Treatment Models for Substance Abuse

Question 1

What is Behavioral and Cognitive Practices?

Answer 1

Effective for alcohol and other drug dependencies, includes behavioral self-control training.

Question 2

What are some components of Behavioral practice treatment?

Answer 2

Community reinforcement, behavior tracking, social skills training, couples/family counselling, self-control training.

Question 3

What are some cognitive behavioral assumptions with substance abuse?

Answer 3

Involves complex cognitive and behavioral process, is largely learned and can be modified.

Question 4

What is a major goal for CBT?

Answer 4

To teach coping skills to resist substance use and to reduce problems.

Question 5

What does CBT (Cognitive Behavioral Therapy) counselling require?

Answer 5

Careful review of the unique components of each clients substance use as well as warm, supportive, collaborative counselling relationships.

Question 6

What are some CBT interventions that target “triggers”?

Answer 6

Social, environmental, emotional, cognitive, physical, and useful techniques such as ride the craving wave/surf the urge.

Question 7

What is behavior contracting?

Answer 7

Counselor and client contract, external incentives such as vouchers, groceries, movie theater tickets.

Question 8

What is CRAFT (Community Reinforcement and Family Training)?

Answer 8

Work with concerned others. More constructive ways of interacting. Natural consequences.

Question 9

What are brief interventions?

Answer 9

Includes FRAMES, often delivered by other professionals, target to those in early stage of change.

Question 10

What is FRAMES?

Answer 10

Feedback, responsibility, advice, menu of alternatives, empathy, self-efficacy.

Question 11

What is solution focused counselling?

Answer 11

Focuses on successes, achievements, strengths, resources, and abilities of the client. Research is positive with treatment plan based reinforcement.

Question 12

What is motivational interviewing?

Answer 12

Created by William Miller, it enhances the change process, is relationship centered, client-centered, collaborative, has an attitude and set of techniques.

Question 13

What does motivational interviewing include?

Answer 13

It includes and makes use of Prochaska and DiClemente’s Transtheoretical Model of Change (Stages of Change).

Question 14

What are the stages of change?

Answer 14

Pre-contemplation, contemplation, preparation, action, maintenance and relapse.

Question 15

What is pre-contemplation?

Answer 15

Stage 1. Denial about the situation/addiction. Unable to see the negative consequences of what they are doing.

Question 16

What is contemplation?

Answer 16

Stage 2. Considering change, ambivalent about the situation. Starting to see the problems.

Question 17

What is preparation?

Answer 17

A half stage of contemplation, where the subject is determined to change, and begins thinking about a plan.

Question 18

What is action?

Answer 18

Stage 4, where the change is implemented.

Question 19

What is maintenance?

Answer 19

Stage 5. Maintaining the change and the positive behaviors.

Question 20

What is relapse?

Answer 20

A stage that can happen at any time. A normal part of change. Signals a need for additional change. If relapse loops occur, the stages must be restarted from wherever the relapse occurred.

Question 21

What is resistance?

Answer 21

Exchange in which client appears to work against the change.

Question 22

What happens with Welcome Resistance?

Answer 22

Sign of turning point in the relationship. Time to do something differently, switch direction. Strategy: roll with resistance.

Question 23

What are the primary principles of helping clients achieve change?

Answer 23

Expressing empathy, developing discrepancy, rolling with resistance, support self-efficacy.

Question 24

What are some techniques for early on in the process?

Answer 24

Asking open ended questions. Reflective listening in which you repeat back what the client is saying. Affirmation, enhancing strengths. Summerization, eliciting change talk.

Question 25

What are some aspects of summerization?

Answer 25

Collecting (recaps to maintain momentum), linking (relate current to past information), and transitional (shift topic focus).

Question 26

How do you reduce the rate of resistance?

Answer 26

Maximize change talk, reduce resistance talk, reflection responses (simplified, amplified, shifting focus, re-framing, agreement with twisting).

Question 27

What are some traps of resistance?

Answer 27

Question/answer, confrontation/denial, expert, labeling, blaming, premature focus.

Question 28

What are some things that are used to guide the change process and enhancing confidence?

Answer 28

Builds self-efficacy, strategies such as reviewing past success, examining personal strengths and supports, creating hypothetical change.

Question 29

What are some components of strengthening commitment?

Answer 29

Highlights accomplishments, share advice with permission, use change plan, written plan of change (setting goals, considering options, etc).

Question 30

What is harm reduction?

Answer 30

Based on client advocacy, compassionate pragmatism (vs moralistic idealism), effort to reduce harm to individuals and/or society, meets individuals where they are.

Question 31

What are some components of harm reduction?

Answer 31

Routes to abstinence (warm turkey approach), tapering down, trial moderation which includes limiting intake.