final Flashcards
1
Q
what does trauma represent
A
experience that overwhelms an individuals ability to cope
2
Q
three e’s of trauma
A
events (circumstances causing trauma)
experiences (personal response to event)
effects (physical, emotional, behavioural, cognitive, spiritual)
3
Q
4 r’s of trauma informed care
A
realize, recognize, respond, resist re-traumatization
4
Q
addiction service providers should assume that all service users…
A
have experienced some level of trauma & should be inquiring, in a respectful and safe manner about the nature of the trauma service users experiences
5
Q
5 key practice provisions when offering trauma informed care
A
safety (provide protected physical and emotional environment where they feel welcome)
trust (a feeling b/w rpn & user, no judgemental, empathetic, and compassionate listening)
choice (sense of control and autonomy)
collaboration (belief that many have experienced power imbalances; work along side user)
empowerment (focus on resilience rather than deficits, understanding that drugs are coping mechanism)
6
Q
reasons for grounding substance misuse in trauma informed practice
A
- given how prevalent trauma is, TIP always be used
- substance misuse only one negative consequence of trauma = assess trauma to determine other negative behaviours
- trauma affects perceptions of self & environment = users become trapped and unable to move forward
- experienced trauma = more likely to perpetuate violence making TIP ethical imperative
- marginalized populations (race, sexual orientation) who struggle with addiction - greater risk of experiencing ongoing trauma, perpetuating substance misuse
- trauma barrier to seeking help = TIP can alleviate stressors in accessing services
- trauma often occurs within institutions, making less likely to seek institutional services
- trauma affects staff, can experience secondary trauma from stories
7
Q
road map to TIP
A
trauma awareness, trauma sensitive, trauma responsive (gather info & prioritize & create plan), trauma informed (implement & monitor)
8
Q
6 stages of trans theoretical model of change
A
pre-contemplation: no intention to change, unaware there is problem
contemplation: aware problem exists, not committed to take action
preparation: intends to take action & makes small changes; needs to set goals and priorities
action: dedicates considerable time & energy; make overt changes; develops strategies to deal with barriers
adaption/maintenance: works to adapt and adjust to facilitate maintenance of change
evaluation: assessment and feedback to continue dynamic change process
9
Q
describe the pre-contemplation stage
A
not ready
resist change & no intention of altering behaviour/doesn’t recognize any problem exists
unaware of impact of behaviour on those around
10
Q
counsellors assist users in the pre-contemplation stage in…
A
distinguishing b/w how they see their circumstances and the reality of their situation
11
Q
describe the contemplation stage
A
getting ready
users become aware that they stuck in situation & must decide whether they wish to change or remain where they are
12
Q
counsellors help the user in the contemplation stage by
A
help equilibrium b/w desire to change and fear of changing & associated unknown consequences
assist in weighing pros and cons of change, whole working to tip the scales towards change
13
Q
describe the preparation stage
A
ready
consider changing drug-using behaviour and anticipate what this future action will entail
identify and resolve barriers to success, including friends and family who may still benefit from users drug use
develop realistic plans that can be easily implemented with min risk of failure
14
Q
describe the action stage
A
doing
work and behavioural change begins; heavy emphasis on problem solving skills
entails changing awareness, emotions, self-image, and thinking
support of positive decisions and reinforcement
identifying and exploring times that may lead to use
15
Q
describe maintenance / adaption stage
A
focus on supporting and consolidating the gains made during the action stage and avoiding brief or longer drug user reoccurrences
focus on social skills training
16
Q
describe the evaluation/termination stage
A
sees service user move beyond problem solving, with a focus on preventing reoccurrence and dealing with the reality of sobriety
service users assess their strengths and areas that may be problematic in the future as they develop a reoccurrence-prevention plan
17
Q
counsellors strategies for the different stages
A
pre-contemplation: build rapport and trust; increase problem awareness
contemplation: acknowledge ambivalence towards change; discuss pros and cons
preparation: build confidence; talk about timing of change; provide information, options, advice; work at their pace
action: offer planning assistance, provide support, develop attainable goals
maintenance: support & encourage new behaviour; talk about possible trouble areas; talk about stressors or triggers
evaluation: reinforce new skills; review triggers; develop strategies on how to return to the new behaviour if lapse occurs rather than drugs
18
Q
consciousness raising
A
increasing information to service users about themselves and their problems
19
Q
dramatic relief
A
experiencing and expressing feelings about one’s problems and solutions grieving losses, partaking in role play to appreciate impact of changed behaviour
20
Q
environmental re-evaluation
A
assesses habits that affect one’s social and physical environment; increase awareness that one can be a positive or negative role model for others
21
Q
self re-evaluation
A
users assess how they think and feel about themselves with respect to their substance use; value clarification, healthy role models,
22
Q
self-liberation
A
choose and commit to change beliefs and actions
23
Q
reinforcement management
A
providing consequences, punishments or rewards
24
Q
helping relationships
A
combining caring, trust, openness, and acceptance and support for healthy behaviour
25
counter-conditioning
sub healthier alternatives for problems drug using behaviours; focus on sub alternatives for problem behaviours with an emphasis on self care
26
stimulus control
removing cues for drug use and replacing them with prompts for healthier alternatives
27
social liberation
increasing engagement in non-drug-related behaviours, considering the needs of others, becoming involved in broader issues; increase in social opportunities or alternatives
28
motivational interviewing
interpersonal and interactional process where there’s the probability of turning negative behaviours into positive ones
29
why people resist change
nature of change is misunderstood, change is forced, hard work required, new skills & knowledge required, threatens one’s competence, too many changes are asked at once, goal is not achievable
30
change talk
talking about the possibility of changing
31
sustain talk
talking about remaining in the same situation
32
MI
brief, person-centred method; uses intrinsic motivation to change
explores and resolves client ambivalence
uses the ideas of attribution, cognitive dissonance, self-efficacy and empathy
interpersonal process that de-emphasizes labelling
emphasizes internal attribution for change and individual responsibility
strength-based approach, works with user instead of doing things for them
33
MI focuses on
locating natural motivating issues within a person’s life
34
MI is non-confrontational in nature, acknowledges that creating conflict is counterproductive
TRUE
35
cognitions include
thoughts and beliefs; our opinions about the environment, ourselves, our actions and behaviours
36
when cognitions align, its called
consistency
37
if balance doesn’t occur b/w cognitions, the individual will experience…
state of tension or inconsistency b/w their opinions, attitudes, beliefs, and action
38
dissonance occurs when
tension motivates individuals to alter their thoughts, bringing their beliefs and perceptions closer
39
principles of MI: RULE
R = resist providing suggestions
U = understand the person’s motivation to change
L = listen intently, provide feedback
E = empowerment through encouragement and support
40
components of MI: PACE
P = partnership (collaborative work)
A = acceptance (absolute worth; autonomy & support; affirmation; accurate empathy)
C = compassion (non-judgemental, non-blaming, non-shaming)
E = evocation (draw knowledge and options from service users rather than imparting information or opinions)
41
attributes of MI
express empathy: sets the stage for acceptance of efforts to facilitate change
develop discrepancies: perceived values vs actual behaviours and outcomes, user must be able to perceive discrepancy b/w present behaviour and personal goals
roll with resistance: resist arguing against resistance, have user voice arguments for change
support self-efficacy: users must believe change can happen
42
counselling approach: OARS
O = open-ended qts (allows user to guide convo)
A = affirmations (compliment user on behaviours, strengths, and efforts
R = reflections (2-3 after open ended qts)
S = summarizing (ensure mutual understanding of discussion)
43
MI processes
engaging = establish mutually trusting relationship
focusing = “what stage” entails clarifying particular goal or direction for change and exploring ambivalence to change
evoking = “why stage” counsellors assist user to find, nurture, and implement their own reasons
planning = “how stage” counsellors helps user develop specific change plan that user is willing to implement
44
prevention
the promotion of constructive lifestyles and norms that discourage drug use. The development of social and physical environments that facilitate drug-free lifestyles.
45
prevention levels
primary, secondary, tertiary
46
primary prevention
occurring before a person begins to use substances, goal is to prevent or delay onset of first use
47
secondary prevention
occurring once a person has begun to experiment with drug use. the goal is to prevent more frequent, reg use
48
tertiary prevention
occurring after substance use has become problematic, goal is to reduce the harm associated with use or if possible abstinence
49
prevention programs focus on
those who chose to abstain from drugs, postpone drug use, already using, experiencing difficulties with current drugs, experiencing difficulties with the use of drugs by family/friends, larger family system
50
3 prevention focuses that can be adopted within the risk continuum
universal, selective, indicated or targeted
51
indicated prevention
- designed to prevent the onset of substance misuse in individuals who are showing early danger
- those who are already using or involved with psychoactive drugs
- programming is individual and can include a formal counselling component
- targets injection drug users and teaches them harm reduction techniques with or without a goal of abstinence
52
selective prevention
targets subsets of the total population that are deemed to be at risk for substance misuse (academic struggles, family issues, poverty, problematic social environments, family history)
53
universal prevention
addressing the whole population
54
selective prevention programs have
smaller # of participants
longer and more intensive structure
more intrusive intervention, with a goal of changing existing behaviours
higher degree of skill among leaders and staff
greater cost
greater likelihood of demonstrating change
55
prevention program components
knowledge, attitudes & values, skills
56
knowledge components of prevention
- concept of abstinence and alternative behaviours to drug use
- how different drugs can affect a person’s ability to perform tasks
- how different contexts and situations influence personal values, attitudes, beliefs, and behaviour
- importance of self-esteem, positive self-concept, and identity
- rights and responsibilities of interpersonal relationships
57
attitude and values prevention components
- a value stance regarding drug use and the confidence to act on those values
- significance of social and cultural influences on beliefs
- empathy and acceptance of a diverse range of people
- individual responsibility for health and universal health protection
- personal beliefs about drugs and their effects on decisions
58
skills components of prevention
- ability to communicate constructively with parents, teachers, and peers
- giving and receiving care in a variety of health-related situations
- setting short and long term health goals
- demonstrating conflict, aggression, stress, and time management skills
- identifying and assessing personal risk and practicing universal protection
- developing assertiveness and dealing with influences from others; working effectively with others; and coping with change, loss, and grief
59
prevention strategies
information strategies, normative education, perceived harm education, social influence education, advertising pressures education, protective factors, resistance skills, competence enhancement skills training, persuasion strategies, counselling strategies, tutoring/teaching strategies, peer group strategies, family strategies, recreational activities, harm minimization/harm reduction, affective education, resilience development
60
effective programming components
bonding
cognitive competence
clear and positive identity
resilience
self-determination
61
the goal of family skills programs is
not only to decrease substance misuse, but to positively affect parent-child family relations by increasing family cohesion, decreasing family conflict, and decreasing family health and social problems overall
62
family programming options
information sharing (harm reduction)
parental skills training
parent support (counselling for parents)
family interaction (family counselling)
63
competencies are
essential skills, knowledge, attitudes, values, specific, measureable
64
technical competencies (considered “hard skills” of counselling)
understanding substance use
understanding concurrent conditions
case management
referral
community development
counselling
crisis intervention
family and social support
group facilitation
medication
outreach
prevention and health promotion
program development, implementation and evaluation
record keeping and documentation
screening and assessment
65
individual counselling
psychotherapy, brief solution-focused therapies, feminist approach, narrative therapy, confrontation
66
psychotherapy overview
- broad title for a host of talk therapies
- belief that substance abuse is a function of some underlying psychopathology
- attempts to facilitate a major personality change through personal insights, relying on historic events, major life developmental stages, and traumas as a guide
67
contemporary psychotherapy
strengths-based approach
68
six principles of psychotherapy
- clients with addiction issues can recover, reclaim, and transform their lives
- focus is on individual strengths, not deficits
- community is viewed as an oasis of resources
- client is the director of the helping process
- worker client relationship is primary and essential
- primary setting for work is the community, not a residential facility
69
brief solution-focused therapies
- brief sessions directed by counsellors
- uses client’s strengths to build a solution; goals are typically practical and concrete
70
parsimonious approach
counsellors is encouraged to take the most direct route to a solution, using the simplest and least invasive treatment option
71
common components FRAMES
Feedback of personal risk due to drugs
emphasis on personal Responsibility of pt
Advice to change behaviour
a Menu of options to reduce drugs
Emphatic counselling
Self-efficacy for client
72
feminist approach
integrates the bio-psycho-social approach to addiction with the person-in-environment context, along with empowerment principles and practice
73
key constructs of feminist approach
- personal is political
- choice
- equalization of power
74
core constructs of feminist approach
- consciousness raising
- social and gender role analysis
- resocialization
- social activism
75
goals of feminist counselling
- symptom removal
- increased self-esteem
- improved interpersonal relations
- competence in role performance
- resolution of target problems through problem solving
- increased comfort with body image and sensuality
- encouragement of political awareness and social action emphasizing independence, autonomy, and personal effectiveness
76
narrative therapy goal
to externalizer the drug use, shifting away from labels. clients begin to see themselves as something other an the label
77
does narrative therapy involve working collaboratively with the counsellors?
TRUE
78
when working collaboratively with the client, they discover…
alternative storylines
79
counsellors focus (3) in narrative therapy
- meaning people make of their lives
- language used in creating meaning
- power relationships in which the client is involved
80
primary themes in narrative therapy
- realities are socially constructed
- realities are constituted through language
- narrative organizes and maintains reality
- there are no essential truths
- our lives are storied
- identity is generated through stories
- people are not problems
- problems are to be externalized
- deconstruct problems
81
what is confrontation
process by which a therapist provides direct, reality-oriented feedback to a client regarding the client’s own thoughts, feelings, or behaviour
based on belief that drug users tend to deny or fail to recognize the reality of their problems
82
johnson model of intervention
through creation of crisis state that oriole would be adequately motivated to change and by precipitating a crisis by forceful confrontation this process can be enhanced
83
verbal confrontation is the most effective means of….
engaging and changing addictive behaviour
84
what are some impacts of addiction on parenting
adverse health and child developmental outcomes
high risk of child maltreatment
attachment disruption
inter-parental conflict
child exposure to domestic violence
85
family orientation
involves informing family members about rehab programs the client is beginning — used to enlist family support in treatment
86
family education
inform members about family-relation issues and how they may be relevant to substance abuse and the user
87
family counselling
bring about the resolution of problems identified by family members as related to substance use
88
family therapy
bring out significant and permanent changes to difficult areas of family dysfunction related to substance use
89
themes in family counselling
- no individual can force someone to change
- personal change comes through accepting responsibility for own behaviour
- all members are involved in the problem
90
stages in family counselling
1. attainment of sobriety and unbalancing the system
2. adjustment to sobriety & stabilizing the system
3. maintenance of sobriety & rebalancing the system
91
four steps in family counselling
- family engagement
- relational reframing
- family change behaviour
- family restructuring
92
relational reframing
interventions designed to move away from individual ways and toward an understanding focused on relationships
93
what is craft
community reinforcement and family training
94
craft consists of
engages non-using family members to affect the behaviour of substance users
stresses the importance of relationships in treatment process
active listening is stressed
emphasis on self care
95
when not to engage in family counselling
- alcohol related crisis thats urgent
- high risk of violence
- if leads to blaming or labelling
96
group counselling
proper guidance users can help eachother
validate subjective experiences by comparing with like experiences of others
97
group purposes
socialization
self concept formation
behaviour change
emotional and instrumental aids
psychoeducation
98
curative factors of group work
- instillation of hope
- universality
- development of social techniques
- role modelling
- interpersonal learning
99
contingency management
arranging person environment so positive consequences = desired behaviours & negative/neutral consequences = undesired behaviours
100
core principle of contingency management
monitoring of target behaviour, quickly rewarding desired behaviours, withholding rewards with undesired behaviour
101
behavioural contracting & the steps
Usually a written contract between two parties
Explicitly defines a set of behaviours and associated
consequences
Ensures all parties agree to expected behaviours, appropriate reactions, how behaviour change will be recognized and rewarded
1. establish clear recovery goals
2. identify specific behaviours
3. identify support people
4. identify behaviour options for support people
102
four stage procedure of problem solving skills
problem identification
description of behavioural options or alternative responses
evaluation of each behavioural option for its possible outcome
employing the best behavioural option based on the best probable outcome
103
cognitive rehabilitation
training in focusing, sustaining & dividing attention, discrimination b/w cues, inhibition, differential responding to cues
104
interpersonal skills training may increase the person’s
real control over stressors by compensating for skill deficiencies or increase individuals perception of control over stressors
105
vocational skills
poor employment
106
vocational skills education usually involves
assertiveness training and instruction in other skills for dealing with coworkers and employers
107
CBT
developing tactics to resist acting on cravings and urges, thus disrupting established substance-related behavioural patterns, limiting the damage from reoccurrences and learning adaptive, alternative, and healthier behaviours
CBT teaches you coping skills for dealing with different problems. It focuses on how your thoughts, beliefs and attitudes affect your feelings and actions
Process of drug use, including reoccurrence, can be controlled by making new cognitive and emotional and, therefore, behavioural choices
108
DBT
mix b/w CBT & mindfulness
109
DBT intended to
- improve client motivation to change
- enhance client capability
- generalize new behaviours
- structure the environment
- enhance counsellors capabilities & motivation
110
DBT activities
- brief mindfulness
- self soothe with senses
- emotion regulation
111
mindfulness
contemplative practices relating to developmental of a state of awareness characterized by an attentive & non-judgemental monitoring of moment-by-moment cognition, emotion, sensation, and perception
112
mindfulness consists of 3 core elements
intention, attention, attitude
113
community reinforcement approach
designed to rearrange vocational, family and social reinforcers
sobriety is rewarded & using results in “time out” from positive reinforcement
Based on the belief that environmental contingencies can play a powerful role in drinking or drug use, and that substance misuse is heavily influenced by social and occupational environmental stressors
Increase life satisfaction in areas to decrease positive reinforcement of drugs
114
self help groups
informal method of social support providing informational, effective, and instrumental support
based on principle of reciprocity = giving and taking
115
fundamental principles to be assessed in self help groups
- social support it provides members
- education & info sharing
- new identity formation
- affiliation & development of a sense of community
- personal growth & transformation
- advocacy & collective empowerment
116
AA
- consists of individuals recovering from alcohol misuse who provide help to other active users as a step to maintaining their own sobriety
- 12 step
117
other 12 step programs
- NA
- cocaine anonymous
- gamblers anonymous
- sex addicts
118
women for sobriety
no drinking, + thinking, believing one is competent, growing spiritually
instead of moving to god for help (AA), WFS asks to discover why initially became dependent
119
SMART recovery
facilitator-led, structures peer discussions on CBT techniques
relational emotive behaviour therapy as foundation
Group-based and facilitator-led with a focus on self-empowerment and identifying irrational beliefs that may be leading to substance use
The client’s irrational beliefs and negative thoughts create emotional distress which can lead to substance use as an unhealthy coping mechanism
The facilitator uses cognitive behavioral therapy techniques to assist the client in recognizing the impact of unhealthy thoughts
120
SMART recovery 4 point program
building & maintaining motivation
coping with urges
managing thoughts, feelings, behaviours
living a balanced life
121
rational emotive behaviour therapy
identifying self-defeating thoughts and feelings, challenge the rationality of those feelings, and replace them with more productive beliefs
present focused approach to understand how unhealthy/negative thoughts and beliefs create emotional distress and unhealthy actions
122
secular organization for sobriety
uncomfortable with spiritual aspects of AA
encourages members to admit they are dependent and work towards total abstinence
123
rational recovery
self empowered recovery
view addiction as behavioural problem
drug use is an irrational choice
124
moderation management
reduce intake and make positive lifestyle changes
30 days of abstinence followed by assessment to choose abstinence or harm reduction
goal to find balance
125
four pillar model
treatment, prevention, harm reduction, enforcement
126
what is daytox
outpatient setting
127
detox
first step in treatment process
requires detox from ALL substances
centres predominantly non-medical
residential settings
128
rapid/ultra-rapid detox
one night residential stay
withdrawal precipitated by opioid antagonists (naltrexone or naloxone)
discomfort avoided by sedating
129
case management
worker performs ongoing assessment, treatment plan adjustment, coordination of required services, monitoring and support, development of discharge plan
130
community based (outpt counselling)
least intrusive
take knowledge from counselling & apply directly into issues of daily living
individual & group counselling
less disruptive of life
Good for individuals who are free from significant medical problems; are self-motivated; have support systems in place (family, friends, work); live within easy access to facility; have not had personal or work life extensively affected by use
131
housing first
goal to develop long-term skills to maintain own residence
increases probability that the marginally housed or homeless will follow through with addiction treatment
component of harm reduction approach
Housing First’ is a recovery-oriented approach to ending homelessness that centers on quickly moving people experiencing homelessness into independent and permanent housing and then providing additional supports and services as needed
132
relapse prevention
goal to provide continuing encouragement, support, and additional services
relapse treated not as failure but as learning opportunity
133
goals of relapse prevention treatment
functional analysis, determining triggers, consequences of use, and skill building
134
concurrent disorders
situation when an individual suffers from at least one substance-related/addictive disorder as well as at least one other mental disorder
135
trimorbidity
co-occurrence of post traumatic stress disorder, traumatic brain injury, and a substance-related/addictive disorder
136
half the pts with schizophrenia have a
concurrent substance use disorder
137
development of concurrent disorders
stress/trauma, acute stress and chronic stress, impulsivity all increase risk of developing addictive disorder
138
screening for a concurrent mental illness or addiction is recommended with the presentation of either condition t/f
TRUE
139
how do you treatment concurrent disorders
sequential (serial) treatment, parallel care, integrated care
140
7 components of integrated care
integration of services
comprehensive approach
assertiveness
reduction of negative consequences
time-unlimited services
adapting interventions
multiple psychotherapeutic modalities
141
what’s a key strategy in relapse prevention related to concurrent disorders
pt education
142
why infectious disease a common complication
sterile technique (drugs contaminated by pathogens)
contamination (sharing needles, decrease immunity, malnutrition, unclean settings)
143
hospitalized MMT client
improves health outcomes
decreases spread of HIV
may require higher doses to control pain
144
MMT should be continued while client treated for other medical/surgical interventions T/F
TRUE
145
endocarditis
bacteria infect valves of heart
bacteria normally found on skin
higher IV users
treatment with antibiotics
146
necrotizing fasciitis
special danger for cocaine users
infection in subcutaneous tissues that are attacked by bacteria normally found on surface of skin
147
cellulitis
use of dirty needles, risk of sepsis if not treated with antibiotics
148
pneumonia
acute infection of lung tissue, normally caused by bacteria
149
fungal pneumonia
common complication of HIV infection & heroin use
150
aspiration pneumonia
strong relationship to alcohol use
151
community-acquired pneumonia (CAP)
poor living conditions
higher risk for clients with co-morbid medical conditions such as diabetes who have a poor immune system
vaccination
152
tuberculosis
bacterial infection of lungs
malnutrition, intensity of exposure, poor health, SUD
153
TB kills by
invading the pulmonary system & can infect virtually every organ in body
154
TB transmitted through
droplets via sneezing
can be dormant or become active if immune system low
155
AIDS
not a dose but constellation of symptoms, most important the destruction of individuals immune system
156
smoking tobacco & drinking speeds up the progression to AIDS T/F
TRUE
157
how is HIV transmitted
male-to-male sex most common
unprotected heterosexual intercourse
sharing needles
158
AIDS and suicide
period of greatest risk appears to be the period immediately after the individual learns they are infected
159
how frequently should HIV test be repeated in SUD
every 5 years
higher risk every year
injection drug use = 3-6 months
160
viral hepatitis
inflammation of liver
161
hep B
transmitted through razor, toothbrush, IV, sex
consequences of HVB = 20% develop cirrhosis
162
hep C
slowly destroys liver over 20-30 yrs
IV use
163
what increases the progression of hep C
alcohol and marijuana
164
hep C pt teaching
medication available
reportable disease, notify partner
harm reduction (needle distribution, free contraception, avoidance of alcohol)
165
symptoms of hep
fever
headache
jaundice
gi symptoms
166
vaccinations for SUD clients
hep A
hep B
influenza
pneumovax 23
tetanus & diphtheria
167
behavioural competencies
flexibility, decision making, person centred change, collaboration, continuous learning, effective communication, interpersonal rapport
168
cultural competency
be open and self aware
understand yourself and work to understand those different from you
engage in supportive interactions
recognize the prejudice that exists
engage in continuous self-reflection
169
school based programs should
be evidenced informed
involve parents and wider community
involve entire school
be taught in a sequentially developmentally and appropriate curriculum
based on students expressed needs and responsive to their developmental, gender, language
be initiated before drug use begins
be harm minimized focused
interactive techniques
used trained peer facilitators
focus on drug use that is most likely to occur initially, to minimize experimentation that becomes integrated
170
ineffective programming
single shot assemblies by former drug dependent person
non integrated programming with no evaluation
inadequate facilitator training
inconsistency
presentations where abstinence is ONLY criteria
no parental involvement
171
what works for prevention
knowledge
attitudes about drug use
drug refusal based interpersonal skills
intrapersonal skills
active involvement
172
day treatment
More intensive, structured non-residential treatment
Typically four or five days/evenings per week, 3-4 hours per session
Involves group activities ranging from formal sessions to education to recreational activities
Home environment just be stable and have support
Appropriate for those who are able to maintain social competence
Aim to develop sense of community support and responsibility
173
approaches that include mindfulness
Acceptance and Commitment Therapy: incorporates mindfulness and acceptance, and commitment and behaviour change processes
Mindfulness-Based Reoccurrence Prevention: self-compassion and acceptance; combines: mindfulness-based stress reduction, mindfulness-based cognitive therapy, and reoccurrence prevention
Mindfulness-Oriented Recovery Enhancement: formal mindfulness meditation, debrief and group process, psychoeducation/didactic material, experiential exercise
