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PYB159 End of Sem > specialist interventions > Flashcards

specialist interventions Flashcards

1
Q

interventions usually target one of three different areas,

it is important to consider all three in a wholistic treatment plan

what are the three different areas of interventions

A

The drug

The Individual

The environment

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2
Q

intervention targeting the drug

it is important to provide accurate drug informaiton

why?

A

particularly useful for those in pre-contemplation stage

  • avoids confrontation and argument
  • raises awareness
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3
Q

when providing drug information what should be portrayed and what shoudl be discussed

A

through brochures and psychoeducation

effects and side effects, dosage, methods, and potential harms

correct inaccurate or dangerous information

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4
Q

what is a major aspect of interventions targeting the drug?

A

withdrawal management (detoxification)

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5
Q

in interventions targeting the drug

what are the different settings in which withdrawal management is implemented

A 
variety of settings:
general hospital 
specialist inpatient units
outpatient clinics
home based
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6
Q

what levels of severity and service are provided and attended to at different settings of withdrawal management

A

inpatient - physical dependence requiring medical assistance

outpatient - less severe or complicated

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7
Q

what is a trend seen between withdrawal management and relapse

A

rates of relapse post withdrawal management are usually high

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8
Q

what is delirium tremens

A

condition caused by alcohol withdrawal

characterised by tremor , visual hallucinations and autonomic instability

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9
Q

what is naltrexone rapid detoxification

A

an intervention targeting the drug

naltrexone is an opiate antagonist - blocks the effects of opioids

causes a rapid withdrawal from opiates

risks associated - overdose

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10
Q

what is naltrexone maintenance treatement

A

reduced cravings, blocks effects of opiates

need to completely detox from opioids to minimise withdrawal reaction

tablet or implant avaliable

best outcome when highly motivated, employed with good support, older and with prior treatment experience

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11
Q

what is methadone maintenance treatment

A

methadone is a full opiate agonist

for those unable to cease opiate use manage withdrawal

  • maintenance over abstinence
  • preferred choice for high levels of opiate dependence

highly regulated

reduces HIV risk behaviour, criminal behaviour and risk of overdose

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12
Q

what is buprenorphine

A

parcial agonist/antagonist

maintanence treatment

can be a detoxification aid

higher doses improve retention in treatment and reduce heroin use

can be taken in 1, 2, or 3 day doses

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13
Q

compare burprenorphine to methadone maintenance treatment

A

similar/slightly less retention in treatment

reduced illicite drug use to an equivilant or greater extent

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14
Q

what pharmacotherapy anti-craving medications are there for alcohol abuse

A

campral (acamproste)
- 3 times daily dosing

Naltrexone

  • daily dosing
  • expensive

both sometimes prescribes taken together

mixed effectiveness

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15
Q

what is antabuse maintenance therapy

A

a pharmotherapy for alcohol abuse

blocks enzymes that metabolise alcohol

reacts with alcohol to make client feel very ill

more effective i used in conjunction with ongoign support

indications: alcohol use disorder with tolerance/withdrawal symptoms and abstinance goal

some risk include hepatitis

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16
Q

what forms of nicotine replacement is there

A

patches - one daily application, socailly acceptable, easy to use, steady and reliable dose

gum - best for smokers heavily dependent on nicotine - poor compliance

inhalers - plastic tube wiht inhalable nicotine

all are more effective with counselling

17
Q

what is varenicline (Champix)

A

12 week Tx for smoking

antagonist and partical agonist on receptors

  • reduces cravings
  • lowers effecs

dopamine levels

successful longer term quit rates 1-3x

best with counselling and support

not recommended for young people

18
Q

what is urine drug screening used fo r

A

screenign to identify drugs used recently - random or intermittent testing

may aid in relapse prevention - best if participating voluntarily

danger of shifting to less detectable drugs
- focus can become beating the test than on the treatment goal

19
Q

how does controlled drinking/drug use training work as a intervention for the individual

A

harm minimisation approach - used if abstinence is not the goal

requires high motivation

difficult for long-standing addiction

environmental factors = key to success (social support)

process involves

  • self-minitoring
  • develop limits and rules around consumption
  • devise strategies for high risk situation s
  • use reward s to maintain changes to behaviour
20
Q

describt self- help groups as an intervention for the individual

A

widely available
easy to set up and run
low/no cost

non-drug using social support - usually run by peers in recovery

most common = 12 step programs

  • strong spiritual based philosophy
  • require abstinence as a goal
21
Q

what are the 12 steps of the 12 step program

A 
admission 
recognition 
submision 
confession 
readiness
humility 
reparation 
apology 
integrity 
meditation 
awakening
22
Q

what is different about BT and MI based group programs compared to 12 step?

A

lead by trained facilitators

23
Q

in CBT and MI based group program

each group session teaches usefull skills to help with what 4 points

A
  1. building and maintaining motivation
  2. cope with urges
  3. learning problem solving techniques
  4. achieving lifestyle balance
24
Q

what are some tools and techniques used in 4 point programs to assist in the management of adictive behaviour

A

identifying pros and cons of problematic behaviour

recognising triggers, beliefs and consequences

coping with cravings and urges

setting acheivable goals

evaluating areas of importance

25
Q

what does the SMART acronym in SMART recovery Australia stand for?

A 
Self
Management 
And 
Recovery 
Training
26
Q

breif interventions are another means of intervention targeting the individual

A

1-5 sessions with follow up an dself help material

very focused interventins
- decision making, problem solving, goal setting, relapse prevention

useful for pre-contemplators, less severe/complicated SUD and primary care settings

results often as good or better than longer therapies in these contexts

27
Q

according to Upton and Thirlaway (2014)

key features of brief intervention include

A

focuses on reduced substance use

adress motivation

remain individualised

have features of

  • give feedback of risk
  • encourage responsibility for change
  • give options
  • demonstrate empathy
  • enhance self efficacy
28
Q

miller and sanches (1994) identified 6 key aspects of key intervention using the acrynom FRAMES

what does FRAMES stand for

A

F- feedback of personal risk or impairment
R- responsibility for change
A- advice to change
M- menue of alternative change options
S- self-efficacy or optimism in client facilitated by practitioner

29
Q

another intervention targetign the individual is

social skills training

what is the premise surrounding social skills training

A

deficient social skills leads to poor adjustment and dysfunction
> substance use is tehn used as a coping strategy

30
Q

what is the focus of social skills training

A

training in areas of deficiency

  • teach new social skills
  • goup therapy can be good setting for this

assertiveness training, anger management, relaxation training, modelling, role playing etc.

31
Q

community development is a means of intervention targeting the environment

what are the prospects of community developmet

A

generates and disseminates drug related recources to the community

prevention and intervention strategies

can raise awareness of drug issues

useful if linked to development of more comprehensive stategies for the community
- liquor licensing interventions, support groups, school based interventions

32
Q

what can employment, education and recriational opportunities do in terms of interventions targeting the environmetn

A

recognises role of social disadvantages in substance abuse problems

if successful, are strong a and protective factors agains drug misuse

opportunities to develop skills and social networks outside the drug using lifestyle

can improve sel-worth and self-esteem

introduces alternative and health lifestyle

33
Q

what are the aims of family therapy in targeting the environment

A

focus on treating and including the whole family

better treatment outcomes

  • improve complience with treatment and earlier engagement
  • can alleviate distress of significant others

members need to agree to be involved

confidentiality issues

multiple needs need to be managed - as with individual counselling

34
Q

case management is an intergention targeting the environment

what does it entitle

A

single point of contact with health and social services

client driven

advocacy

community based

felexible and culturally sensitive

link clients with appropriate services

monitor clients progress in treatment

35
Q

define rehabilitation centres as a enironmental intervention

A

meduim to long term residential programs

public and private options

generally require absinence as a goal

facilitate access to medial services, education, employment, skills training and community support

promote participation in daily running of program - therapeutic community

tend to be group based

staged reintegration programs
- 1/2 way and 3/4 way houses with less structure

36
Q

what is the common factor of predicting a therapeutic otucome

A

the quality and strength of the collaborative relationships between client and therapist

37
Q

why is matchign clients to treatments so important

A

each person is different

each intervention will work differently with individual factors influencing the suitability of different therapies

different problems require different types or combinations of interventions at different levels

38
Q

what is a clincians goal when matching a client to a treatment

A

goal is to place client into the lest intensive treatment that will most likely facilitate treatment goals

PYB159 End of Sem (5 decks)

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