Chapter 8 Study Guide Midterm

Question 1

Principles of Recovery Oriented Systems of Care

Answer 1

The principles of ROSCs emphasize continuity of care; the inclusion of the family, community, and peers in the process; individualized and comprehensive services across the lifespan; culturally responsive services; community-anchored services; inclusion of voices and experiences of recovering individuals and their families; and outcomes-driven, research-based services.

Question 2

Components of Minnesota Model

Answer 2

The first is the belief that clients can change attitudes, beliefs, and behaviors. It adheres to the disease concept of addiction. Long-term treatment goals include abstinence from all mood-altering chemicals and improvement of lifestyle. It uses the principles of AA and NA in treatment.

Question 3

Behavioral models: types

Answer 3

Aversive conditioning- Conditioning the client to develop negative response to the sight, smell, taste, and even thought of alcohol.

Contingency management- an approach in which tangible incentives of various types and magnitudes have been offered to drug abuse treatment clients. Patient’s behavior is rewarded.

Community reinforcement approach- is a biopsychosocial multifaceted approach to change a lifestyle of substance abuse. Emphasis is placed on changing environmental contingencies in the aspects of life, such as labor, recreation, family involvement. It promotes a lifestyle that is more rewarding than using substances.

Question 4

Examples of pharmacological approaches

Answer 4

Usually used in conjunction with other treatment methods. During detoxification, medication is used while the patient is going through withdrawals. Methadone is widely known for treating opioid addiction.

Question 5

Buprenorphine

Answer 5

Is a medication for treating opioid addiction. It is administered through outpatient physician offices. Sold under the brand name Suboxone.

Question 6

Importance of treatment plan and treatment planning

Answer 6

Treatment planning and the treatment plan are the methods by which treatment staff determine what the problems are and what to do about them. Treatment planning involves the assessment and diagnosis of the client.

Question 7

What should be in the treatment plan

Answer 7

Treatment plans should include a statement of the problems, long term goals, short term objectives, strategies to achieve goals and objectives, and review dates.

Question 8

Criticism of group counseling

Answer 8

Groups sometimes have individuals in the group who are not working the program. Groups are used to spread educational information. They are focused too much on gaining client compliance to admit to having a disease rather than analyzing drinking and drug-taking behaviors and developing methods of coping, problem solving, and assertiveness.

Question 9

Reasons for family therapy

Answer 9

Family therapy is an important component to treatment. When there is a positive family adjustment there is better alcoholism treatment outcomes. Family conflicts may often precipitate renewed drinking by abstinent alcohol abusers

Question 10

Outpatient vs. inpatient: advantages

Answer 10

Outpatient advantages- Cost, and clients can continue to work or go to school.

Inpatient advantages- 24-hour supervision, reduced likelihood of clients using AOD while in treatment, highly structured days, and a total immersion in treatment, with removal from everyday stressors and pressures that may interfere with treatment.

Question 11

Reasons for choosing treatment setting

Answer 11

It is important to choose a treatment setting keeping in mind the least restrictive environment for the patient. A treatment setting needs to be chosen that fits the client best keeping in mind, clients motivation, ability to discontinue use, social support, employment, medical condition, psychiatric status, and treatment history.

Question 12

NIDA Principles of Effective Treatment

Answer 12

pg 151-152

Question 13

Evidence-based treatment: definition

Answer 13

Research has shown to be effective and have demonstrated consistent results in multiple studies.

Question 14

Elderly: important considerations

Answer 14

Crteria for substance use disorders may not apply to the elderly, or their difficulties can be caused by other problems. Health care providers and family members may hesitate to ask because of embarrassment or a belief that symptoms such as falls or cognitive difficulties are due to age-related issues.

Question 15

Disabled: important considerations

Answer 15

Treatment programs require a great amount of reading and writing “homework” and for clients with learning disabilities, this is a barrier. Acting out behavior may be a reaction to their disability and not their AOD problem. Instructional strategies need to be modified for those with learning disabilities. More behavioral interventions are needed.

Question 16

Women: important considerations

Answer 16

Barriers to treatment include pregnancy, lack of services for pregnant women, fear of losing custody of the unborn child, fear of prosecution for drug use while pregnant, and lack of child care outside of treatment. Also a lack of employment or means to pay for treatment, high rates of co-occurring disorders, and associated lack of appropriate treatment, greater social stigma, and discrimination, and physical and or sexual abuse.

Question 17

Adolescents: important considerations

Answer 17

Adolescents have difficulty relating to a concept of a life-long disease. They often reject the idea that lifestyle change is necessary. They rarely experience the same level of life problems resulting from their AOD use as adults. They often know what to say to get what they want. They just tell the staff what they want to hear. It is very difficult to convince an adolescent that he or she needs to change his or her social group.

Question 18

Co-occurring disorders: important considerations

Answer 18

Co-occurring disorders are predictors of early treatment termination. People with co-occurring disorders were highly unlikely to receive treatments for both mental health and substance use problems. They tend to get assigned to one system of treatment rather than getting treatment for both. It is difficult to diagnose people with co-occurring disorders. There is always a question of how to treat these clients. Do you treat the addiction first or the psychiatric problem.

Question 19

Criminal Justice Populations: important considerations

Answer 19

Comprehensive services, community links, and aftercare services are needed for these clients. It is important to treat the individual so their isn’t a revolving door of crime, prison, parole, re-arrest, reincarceration.

Question 20

Treatment Effectiveness

Answer 20

The big question: Does treatment work. There are a few problems in understanding if treatment is effective. First, treatment programs are not designed to scientifically evaluate aspects of treatment that are most effective. There are numerous client variables that impact treatment effectiveness such as age, gender, duration of use, etc. The treatment environment may also impact effectiveness. Three long-term studies were completed to help understand if treatment is effective. From the three studies it can be concluded that treatment does appear to have a beneficial, long-term effect on a variety of client behaviors, including AOD use. A variety of treatment approaches and treatment settings have proven effective and even the most vulnerable client’s benefit from treatment.

Question 21

Controlled use: Is it ever appropriate?

Answer 21

Controlled use should only be a treatment goal when other alternatives have been explored and when it is probable that the client will experience more serious problems from an insistence on abstinence. The best candidates for controlled use are young, healthy drinkers, with few life problems related to alcohol, whose problems with alcohol are of recent duration and who resist abstaining.

Question 22

Natural recovery

Answer 22

People who discontinue use of AOD without treatment. Question whether the person who becomes abstinent without treatment is recovering or is a dry drunk. A dry drunk is a person who exhibits any or all feelings and behaviors associated with intoxication although no alcohol is consumed.

Question 23

AA position on medication for treatment of medical conditions

Answer 23

AA takes a strong stand against substituting one addictive drug for another.

Question 24

Recovering individuals as addiction counselors

Answer 24

Recovering individuals bring valuable contributions to the recovery process with their understanding and empathy. The combination of personal experience and professional training is dynamic. Although many recovering individuals can make great counselors without the proper training.