Week 6 - Substance related and addictive disorders Flashcards

1
Q

What is the evidence that behavioural couples therapy works for substance-use disorders?

A
  • sometimes works better than indivudal BT, but not always
  • DOES NOT WORK FOR SMOKING CESSATION
  • Small Effect size
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2
Q

What is the evidence that family-based behavioural therapy works for substance-use disorders?

A
  • works better than TAU in reducing substance use but not in improving family functioning
  • does not work better than MI or CBT
  • small ES
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3
Q

What is the evidence that CBT for substance-use disorders in adolescents?

A
  • works better than psychoeducation for older youth (16+)
  • ES not reported
  • does not work better than psychoeducation for younger youth and does not work better than family-based therapy
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4
Q

What is the evidence for treatment of substance-use disorders long term?

A

no evidence that any treatment works long-term

Outcomes better for cannabis but still not great

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5
Q

What is the evidence that CBT + relapse prevention for substance-use disorders in adults?

A
  • works better than doing nothing, but only slightly better than doing something else
  • trivial to large ES
  • more effective women and cannabis users
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6
Q

What is the evidence for contingency management?

A
  • works better than various controls
  • benefits decrease after contingencies are withdrawn
  • small to moderate ES
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7
Q

What is the evidence that MI works for adults and adolescents with alcohol use related disorders?

A
  • works better than no treatment for some outcomes

- no consistent evidence that it works better than other active treatments

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8
Q

What is the evidence for smoking cessation and adults?

A
  • works better than TAU and in-person health warnings
  • small ES
  • does not work better than no treatment or self help
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9
Q

What is the evidence for smoking cession in adolescents?

A
  • works better than placebo, psychoeducation, brief advice, and the nicotine patch
  • trivial ES
  • keep it short: doing MI for more than an hours is associated with a NS ES
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10
Q

What is the evidence for MI/MET for adults with cannabis use disorders?

A
  • works better than no treatment and pscyhoeducation for most outcomes
  • does NOT improve motivation to quit
  • not more likely to produce abstinence than doing nothing
  • not more effective than CBT
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11
Q

What is the evidence for MI/MET for use of cocaine use in adults?

A
  • DOES NOT WORK BETTER THAN DOING NOTHING
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12
Q

What is the evidence for use of MI in alcohol use in adults

A
  • works better than no treatment for some outcomes

- no consistent evidence that it works better than other active treatments

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13
Q

What is the evidence for smoking cessation and prevention of weight gain?

A
  • works better than smoking cessation alone for abstinence in the very short-term
  • effects on preventing weight gain also modest
  • small ES
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14
Q

What are the common components for cannabis use treatment?

A
  • assess use and dependence and feedback information
  • boost motivation to quit
  • psychoeducation about withdrawal
  • psychoeducation about cravings
  • develop a plan to cope with cravings
  • identify and plan for high risk situations
  • build up confidence to resist use in multiple situations
  • relapse prevention
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15
Q

What are some reasons that may suggest that CBT is not right for substance-use disorders?

A
  • standard CBT teaches avoidance, despite avoidance and control being poor coping strategies
  • if clients are asked to focus on their ability to tolerate cravings while being exposed to drug cues: they should learn that they can tolerate cravings in the absence of use; and cue exposure should also render drug cues less able to elicit cravings.
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16
Q

What is the transtheoretical model for substance-use and how does it relate to substance use treatment?

A
  • MI evolved from the Transtheoretical model
  • change is a dynamic process (change does happen all at once, it might not occur on the first try)
  • motivation for change progresses along a continuum
17
Q

What are the core components of MI?

A
  • PARTNERSHIP (collaborative, guiding rs)
  • ACCEPTANCE (respect the client’s freedom of choice)
  • COMPASSION (genuine care and concern; understand and validate the struggle)
  • EVOCATION (trust that the client has the wisdom and strength for change)
18
Q

What are key principles of MI?

A
  • EXPRESS EMPATHY (acceptance, reflective listening and understanding patient’s potential ambivalence)
  • DEVELOP DISCREPANCY
  • AVOID ARGUMENTATION
  • SUPPORT SELF-EFFICACY
19
Q

What are the 4 overlapping MI processes?

A
  • ENGAGING (establish a working relationship)
  • FOCUSING (develop and maintain a specific direction)
  • EVOKING (elicit the client’s motivation to change: how might they do it, why might they do it)
  • PLANNING (develop a commitment to change and formulate a plan of action)
20
Q

What are 10 ways to evoke change talk?

A
  • ask evocative questions
  • ask for elaboration
  • ask for examples
  • look back
  • look forward
  • query extremes
  • explore goals and values
  • use change rulers
  • come alongside
21
Q

What is another crucial component of MI to elicit change talk?

A
  • open-ended values questions
  • reflecting on values
  • exploring values in more detail
  • follow up with more reflection on values
  • importance of values exploration
  • discrepancy between goals/values and behaviour
22
Q

What are some key principles for evoking change in MI?

A
  • express empathy
  • develop discrepancy (use linking phrases)
  • avoid argumentation
  • roll with resistance (simple reflection; amplified reflection; double-sided reflection; shifting focus; agree with a twist; reframing)
  • support self-efficacy