FINAL EXAM Flashcards
Addictions can be described as…
a condition of being habitually or compulsively occupied with or involved in something
T/F: a person can be psychologically addicted without being physically addicted
True
Although any person may become addicted, which of the following could predisposition a person to be addicted?
socioeconomic factors, physical health, home environment, parents with mental health diagnosis
T/F: alcoholics are self-indulgent people who lack willpower
False
a person usually enters in drug/alcohol treatment because…
they are facing a negative consequence if they continue to use
the benefit of hospital detoxification is…
ability for medical detoxification
a benefit of an Outpatient Treatment program is…
it assists the person to deal with their addiction and their environment stressors at the same time
interventions work best when…
the intervention is organized and directed by a professional counselor
a client will gain greater peer feedback through…
group counseling
relapse is part of recovery; on average it takes how many attempts for a person to quit smoking?
7-8
motivational interviewing works well with…
people who are resistive or in denial
group counseling is effective when…
members have similar issues and provide empathy
T/F: in order to help clients with their problems you should self-disclose and share about yourself
False
T/F: people who have family members who are addicted to drugs and/or alcohol can be guaranteed that they will have difficulty with addictions
False
List 5 possible settings for treatment
inpatient treatment, outpatient treatment, halfway houses, supportive living, self-help
T/F: through medications a person can totally rid themselves of alcohol addicitons
False
T/F: people with addictions can often quit on their own
False
which of the following are motivators for people to seek treatment for addiction…
legal problems, relationship issues, employment issues, financial problems
when a person enters detoxification program they can expect to stay…
until physical dangers have passed
inpatient treatment should be considered after…
person has failed at staying clean/sober in an outpatient treatment program
a difference between self-help and treatment is…
self-help is peer driven
the purpose of a treatment halfway house is…
to help a person adjust to living without using substances with supports
T/F: to treat addictions a counselor must be in recovery themselves to be effective
False
individual counseling provides an individual with…
setting to discuss issues they cannot discuss in group
list at least 4 ingredients used to make methamphetamine that a person would not normally ingest
ether, freon, red phosphorous, gasoline, iodine, prozac, laxatives, drain cleaner
Why group therapy sessions?
therapeutic, educational, work with more than one client at a time, focus on special needs, group feedback, unique learning advantages
the counseling group is…
issue-oriented, issue-focused, growth-oriented, provides empathy and support,
the group counselor…
facilitates interaction among members, keeps the focus, uses verbal and non-verbal techniques, helps clients learn from each other, help establish personal goals
psychoeducational groups are…
short term, imparting information, sharing common experiences, teaching people how to solve problems, offering support, helping people develop own support system, development of specific skills, greater understanding, deal with difficult issues/situations
personality and character traits of group leaders…
presence, personal power, courage, willingness to confront oneself, sincerity, authenticity, sense of identify, belief in the group process, inventive, creative
skills of group leaders…
always growing and improving, enter another’s life without losing own, provide safe environment for clients, help others while being humble, clear boundaries between professional and personal, help others care for self, able to accept feedback
issues for new group leaders…
initial anxiety, self-disclosure, dealing with a system (NYS health systems)
leadership skills…
active listening, restating, summarizing, clarifying, confronting, questioning, interpreting, reflecting, supporting, empathizing, facilitating, initiating, setting goals, evaluating, feedback, protecting, listening, terminating, modeling
most important step of closing the group…
summarization
opening and closing the group…
tell them what you are going to tell them/discuss –> tell or discuss –> summarize what you tolf them/discussed
things to continually question in the group…
the “what”, “how”, and “why” of the group
rights of group participants…
informed consent, pre-group disclosure
pre-group disclosures
purpose, format, appropriate for needs and group concerns, congruency with values and beliefs, responsibilities of members
solution-focused in brief therapy groups…
future-focused, goal-oriented, shifts focus from problem solving to complete focus on solutions (positive orientation)
why do treatment planning…
guide client and counselor through process of change, gauge progress, maintain consistency when inevitable changes happen and between service providers
how is treatment planning developed…
client statement of problem (definition) –> goal –> objective –> interventions
definition
client defines their problem, perception of problem; should be a quote from the client
goal
overall main focus of change; should be an end result, reflects solving problem stated
objective
broken down parts of goal that need to be achieved; main issues but not as general as main goal
intervention
small steps to reach each objective; usually short term, quickly achieved, time limited, demonstrated by action/behavior; what client and counselor agree upon doing to achieve the objective
DSM-5 Substance Use Disorder
must meet 2/11 criteria over a 12 month period; eliminated “legal problems” criteria, added “cravings”, includes/defines “cannabis withdrawal”
criteria for Substance Use Disorder…
failed role, hazardous use, social problems, tolerance, withdrawal, use longer/larger amounts, unable to reduce amounts, time spent seeking/using, activities given up, use despite problems, craving
craving
strong desire /urge to use the drug/drink that interferes with thinking and actions
specifiers
extensions to diagnosis to further clarify
SUD Specifiers - Remission
no SUD criteria present; early = ≥ 3 months < 12 months; sustained = ≥ 12 months
SUD Specifiers - Severity
symptom count; 0-1 = no SUD; 2-3 = mild; 4-5 = moderate; 6+ = severe
SUD Specifiers - In a Controlled Environment
rehab; jail
SUD Specifiers - on Maintenance Rx
opioid agonists; opioid antagonists; tobacco (eg Bupropion, varcenicline); alcohol (eg Acamprosate, naltrexone)
DSM-5 Substance Related and Addictive Disorders
alcohol use, opioid use, cannabis, sedative-, hypotic-, anxiolytic- use, stimulant use, hallucinogen use, gambling
Substance Induced Disorders
bipolar, depressive, anxiety, sleep disturbances, delirium, sexual dysfunction, neuro cognition
Reasons for Documentation
-to keep track of what has happened in each session
-to track progress or lack of
-counselors see between 30-70 clients a week, documentation will help counselor keep interactions separate
- documentation is what is billed
-marks the treatment
-it assists other staff and counselors to pick up where you left off
-documentation must happen for each interaction with the client
-cannot be altered
-should be brief but include what was happening during the interaction
-must be clinical, not a tool to express yourself
-the note should be factual
What Should be Included in Documentation
-basic observations
-review of toxicology reports
-any issues that you and the client discuss
-theoretical approach to guide discussion
- opinions to solve issues
-discussion of any unresolved issues from last session
-plan to address needs.
Structure of Notation in Documentation
-the notes are usually called progress notes because they should be documenting progress
- an easy way to write notes if you’re struggling is SOAP notes
S subjective
O objective
A Assessment (or impression)
P Plan
When do you Document?
-each interaction with client
-ASAP
-most notes should be made on the same day of interaction or according to your agencies standards
-while meeting the client
Concurrent Documentation
Person-centered approach supporting client involvement and providing
Definition: collaborative/concurrent documentation is a process in which clinicians and clients collaborate in the documentation of service planning and ongoing interactions
Key Points to Documentation
-It is “client,” “writer.” no names necessary
-No note should ever state another client
-Client “seems,” “appears” those are observations, not facts.
-Documentation is a legal document, write is as such
Grief Work
the psychological process of working through a loss
-all previous types of groups may be used in a brief time frame.
- focus is on getting the task or deal with the issue in the shortest time frame
-resulted from managed care models
Open Group
can be any number of people, can come and go
Closed Group
specific number of people, no one can join after it starts
Diagnostic Impression
based on the information we’re given, we diagnose, and a doctor signs and reviews to make it official
Cannabis Withdrawal
a. stop / reduce after heavy use
b. 3 or more symptoms within 1 week:
Irritable
Nervous
Insomnia
Reduced appetite
Restless
Depressed
Pain, tremor, fever, chills, sweat, headache
Toxicology
Shows us empirical proof they’re using or not
Monitoring someone helps the client come to terms with the addiction
Not used to prove yourself right, it’s a tool to help the client
Dilution is the Solution
Drinking water can affect toxicology results
Example of the Social Workers Code of Ethics
Commitment to clients
Promote client’s self determination
Informed clients: client knows what is expected of them, and what the program entails
Competence of the social worker: don’t do something if you’re not trained to do it
Cultural competence and social diversity
Conflicts of interest
Privacy and confidentiality
Access to records: clients have access to all information in their charts
Physical contact: could make someone uncomfortable, keep the counselor and client relationship barrier
What is a Treatment Plan
the process of helping a client reach their goals
Addiction versus Habit
When a habit begins to impact parts of the person’s life like family, finance, and work, it becomes an addiction
the governing regular of addictions treatment in NYS…
OASIS
Subjective - SOAP
document information collected directly reported by the client
Objective - SOAP
document information collected from patient encounter; observable by counselor; specific and measurable
Assessment - SOAP
summary of the assessment made and how best to approach it
Plan - SOAP
Factoring in all the considerations outlined in the assessment of the case,
counselor/clinician outlines the plan to achieve the client’s recovery goals, both in terms of the
client and the counselor/clinician
