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39 Cards in this Set

  • Front
  • Back
Stages of Change
(Prochaska & DiClemente)
Precontemplation
Contemplation
Preparation
Action
Maintenance
Termination
(Relapse)
Motivational Interviewing
General Principles in Practice
Express Empathy
Develop Discrepancy
Roll with Resistance
Support Self-Efficacy
Types of Reflective Responses
Motivational Interviewing
Simple Reflection
Amplified Reflection
Double-sided Reflection
Signs of Readiness for Change
Motivational Interviewing
Decreased Resistance
Decreased discussion of problem
Resolve
Change Talk
Questions about change
Envisioning
Experimenting
The phenomenon of "desensitization" of brain cells to the effects of a drug is also known as:
Tolerance
The bulk of the MDA/MDS system is in the ______ region of the brain.
Limbic System
Vulnerability to relapse of individuals in recovery from late chemical dependency can be explained in part by:
• synaptic plasticity
• neurological power of triggers
• psychological power of triggers
True or False

Functional Analysis addresses deep-seated traits & personality types that contribute to use
FALSE

Functional Analysis:
• Focuses on current contextual costs & rewards of continued substance use

• Is clinically useful in that it suggests areas for intervention that may increase motivation to change
According to Miller & Rollnick's model of Motivational Interviewing, "Eliciting Self-Efficacy" refers to:
Attempting to engage the client in optimistic, problem-solving statements about the potential for change
True or False

According to principles of integrated treatment, for clients who suffer from both substance abuse and mental health problems, it is important to identify and treat the mental health disorder first, as substance abuse issues are otherwise unlikely to improve
FALSE

Treatment for both disorders should be provided concurrently in a time-unlimited frame that offers multiple modalities and types of interventions by a team of professionals who share the same philosophical assumptions about behavior change.
Stage of Change:

in which clients often enter treatment under pressure of others, expressing surprise & resentment
Pre-Contemplation
Stage of Change:

involving ambivalence, swings between concern and justifying "unconcern"
Contemplation
Stage of Change:

involving brief experience of serious concern, window of opportunity for movement into action
Determination/Preparation
Stage of Change:

involving anxiety, possible withdrawal symptoms (physical and emotional)
Action
Stage of Change:

involving feelings of accomplishment, relative stability, increased confidence, and possible feelings of loss
Maintenance
Stage of Change:

return from Maintenance to any of the previous four stages
Relapse
Most widely accepted model of Substance Abuse Etiology
Transactional (i.e., Integrated Treatment Model)
Traditional Models of SA Treatment
Sequential --> one d/o as primary
Parallel --> tx for both, but in diff. pgms
Principles of
Integrated Treatment
• Concurrence
• Comprehensiveness
• Long-term Perspective
• Assertiveness of Tx
• Harm Reduction Approach
• Motivational Approach
Predictors of
Behavioral Change
• Internal Perception of Need
• Sense of Self-Efficacy
• Stated Intention to Change
True or False

Grieving the "loss" of an addiction can be essential to recovery
TRUE

The same brain pathways involved in addiction are also implicated in the reinforcing qualities of close relationships; thus, to lose a drug is to lose a friend, a lover.
Whereas addiction changes reward pathways in the striatal dopamine circuit of the brain, treatment involves ____ ?
Retraining the prefrontal cortex to self-regulate emotion and behavior via the amigdala
Basic Principles
of Motivational Interviewing
• Express Accurate Empathy
• Develop Discrepancy
• Avoid Argumentation
• Roll with Resistance
• Support Self-Efficacy
According to Miller and Rollnick's model of Motivational Interviewing, eliciting Self-Efficacy refers to:
Attempting to engage the client in optimistic, problem-solving statements about the potential for change
Appropriate MI interventions for:
Pre-contemplation Stage
• ask open-ended questions
• listen reflectively
• affirm
• summarize
• elicit change talk
Appropriate MI interventions for:
Contemplation Stage
• elaborating change talk
• reflecting change talk
• summarizing change talk
• affirming change talk
• clarifying ambivalence
• clarifying values
Appropriate MI interventions for:
Determination/Preparation Stage
Reflective Responses
• simple reflection
• amplified reflection
• double-sided reflection

Other Responses
• shifting focus
• reframing
• agreeing with a twist
• emphasizing personal choice
• coming alongside
Appropriate MI interventions for:
Action Stage
Initiating
• recapitulation
• key questions
• giving information/advice

Negotiating a Change Plan
• setting goals
• considering change options
• arriving at the plan
• eliciting commitment
• slurred speech
• lack of coordination
• unsteady gait
• nystagmus (involuntary eye mov't)
• impairment of attention or memory
• stupor or coma
Signs of
Alcohol Intoxication
• tachycardia dilation
• papillary dilation
• +/- blood pressure
• perspiration or chills
• nausea or vomiting
• evidence of weight loss
• psychomotor agitation or retardation
• muscular weakness,
• respiratory depression, chest pain
• cardiac arrhythmias
• confusion, seizures, dyskinesias
• dystonias or coma
Signs of
Amphetamine Intoxication
• restlessness
• nervousness
• excitement
• insomnia
• flushed face
• diuresis (+urination)
• gastrointestinal disturbance
• muscle twitching
• rambling flow of thought and speech
• tachycardia or cardiac arrhythmia
• periods of inexhaustibility
• psychomotor agitation
Signs of
Caffeine Intoxication
• conjunctival injection (red eye)
• increased appetite
• dry mouth
• tachycardia (+heart rate)
Signs of
Cannabis Intoxication
• tachycardia or bradycardia
• papillary dilatation
• +/- blood pressure
• perspiration or chills
• nausea or vomiting
• evidence of weight loss
• psychomotor agitation/retardation
• muscular weakness
• respiratory depression, chest pain
• cardiac arrhythmias
• confusion, seizures,
• dyskinesias, or coma
Signs of
Cocaine Intoxication
• automatic hyperactivity
• increased hand tremor
• insomnia
• nausea or vomiting
• transient AH/VH/TH or illusions
• psychomotor agitation
• anxiety
• grand mal seizures
Signs of
Alcohol Withdrawal
• dysphoric mood
• fatigue
• vivid, unpleasant dreams
• insomnia or hypersomia
• increased appetite
• psychomotor retardation/agitation
Signs of Amphetamine
AND/OR Cocaine Withdrawal
Signs of Cannabis Withdrawal
There is not Canabis Withdrawal in the DSM
Signs of Caffeine Withdrawal
There is not Caffeine Withdrawal in the DSM
DSM Criteria
for Substance Abuse
• within a 12-month period
• manifested by one or more Sx

Recurrent or Continued Use
• resulting in failure to fulfill obligations
• in physically hazardous situations
• substance-related legal problems
• despite having related social or interpersonal problems
DSM Criteria
for Substance Dependence
• at the same time in the same 12-month period
• manifested by three or more Sx:

• Tolerance
• Withdrawal
• Persistent desire or failure to control use
• time and energy to obtain, use, recover from substance
• social/occupational/recreational activities given up in favor of use
• continued use is ego-dystonic