Substance Use Disorders and Motivational Interviewing Flashcards
What is stage 1 of motivational interviewing?
The spirit of motivational interviewing.
What is the spirit of motivational interviewing?
A clinical approach that is collaborative, evocative, and respectful of client autonomy.
What assumptions does the spirit of motivational interviewing make?
People possess substantial personal expertise and wisdom regarding themselves and tend to develop in a positive direction if given proper conditions of support.
What is an important starting point in learning motivational interviewing?
Openness to the spirit of MI thinking about clients and consultation, at least a willing suspension of disbelief and active curiosity about the client’s perspective.
Do MI therapists evoke the client’s own motivations to change, or do they instill them?
They evoke the client’s own motivations to change.
What is the second stage of motivational interviewing?
OARS-Client-Centered Counseling Skills.
What is particularly crucial for learning MI during stage 2.
Developing accurate empathy.
What does accurate empathy involve?
Empathetic listening with accurate reflection of what a client has said as well as what the client is experiencing but has not yet verbalized.
What does OARS stand for?
O. Asking open questions. A. Affirming. R. Reflecting. S. Summarizing.
How does MI depart from client-centered counseling?
In being consciously and strategically goal-directed.
What is a key process of MI?
To help clients resolve ambivalence by evoking their own intrinsic motivations for change.
What is change talk?
Verbalizations that signal desire, ability, reasons, need, or commitment to change.
What is stage 3 of MI?
Recognizing and Reinforcing Change Talk.
What is phase 1 of MI?
The counselor focuses on enhancing motivation for change by evoking the client’s own intrinsic motives (desire, ability, reasons, needs).
What is phase 2 of MI?
The counselor shifts to strengthen and consolidate commitment to change.
What is stage 4 of MI?
Eliciting and Strengthening Change Talk.
What is a way to elicit change talk?
Asking open questions which answers are change talk.
What is stage 5 of MI?
Rolling with Resistance.
Why is it negative to refute client’s arguments against change?
Doing so, tends to reinforce the client’s argument.
What is a simple reflection?
Saying something like, “You don’t think of yourself as a problem drinker.”
What is an amplified reflection?
Thecontentisexaggerated,overstated,or
intensified(tocountersustaintalk).
What is a double-sided reflection?
Bothsidesofambivalencearecontainedina
singlereflectiveresponse.
What is stage 6 of MI?
Developing a change plan.
What is stage 7 of MI?
Consolidating Client Commitment.
What does the counselor look for during stage 7 to strengthen a commitment?
Commitment language.
What is commitment language?
A naturally occurring set of speech acts that are present when, for example, people enter into a verbal agreement.
What is stage 8 of MI?
Switching between MI and other counseling methods.
When is MI not needed?
When a client presents for treatment already ready for action.
What does Alcoholdehydrogenase1Benzyme do?
It metabolizes alcohol.
Which variant of the Alcoholdehydrogenase1B(ADH1B)geneis associated with increased alcohol consumption?
The G (Arginine variant) allele.
Which variant of the Alcoholdehydrogenase1B(ADH1B)geneis associated with decreased alcohol consumption?
The A (Histidine variant) allele.
How does Disulfiram work?
It inhibits the enzyme acetaldehyde dehydrogenase, leading to increased sensitivity to negative alcohol effects.
What is sustain talk?
It is when the client is talking about the change, but mainly talking about why they can’t do it.
What are examples of preparatory language (DARN)?
D. Desire. A. Ability. R. Reason. N. Need.
What are examples of mobilizing language (CAT)?
C. Commitment. A. Activation. T. Taking steps.
What is tolerance?
A subjects’ reduced reaction to a drug following its repeated use.
What is psychological dependence?
Dependence that involves emotional–motivational withdrawal symptoms (e.g., dysphoria and anhedonia).
What is physical dependence?
Dependence that involves persistent physical–somatic withdrawal symptoms (e.g., fatigue and delirium tremors).
What are the four core features (symptom groups) of substance use disorder?
- Impaired control. 2. Social impairment. 3. Risky use. 4. Pharmacological criteria.
What is the order in which alcohol is metabolized?
From alcohol to acetaldehyde to acetic acid.
How does the ADH1B A variant lead to decreased alcohol consumption?
It increases the amount of acetaldehyde which leads to unpleasant effects.
Is the ADH1B A variant a protective factor when there is strong peer influence?
No.
What parental influences may lead to substance use disorder? (4)
- Lack of parental involvement and parent-child affection. 2. Inconsistent parenting. 3. Poor monitoring. 4. Negative parent-child and inter-parent interactions.
What neurological factors may underlie substance use disorder?
Greater activation in the front-limbic areas of the brain. It is associated with poor inhibition.
What symptoms are within the “impaired control” core feature of substance-use disorder? (4)
Criteria 1-4: 1. Substance is often taken in larger amounts or over a longer period than was intended. 2. Persistent desire or unsuccessful effort to cut down or control use. 3. Great amount of time spent in activities necessary to obtain substance use, or recover from effects. 4. Craving or strong urge to use the substance.
What symptoms are within the “social impairment” core feature of substance-use disorder? (3)
Criteria 5-7: 5. Recurrent use results in failure to fulfill major role obligations at work, school, or home. 6. Continued substance use despite it causing problems in relationships. 7. Important social, occupational, or recreational activities are given up or reduced because of use.
What symptoms are within the “risky use” core feature of substance-use disorder? (2)
Criteria 8-9: 8. Recurrent substance use in situations in which it is physically hazardous. 9. Substance use is continued despite knowledge of it causing problems.
What symptoms are within the “pharmacological criteria” core feature of substance-use disorder?
Criteria 10-11: 10. Tolerance. 11. Withdrawal.
According to the DSM, what is tolerance defined by? (2)
- A need for markedly increased amounts of substance to achieve intoxication or desired effect. 2. Markedly diminished effect with continued use of the same amount of the substance.
According to the DSM, what is withdrawal defined by? (2)
- The characteristic withdrawal syndrome for a substance. 2. The same (or a closely related) substance is taken to relieve or avoid withdrawal symptoms.
What are the three specifiers for substance-use disorder?
- In early remission. 2. In sustained remission. 3. In a controlled environment.
