.

Answer 19

3.7, monitored

Question 20

• Level 4: Medically ________ inpatient withdrawal management.

Answer 20

4, managed

Question 21

six clinical dimensions of ASAM standards

Answer 21

1. acute intoxication or withdrawal potential
2. biomedical conditions/complications
3. emotional/behavioral/cognitive complications
4. readiness to change
5. relapse potential
6. recovery/living environment

Question 22

CIWA-Ar

Answer 22

clinical institute withdrawal assessment for alcohol scale- revised

Question 23

There are two broad models for stabilization in withdrawal management: a _____ model and a ______model.

Answer 23

social, medical

Question 24

There are various stage models of treatment for addiction, and we think in terms of four phases: _____, _____, _____, and _____.

Answer 24

palliative care, stabilization, rehabilitation, and maintenance

Question 25

In project MATCH, as predicted, more ____ clients fared best with motivational enhancement therapy.

Answer 25

angry

Question 26

In project MATCH, clients whose social networks supported continued _____ rather than _______ fared best in the long run with twelve-step facilitated treatment

Answer 26

drinking, abstinence

Question 27

In project Match, clients with less concomitant _______ fared better in TSF than in CBT.

Answer 27

psychopathology

Question 28

In sum, scientific evidence for the validity of ASAM’s placement criteria is _______ thus far.

Answer 28

weak

Question 29

The logic of stepped care is to offer the least _______and ________ level of care that is likely to help.

Answer 29

intensive, intrusive

Question 30

Kaslow and colleagues (2011) discuss several principles of systems theory that are integral to family therapy. Four of these principles are:

Answer 30

wholeness, anamorphosis, homeostasis, and circular causality

Question 31

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.

Answer 31

wholeness

Question 32

_________ is an evolutionary concept referring to the complex changes that occur in the family unit’s composition and function over time

Answer 32

Anamorphosis

Question 33

_________ 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.

Answer 33

Homeostasis

Question 34

The principle that patterns of interaction are bidirectional, reciprocal, and circular, rather than linear, is referred to as ________ causality.

Answer 34

circular

Question 35

McCrady, Ladd, and Hallgren (2012) identify three models that dominate contemporary family addiction treatment: ________, _________, and __________.

Answer 35

family disease models, family systems models, and behavioral models.

Question 36

In the family disease model of addiction, ___________ is considered an unhealthy relationship pattern, whereas ________ is a common behavior arising from it.

Answer 36

codependency, enabling

Question 37

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

Answer 37

focus, -sacrificing, emotions, controlling

Question 38

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

Answer 38

survivor, caring family member

Question 39

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).

Answer 39

responsible, adjuster, placater

Question 40

Wegscheider-Cruse (1989) later developed five family roles:

Answer 40

the enabler, hero, scapegoat, lost child, and mascot.

Question 41

From a family systems perspective, the chemically dependent member is not diseased; he or she is playing a _____

Answer 41

role

Question 42

The second role is the ______ or simply the ______. Van Wormer and Davis (2013) use the less pejorative term, family manager

Answer 42

chief enabler, enabler

Question 43

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

Answer 43

family hero

Question 44

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.

Answer 44

scapegoat

Question 45

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;

Answer 45

lost child

Question 46

The last commonly described role is the _____ or the family clown

Answer 46

mascot

Question 47

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

Answer 47

anger, affection, intimacy

Question 48

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.

Answer 48

the family system

Question 49

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.

Answer 49

psychodynamically informed and intergenerational-contextual family models

Question 50

________ and ___________ family models define dysfunctional systems as those that have prevented members from fulfilling their personal growth.

Answer 50

Experiential and humanistic

Question 51

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.

Answer 51

strategic

Question 52

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.

Answer 52

structural

Question 53

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

Answer 53

brief strategic family therapy, complementarity

Question 54

Strategies used in brief strategic family therapy are categorized as

Answer 54

joining, tracking and diagnostic enactment, and restructuring

Question 55

________ is described as “an integrative ecological model that combines a family systems view of family functioning with behavioral techniques and a multi-systemic emphasis”

Answer 55

Functional family therapy

Question 56

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

Answer 56

Functional family therapy

Question 57

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) _______.

Answer 57

merging, separating, midpointing

Question 58

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 ___________

Answer 58

ecological validity

Question 59

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

Answer 59

multisystemic therapy