effective treatment and ethics Flashcards by Alecia Yu

principles of effectiveness

no single treatment is…

appropriate for all individuals

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principles of effectiveness

treatment needs to be …

readily available

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principles of effectiveness

effective treatment needs to attend…

to multiple needs of the individual not just their drug use

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principles of effectiveness

an individual treatment plan must be ____________ _________ to ensure the plan meets the persons changing needs

continually assessed and modified as necessary

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principles of effectiveness

what are crucial elements of effective treatment of addiction?

counselling, other behaviural therapies

remaining in treatment for an adequate period of time

medications

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principles of effectivenes

what is improtant when dealing with a DD client

both disorders are treated in an integrated way

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principles of effectiveness

what is important to remember about medical detoxification

it is only a first stage of treatment

by itself it doesnt do much to change long term drug use

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principles of effectiveness

why is it improtant for treatment programs to provide assessment for BBV and other infectious diseases as well as counselling

to help mosify and change behaviours that place the person or others at risk of infection

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principles of effectiveness

what is an important overall concept of recovery

it can be a long term process and frequently require multiple eppisodes of treamtent

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what are the varibales the comprise the biopsychosocial model of addiction

overlapping variables

systems
social
psychological
biological

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what contributes to the systems variable of the biopsychosocial model of addiction

national policies, drug laws and socio-economic context

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what contributes to the social variable of the biopsychosocial model of addiction

interpersonal relationships
treatmetnand drug use settings
social norms around use

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what contributes to the psychological variable of the biopsychosocial model of addiction

identity as a user
ability to cope
counsellign and support services

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what contributes to the biological variable of the biopsychosocial model of addiction

dopaminergic reward 
HPA response (stress response)
Cortical response

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what are the results of comparing 12 step programs and CBT in the 1997 Project MATCH

single diagnosis clients have more abstinent days following 12 step program then CBT

no difference between the two for DD clients

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what is Miller and Hester’s theory of informed eclecticism

that futur progress and practice should be directed to an informed eclecticism and openness to a variety of approaches that is guided by scientific evidence

what are the 4 assumptions of informed eclecticism

there is no single superior approach to treatment for all individuals

Tx programs/systems should be constructed with a ariety of approaches that have been shown to be effective

different individuals respond best to different Tx approaches

it is possible to match client s to optimal Tx therefore increasing Tx effectiveness and efficiency

what is the ATOS

what did it do

the Australian treatment outcomes study

studied heroin users
looked at treatments of replacement, withdrawal, residential rehabilitation, non-treatment control
3 and 12 month post entry follow up

Tx sample differed from gen pop

TSD, Depression, borderline PD and disability
high suicide and overdose rate, criminality

what were the ATOS outcomes

general functioning improved

majority o f participants abstained for the 1 month prior to 12 month follow up

65% replacement
63% rehab
52% withdrawal
25% non-treatment control

noticeable reduction in
criminal behaviours
improve injection related health and
decline in depression

why is it important to consider the needs and engagement of family members in the effective treatment of ones addiction

to improve outcomes fo all jhose effected by an individuals problematic use

what are some key things to consider in regards to ethics in AOD practice

consider the many difficulties you may face when working in the AOD field

how might th eillegality of drug use impact your work
what about working with drug using parents?
or clients under 18
when do you terminate treatment

what are teh levels of ethics

macro ethics (theory 
- frameworks and theory

meso ethics (applies)
- procedural and guidelines

micro ethics (applies)
- in practice

impact of ethics and values

unique moral, ethical and legal issues

risks to user and comminuty balance with therapeutic goals

potential impact on the therapeutic relationship, clinician to client reactions, services offered

who should have access to treatment

consent (intoxication, third party pressures)

minors

harm reduction vs no tolerance/abstinence approaches

impact of ethics and values

values and beleifs:

different beliefs associated with different drugs
- difference between personal beliefs and evidence of harm

stigmatisation of drug use often mean sclients have often experienced judgemental approaches and rejection in the past
- stigma is a barrier to accessing treatment

barriers for metnal health professionals

lack of amiliarity wiht AOD issues - belief that referral is most appropriate way to manage (DD issue) stereotyped beleifs of clients - difficult and chaotic - media influence views on how to manage relapse vary greatly - from supportive to judgmental concerns about lacks of skills/providing ill informed services

ethical guidelines - hat are the 4 codes by which those in the AOD feild use to guide their ethical decisions

ADCA code of ethics APS code of ethics and substance use position paper (2009) individual service code of conduct, policy and procedures legislation - e.g. child protection act, health services act , drug misuse act

what are the key concepts of the ADCA code of ethics

- equality and access - client worker relationship - privacy and confidentiality - training and professional development - responsive services - effective and efficient services - reducing stress and workload issues - community consultation and involvement - ethics committee approval fo research - advocacy in public policies and public health outcomes

what are the tree general ethical principles of the APS - code of ethics

Respect- Propriety - integrity -

in the APS code of ethics, define respect

respect for the right and dignity of people including autonomy and justice

in the APS code of ethics, define propriety

incorporates the principles of beneficience and non-maleficence (inc. competence) and responsibility to clients, the profession and society

in the APS code of ethics, define integrity

reflects the need for good character and acknowledges the high level f trust intrinsic to professional relationships and the impact of conduct

according to the APS how do clinical and ethical decisions differ

clnical decision making is based on evidence where are ethical decision makin is based on respect propriety and integrity

Forester-miller and Davis proposed 5 moral principles of a healthy therapeutic relationship what are they

autonomy justice beneficence (generous, good doing) non-maleficence fidelity (faithfulness to a cause, person, belief)

in Forester-miller and Davis' 5 moral principles of a healthy therapeutic relationship define autonomy

the principle that addresses respect for a clients independence and self-determination allows an individual the freedom of chocie and action counsellors responsibility to encourage clients to pave their own path

in Forester-miller and Davis' 5 moral principles of a healthy therapeutic relationship define justice

treating all clients with equality (not necessarily all exactly th same) counsellor needs to be able to offer rationale that explains the necessity and appropriateness of treating an individual differently.

in Forester-miller and Davis' 5 moral principles of a healthy therapeutic relationship define beneficence

reflects counsellors ability to contribute to the welfare of the client do good, be proactive, to prevent harm when possible

in Forester-miller and Davis' 5 moral principles of a healthy therapeutic relationship define non-maleficence

concept of not causing harm to others - intentional harm and actions that risk harming others "above all, do no harm" considered most critical of all principles

in Forester-miller and Davis' 5 moral principles of a healthy therapeutic relationship define fidelity

involves the notions of loyalty, faithfulness and honouring commitments clients must be able to trust the counsellor and have a faith in the therapeutic relationship if growth is to occur

when are breaches in proffessional practice most likely to occur

- when workloads are high - when staff are under significant stress - when client and clinician values are in conflict - lack in defined policies, procedures and guidelines - lack in supervision and support - lack of proffesional development opportunitues