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PSY 215 (Addictions) > Chap 9 (Methods for Treatment) > Flashcards

Chap 9 (Methods for Treatment) Flashcards

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1
Q

Screening:
Purpose

A

“Is there a problem”

Identify at-risk individuals &/or individuals who are experiencing problematic substance use

Basic screening questions must be asked in a universal (standardized) & non judgemental manner
It is important to also identify any barriers which may impede recovery

“Positive” screen 🡪 assessment

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2
Q

Basic screening questions must be asked in a ______________

A

universal (standardized) & non-judgemental manner

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3
Q

Diagnostic Process

A

DSM-5
Individuals diagnosed with severe/moderate SUD (DSM-5) 🡪 more intensive treatment

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4
Q

Assessment

A

Gathering more detailed information about the existing problem(s)

Collaboratively with the client, deciding on the next steps

Enhancing client motivation through motivational interviewing (if needed)

When client is ready to make a commitment of change (readiness ruler) 🡪 move towards actively planning for change

Higher scores on importance & confidence dimensions 🡪 client is ready to enter, participate in, & benefit from treatment

Motivation is a consistent predictor of client engagement & outcome

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5
Q

________ is a consistent predictor of client engagement & outcome

A

Motivation

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6
Q

Mutual Help Groups

A

A way to provide support from peer recovery networks

Focus on Reciprocal supports & active group engagement 🡪 promotes
abstinence/moderation in substance use

Provides the opportunity to develop personal & social resources

Goal 🡪 build substance-free social networks & lasting support structures to aid with long-term recovery

i.e., AA (Alcohol Anonymous) & NA (Narcotics anonymous) & CA (Cocaine anonymous)

Not formal therapies, but widely incorporated into treatment plans

The combination of formal treatment & mutual help groups 🡪 better outcomes

(Always most effective)

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7
Q

Alcoholics anonymous (AA)

A

12-step program

Helps patients recognize: 1) that alcoholism is a disease , 2) their addiction & 3) its destructive power over them

The addiction is viewed as more powerful than the individual 🡪 seeking help from a higher
power

Advantages:

Providing social support through group meetings

Meetings are attended anonymously

Free & Offered at flexible times

However, not ideal for all individuals:

Those experiencing co-occurring conditions (other substance-use or psych disorders) (May
benefit more from normal/formal treatments)

Those feeling intimidated or stigmatized by group interactions

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8
Q

Success of Alcoholics anonymous (AA) depends on

A

Client Fit

  • Explicitly religious vs spiritual vs secular groups
  • Specialized groups (i.e., for women, adolescents, LGBTQIA+ individuals)
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9
Q
  1. Alcoholics Anonymous (AA) Attendees are typically ____________
    2.
A

1.more committed to abstinence
2. but groups vary in how much abstinence is emphasized

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10
Q

AA (Alcohol Anonymous) & NA (Narcotics anonymous) & CA (Cocaine anonymous) are

A

Not formal therapies, but widely incorporated into treatment plans

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11
Q
  1. The combination of _______ & _________ leads to
  2. ________
A
  1. formal treatment & mutual help groups
  2. better outcomes** (Always most effective)**
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12
Q

Mutual Help Groups However, not ideal for all individuals:

A

Those experiencing co-occurring conditions (other substance-use or psych disorders) (May benefit more from normal/formal treatments)

Those feeling intimidated or stigmatized by group interactions

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13
Q
  1. Mutual help groups vary in how strongly ____ is emphasized
  2. i.e., ____ focus heavily on abstinence, while ____________ promote
    moderation as the final step or a step along the way to abstinence
A
  1. Abstinence
  2. AA & NA, moderation management programs
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14
Q

Harm reduction Primary goal:

A

minimize harm associated with substance use

abstinence may be the final goal

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15
Q

clients are taught to drink in moderation (as opposed to
complete abstinence)

A

Controlled Drinking Interventions

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16
Q

Controlled Drinking Interventions are highly ________

A

Controversial

  • Only a few continue to drink in moderation in the long-run
  • Vs similar effectiveness as total abstinence in the long-run
  • More research is needed
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17
Q

provide clean equipment to allow legal injection under medical
supervision

A

Safe Injection Sites (SSIs)

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18
Q

Goals of Safe Injection Sites

A

Reduce risks of overdose & infection

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19
Q

Opponents of Safe Injection Sites believe they

A

Encourage Drug Use

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20
Q

Proponents of Safe Injection Sites believe they

A
  • Offering safer, more hygienic place to inject with access to medical interventions
  • Benefit the community by reducing drug use in streets
  • Appropriate referrals may be made through sites
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21
Q

A safer drug that has a chemical makeup similar to the addictive drug is offered

A

Agonist substitution

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22
Q

Examples of Agonist substitutions are

A

Methadone treatments
Buprenorphine treatments
Nicotine Replacement therapys

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23
Q

Methadone is an

Study These Flashcards
A

An opioid agonist (given as a heroine substitute)

A synthetic narcotic that provides the same reduction of pain & sedative effects of heroine

24
Q

Aims of Methadone treatment

Study These Flashcards
A

Harm Reduction

Additional benefits: reduce risk of HIV infection & hepatitis

25
Methadone Treatments are most effective when ________
combined with counselling
26
Disadvantages of Methadone Treatment
Heroine & Methadone are cross-tolerant (act on the same neurotransmitter receptors), thus may result in dependence on methadone instead some individuals may become dependent on methadone (or other substances ie cocaine, etc) as a result 🡪 must help individuals to gradually stop using methadone in the final treatment phase
27
Heroine & Methadone are
cross-tolerant
28
When two substances are cross tolerant, this means they
act on the same neurotransmitter receptors - Tolerance / Addiction to one = other
29
A newer substitution treatment for heroine dependence
Buprenorphine treatment
30
Buprenorphine treatment May offer some advantages over Methadone such as
Less frequent dosing required Self-administration at home **Less risk of dependence **and thus more ideal if the client’s goal is to become completely drug-free (rather than maintaining on medication – i.e., Methadone)
31
Disadvantages of Bupernorphine treatment
However, the structured support & close monitoring of Methadone treatment may result in better results compared to high rates of drop out from Buprenorphine treatment
32
Nicotine Replacement therapy
Gums, patches or nasal sprays used in place of the nicotine in cigarettes Most effective when combined with **therapy &/or physical exercise** However, a proportion of people become **dependent on the replacements**
33
________ drugs 🡪 block/counteract the effect of drugs
Antagonist
34
(opioid-antagonist drug)
Naltrexone
35
Naltrexone
Is given to an individual who is dependent on opioids 🡪 it reduces the rewarding effects of opioid use - blocks the alcohol-induced feelings of pleasure by inhibiting dopamine release in the nucleus accumbens - Blocking the euphoric effect of alcohol helps individuals return to abstinence more quickly if they engage in drinking again
36
Naltrexone is effective if
Effective if individual is completely withdrawn from opioid before starting Naltrexone (must be opioid-free at least 3 Or More days) also Effective if used simultaneously with another treatment program
37
- use results in quickly developing unpleasant physical effects to punish drinking alcohol Effective in helping individuals achieve sustained abstinence, particularly for clients who are: - Older - More socially stable - Committed to taking the medication daily - Effective if consistently taken
Disulfiram
38
Agonist substitution & antagonist treatments and well as Pharmacotherapies /prescribed medications are known as
Medication-Assisted Treatment (MAT)
39
Pharmacotherapies or the use of prescribed medications should be combined with behavioural interventions to help clarify & set expectation of:
Benefits, side effects management & potential barriers to compliance with the medication protocol
40
Medication-Assisted Treatments (MAT) are
Are useful additions to other treatment approaches However, MAT & “minimal care” can still have substantial impact on individual’s functioning
41
chemical substances that increase the activity of a neurotransmitter by initiating its effects
Agonists
42
medications that block or counteract the effects of psychoactive drugs
Antagonist drugs
43
Help patients get through the initial withdrawal period, & then through supportive therapy return back to their communities Extremely effective Disadvantage 🡪 expensive & not more effective than outpatient treatments
Inpatient facilities
44
Extends therapeutic progress by teaching how to cope with future troubling situations Remove ambivalence about stopping drug use: Re-examine beliefs about the positive aspects of the drug Confront the negative consequences of using Identify high-risk situations & learn strategies to deal with them Relapse is viewed as a result of stress & can change
Relapse prevention
45
Helps clients modify their cognitive processes to develop & implement skills necessary for managing: 1. Life stressors (ie; avoiding/coping with high risk situations) 2. Cravings (ie; drink refusal skills) 3. Mental Health Problems (ie; managing negative moods / depression)
Cognitive Behavioural Therapy/Coping Skills Training (CBCST)
46
CBCST approaches must be ___________
client-centered & flexible as different clients need different skills
47
Common needs included in CBCST treatment are
Coping with urges & cravings, social skills, emotional regulation, behavioural self-control & general life skills related to housing & employment
48
CBCST __________ helps prevent relapse & enhance success in recovery
Skill building
49
Involving Significant Others in Treatment
The involvement of significant others in treatment 🡪 higher rates of retention, adherence abstinence & maintaining/maitenance after treatment Numerous approaches have been developed which work with significant others
50
A technique targeted towards significant others in developing skills related to motivation, communication, treatment entry & safety Builds significant other’s confidence to help their partners towards reduced substance use & entering treatment through positive reinforcement for sobriety Effective in getting initially unmotivated individuals into treatment & engaging them in care Significant others also benefit 🡪 increased happiness & reduced depression, anger & family conflict
CRAFT Community Reinforcement & Family Training
51
Engages significant others in treatment to improve the couple’s relationship & support behaviours that encourage sustained abstinence Primary components: Establishing goals related to supporting sobriety Improving the positivity of the relationship Strengthening communication skills Reducing conflicts & negative interactions Can be combined with psychosocial & medication-assisted services Successful in treating addictions with an overall better outcome compared to individual treatments , resulting in increased: Abstinence Adherence to medications Relationship functioning
Behavioural Couples Therapy (BCT)
52
Important for adolescents as family dynamic & home environment play a major role in supporting treatment engagement May use cognitive behavioural family therapy approach Focus on behaviour change related to improved 🡪 decision making, problem solving, communication skills & relationship building Results in reduced adolescent substance use & increased positive family relationships Effective cross-culturally & long-lasting (into adulthood) However, not all relationships are suited for couple or family-based approaches (ie; Relationship violence) Working with couples & families supports treatment & recovery & may be more effective than individual treatment in terms of: entry to care, engagement & long-term recovery success
Family-Involved Treatment
53
Motivational Enhancement Therapy
Helps individuals increase motivation to change
54
1. Which treatment is most effective is treating SUDs? 2. Which individuals would not benefit from certain treatment approaches?
GENERALLY, CBCST (formal structured, CBT based) combined with other approaches IS THE BEST FOR SUDS (AT LEAST ONE OF THE APPROACHES)
55
Case management _________ behavioural treatment to address such issues which may interfere with recovery
complements (not a replacement!)
56
Case Management
Failure to address unemployment/financial/other problems may place individuals with SUDs at increased risk for continuing substance misuse Case management complements (not a replacement!) behavioural treatment to address such issues which may interfere with recovery Establishing a strong case manager-client working relationship is the first (& key) step The case manager & client clarify needed services & assess client’s levels of commitment towards seeking & participating in services A service request form is useful in assessing the need for specific services & determining which problems need to be addressed first May enable individuals to assume ownership of goals , increase readiness for steps necessary to facilitate change & develop a high-quality change plan
57
NIDA’s Principles of Effective Treatment
1. No single treatment is appropriate for all individuals 2. Treatment needs to be readily available 3. Effective treatment attends to multiple needs of the individual, not just their drug use 4. An individual’s treatment & services plan must be assessed continually & modified as necessary ensure that the plan meets the person’s changing needs 5. Remaining in treatment for an adequate period of time is critical for treatment effectiveness (i.e., three months / longer) 6. Counselling (individual &/or group) & other behavioural therapies are critical components of effective treatment for addiction 7. Medications are an important element of treatment for many clients, especially when combined with counselling &/or behavioural therapies 8. Addicted or drug-misusing individuals with coexisting mental disorders should have both disorders treated in an integrated way 9. Medical detoxificaiton is only the first stage of addiction treatment & by itself does little to change long-term drug use 10. Treatment does not need to be voluntary to be effective 11. Possible drug use during treatment must be monitored continuously 12. treatment programs should provide assessment for HIV/AIDS, Hepatitis B and C, tuberculosis & other infectious diseases, & counseling to help patients modify or change behaviours that place themselves or others at risk of infection 13. Recovery from drug addiction can be a long-term process & frequently requires multiple episodes of treatment

PSY 215 (Addictions) (9 decks)

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