Background Module 3 Flashcards
What is the main aim of CBT? (2)
- Help patients recognize problematic situations/triggers
- Learning to avoid the above/how to deal with their problematic behaviour in those situations
On which client abilties is CBT based? (2)
- Ability to change
- Commitment to stop/reduce problematic behaviour
How does CBT accomplish its aims? (4)
basically CBT methods
- Self-perception
- Improving self-insight
- Adjusting dysfunctionial cognitions
- Behavioural exercises
What is one of the main reasons that CBT is a useful therapy?
Its wide applicability + adaptability to the wishes and individual circumstances of clients
Which two approaches are used to treat addiction (within the framework of CBT), that have its roots in Pavlovian conditioning?
- Negative reinforcement of substance abuse (e.g., disulfiram)
- Positive reinforcement of desired behaviour (e.g., tokens, coins, etc.)
What is contingency management?
Positive reinforcement of desired behaviour, with direct, small rewards (for addiction)- this is based on a behavioural contract between the healthcare professional and the client
What is a problem with contingency management?
That it, despite empircal evidence of its effectiveness, is still not applied systematically in addiction treatment centers
lowkey a trick question on my end, but yaknow
Why is cue exposure not that effective in addiction treatment?
Because it relies on offering triggers in the absence of the opportunity to consume the substance; thus the pavlovian association should gradually weaken. However, research has shown that it is virtually impossible to erase associations once they are formed
What are the main traits of motivational interviewing? (3)
See: definition
- Collaborative, goal-oriented conversation style with special attention to change language
- Designed to enhance personal motivation and commitment
- Does this by eliciting and exploring a person’s reasons for change in an atmosphere of acceptance and compassion
What is specifically investigated in motivational interviewing?
Client’s ambivalence with regard to substance use and to encourage to change it
What is meant by “change talk” & “sustain talk”?
Respectively:
- Language focused on change (“I would like to quit”)
- Language focused on staticity (“I’ve tried, and I can’t quit”)
Incredibly difficult question, I know
What are two ways to encourage change talk?
Open questions & questions about the benefits of change/disadvantages of continuation
What is the final stage of motivational interviewing?
Therapist creates a plan of change with the patient
What is the most common mistake therapists make in motivational interviewing?
Wanting to move on to the planning stage too quickly- high willingness is considered necessary for a succesful treatment plan
For which substance abuse cases is motivational interviewing most useful?
Mild cases, althought it can be a valuable addition to CBT for more severe cases to enhance adherence
What are the four different ways in which pharmacotherapy can support CBT (just name them)
- Detoxification
- Aversive Drugs
- Anti-craving meds
- Preservation treatment
Detoxification? (3)
- (obvs) Stop using drugs
- Meds are used to reduce withdrawal symptoms (e.g., prevention of seizures/delirium)- benzodiazepines are used
- In opiod addiction, abuse is gradually reduced whilst being monitored (preservation treatment is common here)
Which replacements are specifically metioned to be used for opion addictions when giving preservation treatment?
Methadone or buprenorphine/naloxone (suboxone)
idk if you have to know this tbh
Aversive drugs?
Drugs (paired with substance) that result in aversive symptoms (e.g., nausea, headaches, etc.)
- Disulfiram is an example that is used for AUD
Anti-craving meds? (5)
- Naltrexone leads to the obstruction of the mu-opiod receptor (involved in the regulation of dopamine), reducing the rewarding effect of alcohol (and opiods) = less craving
- Some research has shown this to be relatively ineffective for chronic alcoholics
- Has been shown in some research to be effective for gambling
- Acamprosate is another type that has an inhibitory effect on the glutamatergic system and reduces craving for alcohol after abstinence
- Nalmefene similar to first, but first-acting (can be taken preventatively)
isn’t an alcoholic by default chronic?
Preservation treatment?
Prescribing meds that has the same chemical properties as the abused drug
- Especially for opiod addiction as it is increasingly seen as chronic & requiring ongoing attention/preservation treatment, sometimes for life
