Principles for Effective Treatment and Ethics

Question 1

What are the 4 main effective treatment principles?

Answer 1

• 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

Question 2

What is the Biopsychosocial Model of Addiction?

Answer 2

Overlapping Systems, Social, Psychological & Biological variables

Question 3

What are the system variables in the Biopsychosocial Model of Addiction?

Answer 3

○ National/regional public policies
○ Drug laws
○ Socio economic context

Question 4

What are the social variables in the Biopsychosocial Model of Addiction?

Answer 4

○ Intrapersonal relationships
○ Treatment and drug use settings
○ Social norms around use

Question 5

What are the psychological variables in the Biopsychosocial Model of Addiction?

Answer 5

○ Identity as user
○ Ability to cope
○ Counselling and support services

Question 6

What are the biological variables in the Biopsychosocial Model of Addiction?

Answer 6

○ Dopaminergic reward
○ Hypothalamic, Pituitary, Adrenal axis (HPA) response
○ Cortical responses

Question 7

What was Project MATCH?

Answer 7

• eight year period

- 12 step programs; CBT; MET (Motivational Interviewing)

Question 8

What are some criticisms of the Project MATCH?

Answer 8

• 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

Question 9

What has project MATCH been compared to?

Answer 9

the Titanic of treatment outcome studies

Question 10

What is informed Eclecticism (Miller & Hester)?

Answer 10

an openness to a variety of approaches that is guided by evidence

Question 11

What are the 4 assumptions of informed Eclecticism (Miller & Hester)?

Answer 11

• 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

Question 12

What were the outcomes of the Australian Treatment Outcomes Study (ATOS)?

Answer 12

• 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

Question 13

What does utilitarian mean?

Answer 13

that you judge actions as right or wrong in accordance with whether they have good consequences

Question 14

What are macro ethics?

Answer 14

framework/theory

Question 15

What are meso ethics?

Answer 15

procedural/guidelines

- applied

Question 16

What are micro ethics?

Answer 16

applied in practice

Question 17

What are barriers for mental health professionals?

Answer 17

• 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

Question 18

Under the ADCA Code of ethics, what are the Guiding principles?

Answer 18

• 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

Question 19

Under the APS Code of ethics, what are the 3 general ethical principles?

Answer 19

○ Respect for the rights and dignity of people
○ Propriety, incorporates the principles of beneficence, non-maleficence
○ Integrity, reflects the need for good character

Question 20

What is the difference between clinical decision making and ethical decision making?

Answer 20

Clinical decision making is based on evidence & Ethical decision making is based on respect, propriety, & integrity.

Question 21

What are the Forester-Miller & Davis five (5) Moral Principles proposed as the “cornerstone” of a healthy therapeutic relationship?

Answer 21

○ Autonomy
	○ Justice
	○ Beneficence
	○ Non-maleficence
	○ Fidelity

Question 22

Breaches in professional practice are most likely to occur when…

Answer 22

○ 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

Question 23

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?

Answer 23

1. identify the practical ethical problem
2. identify the client’s individual context
3. identify the duty of care responsibilities of each staff member
4. identify the values essential to responding to the problem
5. identify any conflicting values
6. identify alternative solutions to the ethical conflicts identified
7. choose the consensus option best suited to the program objectives; and
8. provide justification for the choice.

Question 24

What are the APS Guidelines on confidentiality?

Answer 24

• 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.