Chapter 18: Working with Substance-Related Disorders, Domestic Violence, and Child Abuse Flashcards
For some families, abuse is an entity from which they ____ recover
Never
Family abuse or violence appears to be directly linked to both ____ and ____.
both general anxiety disorder // romantic relationship distress
According to Gladding, what are the three forms of abuse discussed in chapter 18?
substance-related disorders
domestic violence
child abuse
____ defined as “disorders related to the taking of a drug of abuse (including alcohol), to the side effects of medication, and to toxin exposure” are even more disruptive.
substance-related disorders
How are substances grouped for diagnostic purposes?
into 11 classes alcohol amphetimines or similar acting sympathomimetic; caffeine; cannabis; cocaine; hallucinogens; inhalants; nicotine; opioids; phencyclidine (PCP) and sedatives, hypnotics, or anxiolytics”
What are the two general levels or forms of alcohol use disorders?
alcohol abuse
alcohol dependency
.____ alcohol problems, which includes two levels: alcohol abuse and alcohol dependency.
Alcohol use disorder
____ “a problem pattern where the drinking interferes with work, school, or home life” in addition to other difficulties with the law and society
Alcohol Abuse
____ in which the person is unable to control his or her drinking behavior even after trying.
Alcohol Dependency
How are substance-related disorders considered to be family-based and supported?
- As a way of coping with a crisis or connecting with one another
- Family communication can also act as an enabler of the substance abuser
How do families play a role in the development and maintenance of substance abuse
Family conflict and communication can reinforce undesirable behavior.
How does substance misuse affect families and society?
- Causes deaths, illnesses, and disabilities than any other preventable health condition
- Affects families by undermining family life
- Affects the economy and public safety
_____ falls sense of identity that an individual may create for themselves.
Pseudo individuation/ pseudo self
Who does substance abuse disorder affect?
- Couples
- Families
- Individuals within them
- Society
How do the behaviors of a person experiencing substance mise affect others?
- Behaviors permeate and penetrate into other relationships and affect the actions of everyone who comes into contact with the person who has the disorder.
Society is affected by those that abuse substances, in what ways?
- Substance abuse costs the U.S. more than 400 billion annually in crime, health, and lost productivity.
Families may try ____ or ___ methods initially when dealing with a family member with a substance abuse disorder.
unhealthy
dysfunctional
What is a consequence of a couple or family dealing with a substance-related disorder when the non-abusing members of the couple/family shield the substance-related abuser from the negative consequences of his or her actions?
The abuser does not get a true picture of the seriousness of his or her actions
What is a consequence of a couple or family dealing with a substance-related disorder through denial and pretending that the disorder is not present in their household and non-abusing members make excuses for the abusing member?
The couple/family does not acknowledge the “elephant in the room” and shields the abuser from the consequences of his or her actions.
What is a consequence of a couple or family dealing with a substance-related disorder through the expression of negative feelings?
The family except for the abuser experience a plethora of unpleasant emotions, such as fear, anger, shame, guilt, resentment, insecurity, confusion, and rejection.
___ a role that an individual may take on in a family with a substance abuser to allow them and others to survive.
A spouse or other family member on whom the substance abuser is most dependent and who allows a substance abuser to continue and become worse.
Enabler
___ a role that an individual may take on in a family with a substance abuser to allow them and others to survive.
Adult or oldest child who functions to provide self-worth for the family.
Family hero
___ a role that an individual may take on in a family with a substance abuser to allow them and others to survive.
Often a child who attempts to distract the family focus away from the substance abuser by acting out in a disruptive manner and being blamed for the family’s problem.
Scapegoat
___ a role that an individual may take on in a family with a substance abuser to allow them and others to survive.
Usually, a child in the family who suffers from rejection and loneliness and offers a substance-abuser family relief.
lost child
___ a role that an individual may take on in a family with a substance abuser to allow them and others to survive.
Often the youngest member of the family whose function is to provide the family with humor and thus reduce tension?
Family clown
What is a consequence of a couple or family dealing with a substance-related disorder through deterioration such as drinking or using substances together?
Children in these families grow into adolescents and the consumption of a harmful substance within a couple or family is centered on an adult or adults.
What is a consequence of a couple or family dealing with a substance-related disorder through misuse or abuse of the family resources as well?
Everyone suffers physically because of a lack of money and effort to purchase essential necessities.
Children who come from couples and families with substance-related disorders may behave in a confused way about their self-identity and self-worth, what are the consequence of their lack of identity and self-worth?
They may become controlling in their interpersonal relationships as a way of gaining security.
May develop social and emotional problems
Low school achievement and trouble with the law.
Fell less attached and bonded to others
have more difficulty with intimate relationships ex: marriage.
____ is an especially effective intervention for treating adolescent drug use when compared with nonfamily-based interventions.
Family Therapy
What is considered the most difficult and critical part of the process for providing substance-related disorders in families and can become especially difficult when working with families of minority populations?
Getting the family to agree to therapy
A method for getting the family engaged in the therapy process is when a family member has a substance-abuse disorder that involves spouses, relatives, or children of the substance abuser or dependent person.
Concerned Significant Other (CSOs)
____ where family members meet with a substance abuser in a surprise meeting and the abuser is confronted by the family about all of the problems that his/her behaviors have caused.
Intervention
Widen “the focus of attention from providing therapy once a family brings itself to the clinic to considering that the treatment begins prior to the first clinic visit” How does this help engage a family in the treatment process?
Deemphasis is placed on the therapist as the ally of the family member who made the initial call.
What are developmental issues that may present themselves most blatantly in the early stage of treatment?
The status of the identified patient in the family system.
___ an extremely powerful member of the family whose development has been arrested and who is generally resistant to therapy because to engage in the process is to agree to someone else’s agenda and weaken the position of power.
Identified patient
What is a way for a therapist to engage a substance-related disorder family to its fullest?
Call the person in the family who is the most disengaged.
Many families are affected by ______ that involve taking a drug of abuse. This is often considered a family systems problem.
substance-related disorder
Treatment for substance-related disorder families must address issues such as: ____, ___, and _____, and ____.
relapse
the environment
intrapersonal(emotions)
interpersonal (social) relations
Which way are useful in working with substance-related disorder families:
- ___
- ___
- ___
- ___
- structural- strategic family therapy
- Bowen family therapy
- Behavioral family therapy
- Multifamily therapy
What are community resources that can be utilized by families with a substance-related disorder as a part of therapeutic treatment?
AA or Al-Anon and prevention activities
What are the types of violence against spouses?
physical
sexual
psychological
economic
Violence in families stems from a _____.
power imbalance
What are the two levels of violence in families?
- common couple violence
2. SPV or IPV
How is the assessment of domestic violence best done?
In an open manner with an emphasis on how the family is hurt rather who is to blame
Each year ___ children are victims of child abuse.
1 million
What are the different types of child abuse:
Physical
Sexual
Psychological
Neglect and Abandonment
____ or ___ abuse is the most long-lasting and damaging.
Emotional/ Psychological
Why is the treatment of child abuse complicated?
It involves legal, developmental, and psychological issues
Treatment of child abuse and neglect may focus on ___ and on current issues
historical
What are the common therapeutic approaches used to treat child abuse and neglect?
Bowen and behavioral family treatments
peer groups of children and parents
___ an evidence-based treatment approach for working with adolescent substance abusers. Recovery in this model is a process that occurs in and with systems support and in stages
Community reinforcement approach (CRA)
___ the physical aspects of a family’s life, such as getting the substance abuse behavior stopped.
Environmental influences
___ home-based family counseling based on social ecology. Individuals are viewed as nested within a complex of interconnected systems that encompass individual, family, and extrafamilial factors.
The behavior is seen as the product of reciprocal interplay between the family.
Multisystemic therapy
_____ treatments are based on the recognition that substance use and other related problem behavior derive commonly form many sources of influence and occur in the context of multiple systems
multisystemic
____ Treatment should initially address excessive drinking or other forms of substance abuse in order to get it stopped.
EX: inpatient detoxification, enrolling in support program (AA)
After abuse ends, treatment based on clear thinking and a drug free mind.
Can be used with multigenerations and minority. populations.
Structural-strategic family therapy
A technique for working with families who have individuals who are substance-related abusers. The idea behind this therapy is to treat several families at the same time.
Multi-Family therapy
Which of the following is not a factor of multi family therapy?
A. Not cost effective
B. Reported to have high success rate
C. A person may experience dynamics in other families
D. Helpful for substance abuser gaining different perspective
A. Not cost effective
___ are prime beneficiaries of multi family therapy.
Women
In what way do women have pressure alleviated off them by attending multi family therapy.
Women may typically feel pressure to leave treatment before they are ready because of family obligations by attending this therapy, the family gives the client permission to stay in treatment and demonstrates that its members are managing at home without client.
____ from substance-related abuse is dependent on which of the following?
A. Keeping a person abusing the substance
B. Replacing old behaviors with non productive
C. Keeping a person or family from engaging in the habitual activity.
D. Keeping the family from engaging in the habitual activity
C. Keeping a person or family from engaging in the habitual activity.
Which of the following is a prevention method used to prevent adolescents from using alcohol?
A. Giving young people accurate information about alcohol use in an objective way
B. Presenting information through a “teen-respected” source
C. Using parent networking
D. All of the above
D. All of the above
___ are aimed at keeping substance-related abusers free from the resumption of the habits that harmed their family lives
12-step programs
__ assist family members in both understanding the dynamics involved in substance-related abuse and finding ways of not enabling the abuser to resume his or her destructive behavior.
A. Al- Anon
B. Interventions
C. 12-step program
D. General offering groups
A. Al-Anon
___ Is effective family therapy for alcohol abuse. Is especially helpful as a component in implementing a program that deals with codependency treatment.
Bowen Family Therapy
What is a feature of Bowen family therapy in which one reaches a balanced state of being gain from the therapeutic process?
Learn to distinguish between subjective feelings and objective thoughts to become more flexible, adaptable, and independent.
Which methods are implemented within Bowen family therapy for treatment?
Genogram s
I position statements
Reconnections of emotional cutoffs
What is something that individuals receiving therapy from the Bowen family therapy model?
A. Have a greater sense of self by attending support groups
B. Stop behaving in ways that make them dependent
C. Greater freedom to change how they relate to others
D. Both B&C
D. Both B &C
___ a form of treatment for families with a substance-abuser that involves getting the entire family in treatment. The treatment itself should initially address excessive drinking or other forms of S/A in order to get it to stop. May involve inpatient treatments
Structural-Strategic family therapy
__ Refers to “Aggression” that takes place in intimate relationships, usually between adults. Is the willful intimidation, assault, battery, sexual assault, and/or other abusive behavior perpetrated on one intimate partner or another.
Domestic Violence (D/V)
In which types of populations is d/v higher?
Military with mental disorders, veterans with PTSD than general population
What is the worst form of D/V that includes severe physical assault or risk of serious injury?
Battering
___
Intimate Partner violence
Who developed the typology that created a classification system that identifies batters as Pitbulls and Cobras?
John Gottman including Neil Jacobsen
A type of batterer that was identified by assessing the relationship of violent behaviors, and physiological makers such as heart rate and marital conflict.
__ Heart rate increases as they become more verbally aggressive with their partners.
Pitbulls
A type of batterer that was identified by assessing the relationship of violent behaviors, and physiological makers such as heart rate and marital conflict.
Heart rates decreases as they become more verbally aggressive and who engage in antisocial and violent behavior with just about everyone.
Cobras
Relationships that develop between partners in domestic violence situations mimic___ with the victim losing his/her sense of autonomy as the perpetrator asserts increasing degrees of physical, psychological, and sexual control.
Those of hostage and captor
Which of the following is a reason that one may decide to remain or leave an abusive relationship.
A. Fear
B. Rationalization
C. Finances and Children
D. All of the above
D. All of the above
What is a common barrier that impedes the assessment of the degree of domestic violence that couples and families experience?
Legal
Psychological
___ a barrier that may impede the assessment of the degree of domestic violence that couples and families may experience that involves court orders that mandate separation of family members from one another.
Legal
___ a barrier that may impede the assessment of the degree of domestic violence that couples and families may experience that involves stigma that surrounds abuse of this nature.
Psychological
What are the two levels of violence?
Common Couple violence (CCV)
Severe Abusive Violence (SAV)
___ low level violence initiated by either women or men that is infrequent and non injurious.
Common Couple Violence
__ known as battering or “patriarchal/ intimate terrorism,” is often physically injurious, meant to intimidate and largely perpetuated by men against women.
Severe abusive violence (SAV) aka intimate partner violence (IPV)
Families in which there is considerable violence will go to almost any length to keep this secret __.
Hidden
Physical VIOLENCE sexual ___
Making and/ or carrying out threats to do something to hurt her, Threatening to leave her, to commit suicide, to report her to welfare, making her drop charges, making her do illegal things
Using Coercion and threats
Physical VIOLENCE sexual ___ making her afraid by using looks, actions, gestures: smashing things, destroying her property, abusing pets, displaying weapons
Using intimidation
Physical VIOLENCE sexual ___ putting her down, humiliating her, calling her names, playing mind games, making her feel guilty, making her think she’s crazy, making her feel bad about herself.
Using Emotional Abuse
Physical VIOLENCE sexual ___ Making light of the abuse and not taking her concerns about it seriously, saying the abuse didn’t happen, shifting responsibility for abusive behavior, saying she caused it.
Minimizing, Denying, and blaming
Physical VIOLENCE sexual ___ controlling what she does, whom she sees and talks to, what she reads, where she goes, limiting her outside involvement, using jealousy to justify actions.
Using Isolation
Physical VIOLENCE sexual ___ making her feel guilty about the children, using the children to relay messages, using visitation to harass her, threatening to take the children away
Using Children
Physical VIOLENCE sexual ___ treating her like a servant, making all the big decisions, acting like the master of the castle, being the one to define men’s and women’s roles
Using male privelege
Physical VIOLENCE sexual ___ preventing her from getting or keeping a job, making her ask for money, giving her an allowance, taking her money, not letting her know about or have access to family income.
Using Economic Abuse
An assessment conducted in an open manner that usually results in obtaining the most information where blame is not a primary emphasis and the therapist emphasizes that the expression of violence in the family hurts the entire family rather than just one person is called a(n)___.
Open Assessment
In open assessment the focus of the assessment centers on dynamics ___ the family.
Within
Non-violence and equality that promotes positive behaviors ___: seeking mutually satisfying resolutions to conflict, accepting change, being willing to compromise
Negotiation and Fairness
Non-violence and equality that promotes positive behaviors ___: talking and acting so that she feels safe and comfortable expressing herself and doing things.
Nonthreatening behavior
Non-violence and equality that promotes positive behaviors ___: listening to her non judge mentally, being emotionally affirming and understanding, valuing opinions.
Respect
Non-violence and equality that promotes positive behaviors ___: accepting responsibility for self, communicating openly and truthfully, admitting being wrong, acknowledging past use of violence
Honesty and accountability
Non-violence and equality that promotes positive behaviors ___: supporting her goals in life, respecting her right to her own feelings, friends, activities,and opinions.
Trust and Support
Non-violence and equality that promotes positive behaviors ___: sharing parental responsibilities, being a positive nonviolent role model for the children
Responsible parenting
Non-violence and equality that promotes positive behaviors ___: mutually agreeing on a fair distribution of work, making family decisions together
Shared responsibility
Non-violence and equality that promotes positive behaviors ___: Making money decisions together, making sure both partners benefit from financial arrangements
Economic partnership
___ therapy that involves seeing the couple together in which the primary concern about the wisdom of couples therapy is the woman’s safety
Conjoint therapy
Concern of the woman’s safety in conjoint therapy may undergo an assessment, consisting of which categories?
Frequency Severity of violence Presence of weapons Alcohol or other substance abuse Jealousy Possessiveness Obsession with partner
__ includes the ethical context of abuse and violence in intimate relationships that encompasses three ethical dimensions and nine ethical concepts.
Encourages therapists to confront, challenge, explore,and educate clients about abuse of power in emotional systems
Akin to solution-based approaches
Explores experiences, empowerment, disempowerment, and abuse of power in one’s family of origin.
Effective for couples who voluntarily enter therapy.
Intimate justice theory
___ cognitive-behavioral model of treatment
Premise: people learn violent behaviors because they are reinforced and therefore they can unlearn them through CBT EX: education
Effective in producing rehabilitation in perpetrators if they are long lasting, or the span of 1 year
Participants must be held accountable for their actions
Duluth Model
____ involves the act of commission.
Child abuse
___ involves the acts of omission.
Child neglect
___ most common form of family violence. Is attributed to having parents who are not emotionally responsible.
Sibling abuse
___ manifested in everything from skin injuries, physical traumas, broken bones, soft tissue swelling, bleeding, to death.
Child Physical abuse
Many children who are physically abused become: A. Distrustful of others B. Delinquent C. Severely depressed D. All of the above
D. All of the above
Jared a twelve year old, is a child who has difficulty forming close, lasting relationships with peers, has cognitive problems, poor school performance, has been seen with physical marks more frequently lately and has also had a broken arm in the previous month. What type of abuse is he experiencing?
Physical abuse
Tiffany has recently reported to her mother that her uncle’s friend has been making unwanted sexual remarks to her, has been caught sneaking outside of her bedroom, and has also propositioned her for sexual favors, citing that “she shouldn’t tell anyone, because it is their secret.” What type of abuse is she experiencing
Childhood sexual abuse (CSA)
What is the longest range type of abuse that is more constant in nature and more damaging throughout life?
Psychological abuse or emotional neglect
Treatment of child abuse and neglect becomes complicated because it involves what?
Legal
Developmental
Psychological issues
___ to report child abuse usually constitutes unprofessional conduct that can lead to disciplinary action by a regulation board, possible conviction of a crime, and a civil lawsuit for damages.
Failure
When working with a child that has endured sexual abuse that was discovered in childhood, which approach is most effective and why?
Trauma-Focused Cognitive behavioral therapy
Is structured to include child only sessions and parent only sessions, and joint family sessions.
