Chapt 22-Substance abuse Flashcards
What gender is more likely to have an alcohol and illicit drug use disorder- can cooccur with mood, anxiety, and personality disorder?
Men
Alcohol abuse is the leading cause of death between what age range?
16-24 year olds
Alcohol is highly correlated with what?
murder, suicide, and accidental death rates
What is the most abused illicit drug?
marijuana
how many Americans have an alcohol drinking problem>
13 million
How is alcoholism understood to be caused by?
biopsychosocial
theory that states that addiction to be biologically based illness
-chronic and progressive
-addiction is most often characterized by denial and loss of control
-tx follows a medical model-hospitalization, medication, and education
what model?
disease model
type of model that states addiction to be a maladaptive response to underlying psychopathology
traditional psychiatric models
type of model that views addiction as a primary psychiatric condition
-tx consist of the medical model in addition to emphasis on psychiatric symptomatology
contemporary psychiatric models
type of model that believes there is a high co-occurance of trauma experiences and substance abuse.
- the capacity for inner self soothing and self regulation are greatly diminished or absent, causing the person to go for external sources.
- tx includes initial stabilization with later emphasis on exploration of the trauma
trauma model
model that believes the influence of deficits in coping capacity and familial modeling in the development of a substance use disorder- what model?
-targets coping skill enhancement and examination of underlying use expectancy
Bandura’s social cognitive model
model that believes addiction to be a family disease
-each person is affected and plays a role in the family drama
-
systems theory model
model that believes addiction as a environmental factor- such as poverty, poor job availability, lack of education, lack of house, racism, sexism, drug availability contribute to addiction
social model
What are Jackson’s 7 stages of alcoholic families?
- family attempts to deny the problem
- family tries to eliminate the problem
- family becomes disorganized
- family makes a first attempt at reorganization
- family attempts to escape the problem
- family makes a second attempt at reorganization
- family reorganizes with the substance abuser seeking help
What are the 5 stages of treatment for alcohol abusers?
confrontation, detoxification, education, therapy, and reintegration
What are the roles of the children?
based on research the children of alcoholics often adopt rigid roles in the family
- the hero
- scapegoat
- lost child
- mascot
What are additional roles that family members unconsciously adopt in order to provide relief from the stresses in the alcoholic family system?
-based by Wegscheider
dependent
enabler
type of role that: outwardly appears hostile, rejecting, angry, and grandiose; the inner feelings is shame
dependent
type of role: outwardly super responsible, self righteous, and powerless
-keeps the family functioning; the inner feeling is anger
enabler
For the therapist, what assessment approaches need to be done?
behavioral/physiological approach
-family history, use history, potential for withdrawal, health consequences
psychological assessment: ways of coping, potential co-occurring psychiatric conditions
cognitive- expectancies
social- interpersonal difficulties, environmental stressors and consequences
What are the common warning signs of an alcohol abuser?
- drinking alone or secretively
- using alcohol to cope with difficult situations
- feeling uncomfortable on occasions when alcohol is not available
- escalating consumption
- consuming alcohol heavily in risky situations
- getting drunk regularly or more frequent than the past
- drinking in the morning or unusual times
Before treatment to begin, what has to be acknowledge by who?
the drinking as the problem BY THE DRINKER and the family members
What disrupts the family balance when the family is organized around the alcoholism?
sobriety
What is the model of choice for adolescent substance use disorderes?
targeting multiple areas of functioning
-ecologically baed family treatments
type of treatment that: utilizes a systems lens through which to identify a constellation of intervention foci
- joining, reframing, enactment paradox
- shown to decrease substance use rates and arrests at a 4 year follow up
multisystemic family therapy
type of treatment that: involves both developmental and systems oriented case formulation
- targets individual, family, and social areas of risk that are understood as symptom maintaining factors
- tx last 4-6 months in 3 stages
- shown improvements in adolescent group therapy
multidimensional family therapy
an intervention that facilitate treatment initiation among resistant substance abusers through work with one or more concerned family members
- ex: pressures to change and community reinforcement and family training
- tx ranges from 1 session-6 months
- tx involves motivational enhancement, communication skills, behavioral analysis, and contingency contracting
Unilateral interventions
type of intervention used with couples; active treatment with individuals affected by substance use disorder
- tx lasts 4-6 months
- targets abstinence or use reduction and marital functiong
- tx includes: communication skills, assigned shared activities, and contingency contracting
Behavioral marital therapy
a therapeutic approach the confronts denial in the alcoholic unwilling to seek help on his/her own
-has roots in the network family therapy
-involves a group of participants
-suggestion is confrontation in the morning
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Intervention
