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PYB159 End of Sem > effective treatment and ethics > Flashcards

effective treatment and ethics Flashcards

1
Q

principles of effectiveness

no single treatment is…

A

appropriate for all individuals

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2
Q

principles of effectiveness

treatment needs to be …

A

readily available

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3
Q

principles of effectiveness

effective treatment needs to attend…

A

to multiple needs of the individual not just their drug use

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4
Q

principles of effectiveness

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

A

continually assessed and modified as necessary

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5
Q

principles of effectiveness

what are crucial elements of effective treatment of addiction?

A

counselling, other behaviural therapies

remaining in treatment for an adequate period of time

medications

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6
Q

principles of effectivenes

what is improtant when dealing with a DD client

A

both disorders are treated in an integrated way

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7
Q

principles of effectiveness

what is important to remember about medical detoxification

A

it is only a first stage of treatment

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

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8
Q

principles of effectiveness

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

A

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

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9
Q

principles of effectiveness

what is an important overall concept of recovery

A

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

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10
Q

what are the varibales the comprise the biopsychosocial model of addiction

A

overlapping variables

  • systems
  • social
  • psychological
  • biological
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11
Q

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

A

national policies, drug laws and socio-economic context

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12
Q

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

A

interpersonal relationships
treatmetnand drug use settings
social norms around use

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13
Q

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

A

identity as a user
ability to cope
counsellign and support services

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14
Q

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

A 
dopaminergic reward 
HPA response (stress response)
Cortical response
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15
Q

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

A

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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16
Q

what is Miller and Hester’s theory of informed eclecticism

A

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

17
Q

what are the 4 assumptions of informed eclecticism

A

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

18
Q

what is the ATOS

what did it do

A

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
19
Q

what were the ATOS outcomes

A

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

20
Q

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

A

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

21
Q

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

A

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
22
Q

what are teh levels of ethics

A 
macro ethics (theory 
- frameworks and theory 
meso ethics (applies)
- procedural and guidelines
micro ethics (applies)
- in practice
23
Q

impact of ethics and values

unique moral, ethical and legal issues

A

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

24
Q

impact of ethics and values

values and beleifs:

A

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

25
Q

barriers for metnal health professionals

A

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

26
Q

ethical guidelines -

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

A

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

27
Q

what are the key concepts of the ADCA code of ethics

A
  • 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
28
Q

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

A

Respect-

Propriety -

integrity -

29
Q

in the APS code of ethics, define respect

A

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

30
Q

in the APS code of ethics, define propriety

A

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

31
Q

in the APS code of ethics, define integrity

A

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

32
Q

according to the APS how do clinical and ethical decisions differ

A

clnical decision making is based on evidence

where are

ethical decision makin is based on respect propriety and integrity

33
Q

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

what are they

A

autonomy

justice

beneficence
(generous, good doing)

non-maleficence

fidelity
(faithfulness to a cause, person, belief)

34
Q

in Forester-miller and Davis’ 5 moral principles of a healthy therapeutic relationship

define autonomy

A

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

35
Q

in Forester-miller and Davis’ 5 moral principles of a healthy therapeutic relationship

define justice

A

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.

36
Q

in Forester-miller and Davis’ 5 moral principles of a healthy therapeutic relationship

define beneficence

A

reflects counsellors ability to contribute to the welfare of the client

do good, be proactive, to prevent harm when possible

37
Q

in Forester-miller and Davis’ 5 moral principles of a healthy therapeutic relationship

define non-maleficence

A

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

38
Q

in Forester-miller and Davis’ 5 moral principles of a healthy therapeutic relationship

define fidelity

A

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

39
Q

when are breaches in proffessional practice most likely to occur

A
  • 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

PYB159 End of Sem (5 decks)

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