Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ACD 1 > L3: CBT for Addiction > Flashcards

L3: CBT for Addiction Flashcards

1
Q

What are the 3 evidence based treatments for addiction?

A
  • CBT
  • Motivational Interviewing
  • Contingency management
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What’s the difference between self control measures and emergency measures?

A

self control: prevent use
emergency: interrupting use during a relapse
can be difficult topic for clients (cus its like safety instructions when you fly)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Define acceptance & commitment therapy

A

guiding people to accept the urges and symptoms associated with substance abuse and use psychological flexibility and valuebased interventions to reduce those urges and the symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Define the minnesota model

A

12- step facilitation throughgroup therapy, based on the Alcoholics Anonymous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Define contingency management

A

desired behaviour is “reinforced” or rewarded

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the aim of CBT?

A

changing the pattern of problematic substance use (reducing or quitting)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is CBT?

A

umbrella term for therapies that focus on “cognitions” (thoughts, beliefs, schemas etc) & behaviour as the central driver of and solution to healthy emotion regulation
- has protocolled treatment + workbook
- has aspects of Motivational interviewing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the 3 learning principles that play a role in the dev of substance use?

A
  • Social learning: observing and imitating
  • Operant (i.e., instrumental) Conditioning: Substance use is rewarded
  • Classical (i.e., Pavlovian) conditioning: substance use is maintained Pavlovian
    associations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the self control measures (to prevent use)?

A
  • stimulus control (avoidance)
  • stimulus response prevention (alternative behaviour)
  • response consequences (reward, negative consequences)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the assumptions behind Cognitive Behavioural Therapies?

A
  • thoughts, behaviours, and emotions are learned
  • substance use is automized behaviour
  • using is rewarding, disadvantages are usually not experienced until later
  • set well considered goals
  • make inventory of risk situations
  • strengthen skills to deal with risk situations
  • therapeutic alliance is a necessary but not sufficient for change
  • focus on the here and now
  • the client as their own therapist & importance of homework
  • guided discovery as a self-reflection tool
  • scientists-practiioner approach & collaborative empiricism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the length & structure of CBT?

A

length: relatively brief (12-16 sessions)
structure: plan broken into 3-4 interconnected sections, adapted to clients needs (so still a bit flexible). within session: 1. discuss homework 2. introduce new theme 3. give new homework

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the major phases in CBT?

A
  • taxation
  • interventions
  • relapse prevention
  • conclusions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the pros of CBT?

A
  • widely applicable
  • adaptable to the wishes & circumstances of clients
  • reasonable empiricable evidence for it effectiveness
  • helps address multiple issues at once, which is good cus addiciton is very co-morbid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the 6 elements in the general cognitive behavioural model?

A

early experiences, beliefs, triggers, thoughts, feelings, and behaviours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How can the 6 elements in the cognitive behavioural model be addressed?

A

triggers:
- identify triggers & associated thoughts/feelings/behaviours
- manage triggers to prevent relapse
thoughts & beliefs:
- analyzing, challenging, accepting them
feelings:
- emotion regulation, distress tolerance, mindfulness
- dialectical behaviour therapy
behaviour:
- interventions targeting substance use & associated behaviours
- coping skills therapy
- relapse prevention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the 9 main treatment components of CBT for addiction?

A

(register substance use &craving)
- prepare for change (motivation)
- goal setting (SMART)
- self-control measures
- functional analysis
- emergency measures
- dealing w craving
- change thoughts
- refusal of offered substances
- evaluation & choose extra topics for leftover sessions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

how can you deal with craving?

A
  • seek distraction
  • surfing the urge
  • identify alternative thoughts
  • mindsurfing
  • seek social support
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How can you change thoughts (in CBT)?

A
  • thoughts actually play no role as trigger of substance use! its habit behaviour
  • we interpret certain bodily sensations as craving and then use substance
  • challenging thoughts doesnt have an added value
  • what can you do: formulate a helpful thought, like a pep talk! (ex: what would you say to a friend in the same situation?) & list dangerous thoughts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How can you decline/refuse offered substances?

A

not as exposure exercise! as role play with client
how
- react quickly
- be clear, dont hesitate
- make eye contact
- first say no
- suggest an alternative
- when pressured: ask other to stop
- change topic of convo, avoid discussion
- dont apologize or give vague answers

20
Q

What is mindsurfing?

A

identifying the positive consequences of not using, negative consequences of using

21
Q

How do you prepare for change (motivation)?

A
  • increase SELF motivation through MI
  • make cost/benefit balance (pros of abstinence, cons of use, short term & long termà
    = to provoke “change language)”
22
Q

How do you set treatment goals (SMART goals)?

A

must be
- collaborative
- abstinence or controlled use
- advice: 4-6w of absitencne
Specific Measurable Achievable Realistic Timely

23
Q

What are the 4 key cognitive behavioural therapies for addiction?

A
  • Relapse Prevention
  • Cognitive Therapy
  • Coping Skills Therapy
  • Mindfulness-Based Cognitive Behavioural Approaches
24
Q

How does CBT Relapse Prevention appoach work?

A

develop skills to identify & prepare for situations & risk factors that lead to relapse

25
Q

How does CBT Cognitive therapy approach work for addiction?

A

focus on “proximal, situational factors” like psych, emotional, behavioural variables that are triggers for drug use, and “distal background factors” like personal history, long standing cognitive, behavioural & personality variables that may act as vulnerabilities or maintaining factors for the use

26
Q

What are the 4 main components of CBT Coping Skills therapy for addiction?

A
  • relapse prevention training
  • social & communication skills training
  • training in coping w urges and cravings
  • mood management
    may also use cue exposure therapy to extinguish alcohol related cues
27
Q

How do CBT Mindfulness based cognitive behavioural approaches work for addiction?

A

purposeful attention to present & opennes to accept things as they are
- can be combined with relapse prevention

28
Q

What are variations on CBT for addiction?

A
  • BRIEF CBT: for ppl not ready to do intense treatment, for moderate to high risk users
  • LOW INTENSITY CBT: usually means less intensive for the practitioner. can be delivered by non-specialists & use range of remote & self directed tools. help increase accessibliity, flexibility, cost-effectiveness…Etc
  • DIGITAL CBT: created cause many barriers to in person treatment (long waiting lists, no anonymous, less accessibility) but might still have some methodological issues
29
Q

what are CBT interventions aimed at improving?

A
  • self control
  • coping skills
  • social skills
  • cognitions (cognitive therapy)
  • motivation (MI)
30
Q

What is a functional analysis & how do you formulate one based on a case?

A

helps clients gain insight into own behaviour
- one FA per substance
- determine function of use
- Sd: risk situations
- choosing interventions on basis of FA
- invite support person

31
Q

Define motivational interviewing

A

a collaborative, goal-oriented conversation style with special attention to change language. designed to enhance personal motivation & commitment to a particular goal by eliciting and exploring a person’s reasons for change in an atmosphere of acceptance and compassion

32
Q

How does motivational interviewing work?

A
  • patient asked emphatically about the suffering, motives for / against change, their values​​/norms/objectives, discrepancy between the situation now and the desired one
  • attempts to improve the patient’s sense of competence (‘self-efficacy’) by identifying main obstacles, by exploring past successes, and by letting them reflect on possible strategies.
  • empathetic conversation style combined with directivity to investigate patient’s ambivalence w regard to substance use and to encourage change
  • therapist guides patient towards change
  • eliciting “change” talk (i want to quit) & reducing “sustain” talk (i have to drink cause x) through open questions
  • last phase: create plan of change
33
Q

What are the 4 specific things to focus on in MI?

A
  1. Engaging: engage the client from the start by establishing trust & a relationship through good listening
  2. Focusing: establish goals WITH client. discuss what they want, work on changes they want, and do harm reduction. honor their autonomy.
  3. Evoking: elicit the clients own reasons for change, their own motivations (“change” talk). to do when you hear change talk: ask more, reflect, affirm, summarize.
  4. Planning: once enough motivation, make a (flexible) plan for how to get change.
34
Q

Why does Motivational Interviewing work better than confrontational methods?

A

Confrontation -> high levels of resistance to change & treatment. cus if ppl are ambivelent feelings about their use, then a counseler strongly voicing prochange arguments makes the client evoke the other side of the ambvilence: the counterchange arguments.
MI -> client makes the arguments for change by voicing their own motivations

35
Q

How does motivational interviewing contribute to addiciton treatment?

A

more effective than confrontational interventions
- as stand alone treatment its suitable for mild forms of substance abuse
- in more severe cases its a valuable addition to CBT

36
Q

Define the “abstinence-violation effect”

A

negative emotional and cognitive response to relapsing after a period of abstinence. A person may feel guilt, shame, and self-doubt, and this may increase the risk of further relapses and hinder the recovery process.

37
Q

What should be in an emergy plan?

A
  • how do you prevent a slip from turning into relapse?
  • emergency measures
  • helpful thoughts
  • help -> who?
  • medication
38
Q

What were Skinner’s main 2 ways of addressing substance abuse?

A
  • negative reinforcement of substance use: disulfiram for alcohol abuse: form of aversion therapy cus in combination w alcohol it produces a negative physical reaction
  • positive reinforcement of desired behaviour: contingency management (get direct, small rewards like lottery tickets for desired behaviour like abstinence or showing up to therapy)
39
Q

What are the main psychopharmacological interventions in substance use disorders & how they work (in terms of 4 different ways in which they can support CBT)

A
  • detoxification
  • aversive drugs
  • anti craving medication
  • preservation treatment
40
Q

How does detoxification work as a treatment for substance abuse and as a support to CBT?

A

patient stops using drugs
- in alcohol detox, meds used to reduce withdrawal symptoms (benzos) & to prevent seizures / deliruim
- in opiod addiction, abuse is gradually reduced after being administered & while being monitored. usually opiate first replaced w methadone or naloxone, after which this new drug can be reduced or an serve as basis for opioid maintenance therapy (preservation treatment).
- these replacement drugs can help patients get their lives back on track

41
Q

How do aversive drugs work as a treatment for substance abuse and as a support to CBT?

A

Disulfiram prevents alcohol in the body of breaking down, resulting in nausea, headache, dizziness, sweating and palpitations.
most effective when taken under supervision of a partner / doctor (to increase treatment compliance).

42
Q

How does anti craving medication work as a treatment for substance abuse and as a support to CBT?

A
  • naltrexone -> obstruction of opiod receptor -> reduced rewarding effect of alcohol + opiates -> reduced craving
  • can be initiated while patient is still drinking
  • relatively ineffective for chronic alcholoics
  • can work for gambling addiction
  • acamprosate -> inhibits affect on glutametergic system -> reduced craving for alcohol after abstiencne
  • nalmefen, similar to naltrexone, but fast acting and can even be taken preventatively on days when patients feels increased risk of relapse
43
Q

How does preservation treatment work as a treatment for substance abuse and as a support to CBT?

A
  • involves prescribing medicatino that has the same chemical properties as the drug to which person is addicted -> withdrawal symptoms & craving prevented
  • usually for more “chronic” addictions like opiod addiction
    most common meds used: methadone & naloxone
44
Q

What is cue exposure?

A

triggers offered in absence of the opportunity to consume the substance
idea behind it: pavlovian association weakened in this way
but research showed that its very hard to erase associations once they are formed
so now in cue exposure: the unwanted behaviour is replaced w a new desired behaviour, so that a new association is created that can compete w the old association

45
Q

What is surfing the urge?

A

Learning to experience and accept craving as a normal response to conditioned stimuli, that will subside by itself.
* Phase 1: The craving presents itself.
* Phase 2: The craving gets bigger and bigger as long as you don’t do anything about it and don’t give in to what you normally would
* Phase 3: And eventually the craving diminishes.

ACD 1 (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions