Principles for Effective Treatment and Ethics Flashcards
What are the 4 main effective treatment principles?
- no single treatment is appropriate for all individuals
- effective treatment attends to multiple needs of the individual, not just his or her drug use
- remaining in treatment for an adequate period of time is crucial for treatment effectiveness
- treatment does not need to be voluntary to be effective
What is the Biopsychosocial Model of Addiction?
Overlapping Systems, Social, Psychological & Biological variables
What are the system variables in the Biopsychosocial Model of Addiction?
○ National/regional public policies
○ Drug laws
○ Socio economic context
What are the social variables in the Biopsychosocial Model of Addiction?
○ Intrapersonal relationships
○ Treatment and drug use settings
○ Social norms around use
What are the psychological variables in the Biopsychosocial Model of Addiction?
○ Identity as user
○ Ability to cope
○ Counselling and support services
What are the biological variables in the Biopsychosocial Model of Addiction?
○ Dopaminergic reward
○ Hypothalamic, Pituitary, Adrenal axis (HPA) response
○ Cortical responses
What was Project MATCH?
- eight year period
- 12 step programs; CBT; MET (Motivational Interviewing)
What are some criticisms of the Project MATCH?
- Eligibility criteria: Polydrug users excluded (except THC)
- Too much focus on assessment and follow-up for research: interrupted usual therapy
- All participants attended AA groups: the 12-step group just went to more
- Abstinence was the determinant of success
- No control group
What has project MATCH been compared to?
the Titanic of treatment outcome studies
What is informed Eclecticism (Miller & Hester)?
an openness to a variety of approaches that is guided by evidence
What are the 4 assumptions of informed Eclecticism (Miller & Hester)?
- There is no single superior approach to Treatment for all individuals
- Programs/systems should be constructed with a variety of approaches that have been shown to be effective
- Different individuals respond best to different Rx approaches, and
- It is possible to match clients to optimal Rx, therefore increasing Rx effectiveness and efficiency
What were the outcomes of the Australian Treatment Outcomes Study (ATOS)?
- General functioning improved (Ross et al 2004)
- Majority of participants abstinent for the 1 month prior to 12-month follow-up
- Noticeable reduction in criminal behaviours, improved injection-related health, the decline in Depression
What does utilitarian mean?
that you judge actions as right or wrong in accordance with whether they have good consequences
What are macro ethics?
framework/theory
What are meso ethics?
procedural/guidelines
- applied
What are micro ethics?
applied in practice
What are barriers for mental health professionals?
- Lack of familiarity with AOD issues
- Stereotyped beliefs of clients
- Views on how to manage relapse vary greatly
- Concerns about lack of skills / providing ill-informed service
Under the ADCA Code of ethics, what are the Guiding principles?
- Equity and access
- The client/worker relationship
- Privacy and confidentiality
- Training & professional development
- Responsive services
- Effective and efficient services
- Reducing stress and workload issues
- Community consultation and involvement
- Ethics committee approval for research
- Advocacy in public policy and public health outcomes
Under the APS Code of ethics, what are the 3 general ethical principles?
○ Respect for the rights and dignity of people
○ Propriety, incorporates the principles of beneficence, non-maleficence
○ Integrity, reflects the need for good character
What is the difference between clinical decision making and ethical decision making?
Clinical decision making is based on evidence & Ethical decision making is based on respect, propriety, & integrity.
What are the Forester-Miller & Davis five (5) Moral Principles proposed as the “cornerstone” of a healthy therapeutic relationship?
○ Autonomy ○ Justice ○ Beneficence ○ Non-maleficence ○ Fidelity
Breaches in professional practice are most likely to occur when…
○ workloads are high
○ staff are under significant stress
○ client and clinician’s values are in conflict
○ lack of defined policies, procedures and guidelines
○ lack of supervision / support
○ lack of professional development opportunities
Application Benaroyo (2004) is an applied ethics process, the goal of which is to reach consensus decisions on ethical challenges, through structured open discussion in a series of steps: what are these steps?
- identify the practical ethical problem
- identify the client’s individual context
- identify the duty of care responsibilities of each staff member
- identify the values essential to responding to the problem
- identify any conflicting values
- identify alternative solutions to the ethical conflicts identified
- choose the consensus option best suited to the program objectives; and
- provide justification for the choice.
What are the APS Guidelines on confidentiality?
- Understand the legal context and the organisational requirements associated with confidentiality
- Informed Consent
- Only breach confidentiality when consent exists to do so, there is a legal obligation to do so or if there is an immediate and specified risk
- Only disclose what is needed to achieve the purpose of the disclosure and only to individuals who require the information
- Where safety permits, psychologists inform clients if their information is to be disclosed and what information is to be disclosed.
