lab 4 and 5- withdrawal, harm reduction, intro to psychotherapy Flashcards
history
things to know
- ask about substances in non judgemental way
- assume they are using something
- give wide range of numbers of days of use
- review other use of substances
- last use
- previous withdrawal experiences
- seizure history
- other health problems
signs and symptoms
alcohol withdrawal
- sweating
- increased pulse/temp/BP
- tremors
- N+V
- anxiety/agitation
- tactile and auditory disturbances
signs and symptoms
opiate withdrawal
- dilated pupils
- gooseflesh skin
- stomach cramps/diarrhea
- rhinorrhea
- light sensitivity
- myalgia
- restless
- increased pulse
AWS (alcohol withdrawal syndrome)
diagnostic criteria (2), assessment tool
- clear evidence of cessation of prolonged use
- symptoms are not accounted for by a medical disorder
- use CIWA to measure
AWS (alcohol withdrawal syndrome)
scoring
less than 8: mild withdrawal
8-15: moderate withdrawal
greater than 15: severe withdrawal
minor AWS
will last about 48 hours
- autonomic and motor symptoms
moderate AWS
will last about 6 days
- illusions and hallucinations
severe AWS
will last about 14 days
- delirium shows up at 48 hours
- paranoia and disinhibition
seizures
occur primarily during early phase of withdrawal
delirium
occur in late stages of AWS
- perceptual changes, confusion, changes in LOC
- agitation/hyperarousal
alcohol withdrawal interventions
- seizure precautions
- encourage fluids
- CIWA q 1-4 hours
- antiemetics, electrolytes
opiate withdrawal interventions
- decrease discomfort
- use COWS q 1-4 hours
- symptom management
- fluids
- suboxone
4 pillars of healthy drug and alcohol policy
- prevention
- treatment
- harm reduction
- enforcement
abuse
definition (substance)
person is misusing
abuse –> addict
there must be a degree of tolerance and elements of withdrawal
moral model
substance use is a moral weakness and is indicative of an individuals character
drug-set-setting model
a way to think about how problems with drug use come about
drug
drug-set-setting model
potency, action, delivery, legality
set
drug-set-setting model
persons physiology, emotional state, motivation, cultural identity
setting
drug-set-setting model
stress/support factors, people using with, social/cultural attitudes
psychotherapy
definition
treatment using psychological methods through collaboration and conversation
goal of psychotherapy
teach person skills to manage current and future problems in a healthy way
- improved self concept and increased sense of agency
ways to develop competence in psychotherapy
3
- workplace learning
- structured courses
- certification program
CBT
characteristics
problem oriente therapy that focuses on present and future
- structured short term format
- requires insight and self awareness
CBT teaches person to
identify, and challenge dysfunctional patterns of thinking and behaving
Becks negative cognitive triad
self, future, others/world
CBT process
identify –> examine –> respond
C in CBT
techniques designed to help people detect, evaluate, and modify inner thoughts as well as identify thoughts associated with emotional symptoms
B in CBT
tracks how you behave when you have certain thoughts
- actions connected to the way we feel
most difficult thinking styles to change
3
global, rigid, over generalized
core beliefs
absolute rules for interpreting information related to self esteem
- arent directly observable
DBT
definition
follows CBT based approach but emphasizes psychosocial to help people who react in a more intense manner
DBT characteristics
- used for patients with borderline personality disorder
- balances change and acceptance with validation
skills learned from DBT
important for final
- mindfulness
- emotional regulation
- distress tolerance
- interpersonal effectiveness
distress tolerance
getting through crisis without making things worse and accepting reality
interpersonal effectiveness
maintaining relationships and increasing self respect
when to use distress tolerance skills
when you cannot leave or change the situation
- eg. snapping rubber band on wrist
emotional regulation skills
logic or cognitive based techniques used to understand and change emotions
interpersonal effectiveness skill
DEAR MAN
- describe
- express
- assert
- reinforce
- mindful
- appear
- negotiate
motivational interviewing
characteristics
- highly useful for people considering change
- asking questions in a specific way to have person want to change certain things
- about developing persons motivation to change
motivational interviewing
definition
method for enhancing intrinsic motivation to change by exploring and resolving ambibalence
conviction
importance of the change to the person
- related to relevance and impact they feel it could have
confidence
how capable a person feels to make change
- related to their sense of control and previous experience with change
interventions to increase conviction
- provoke expression of their benefits
- reinforce emotional benefits of change
- provide information on benefits of changing the behavior
interventions to increase confidence
- remove barriers
- help find strategies
- build on prior success
types of summaries
3
- collecting
- linking
- transitional
transitional summary
used to gather info that the client has given to you and then move them to next steps
