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36 Cards in this Set

  • Front
  • Back
what are the four general categories of substance abuse
intoxication
abuse
addiction
withdrawl
what is intoxication
single episodes of substance abuse during which behavior is affected
what amount of time is characterized by substance abuse?
12 month period
what is withdrawl?
-emotional distress or impairments in functioning directly due to efforts to stop using a substance
-medically unstable in acute withdrawl phase
-irrational thinking, cognitive disabilities evident
what is addiction?
psychological and physical need for a substance
what is the neurochemistry of dependence theory of dependence?
-drug displaces the neurochemical for pleasure or naturally occuring endorphins
-later the body decides to shut down production of the endorphins because the individual is externally proficing the brain with the chemical
-if you do not provide the endorphin receptors with the chemical you have craving
what is the alcohol and youth theory of dependence?
-the younger the age of onset of drinking or drug use, the greater the chance of developing alcoholism or drug addiction
-youth who begin drinking before age 15 are 4 times more likely to develop alcohol dependence than those who begin after age 21.
-those who become addicted are emotionally paralyzed at the age they began using drugs or alcohol
describe neurochemistry of dependence.
-decreased norepinephrine (craves sweets, sugar, candy)
-decreased serotonin (craves alcohol, patries, bread, carbs)
what are defense mechanisms used by persons with alcoholism
-attitudes, behaviors, beliefs that are used to maintain the addictive process
(denial, rationalization, minimization, blaming, charming, aggression)
abstinence
a period of substance free living
sobriety
more than abstinence byt a style of livng without drugs or alcohol and the person engages in ways to present future use
recovery
process of regaining important life roles, routines, habits that support abstinence and sobriety
enabling
description of behavior of others that allows the user to continue his of her substance using behaviors without logical consequences
what are feelings associated with chemical dependency in the family?
suspicion
insecurity
guilt
fear
disappointment
isolation
embarrassment
resentment
what are symptoms of adult children
denial
illusion
intimacy and relationship problems
shame and guilt
family rules about controlling the situation
what are disruptions caused by parents with alcoholism
emotional unavailability
secret keeping
abuse
chaos
emotional roller coaster
dysfunctional roles
what are the common roles in the family?
user (victim)
chief enabler
scapegoal/problem child
family hero
lost child
mascot/clown
prince/princess
saint/priest/nun/rabbi
the common denominator in the family is PAIN
Key components of evaluation and treatment
Risk factors for substance abuse and addiction
Identification and expression of emotions
Examining unhealthy relationships and roles
Coping with peer influences
Styles of problem solving and decision making
Examining communication within the family and promoting clear, open, and honest communication
Psychoeducation about substance abuse and addiction
Promoting resiliency and nurturance
Exploring healthy occupations and leisure interest
Re-establishing productivity without the use of drugs and alcohol
what is motivational interviewing?
it is a therapeutic style with a focus on empathy, promoting self efficacy, and facilitating personal choice
who is motivational interviewing NOT good for?
those in detox or serious medical withdrawl
what components does motivational interviewing have?
skills training (social skills and examination of volition)
what are the 4 general principles of motivational interviewing?
Express empathy (reflective listening, acceptance)
Develop discrepancy (present behavior vs goals, client articulates the reason for change)
Roll with resistance (client generates resources or solutions)
Support self efficacy (client must believe in the possibility for change as a motivator for action, client is responsible for deciding what to change and carrying out that change, therapist must have strong belief that the client has the ability to change and the therapist to help providing skills to make that change)
what should you do when motivational interviewing someone?
Use open ended questions
Identify circumstances or events leading to treatment
Explore motivation to continue substances
Review past successful efforts to change
Discuss accurate information about use
Reinforce client’s efforts to change
Imagine the future if continuing to use substances
Establish or co-create concrete goals
what is RAFFT?
-evaluation tool for persons who use alcohol or drugs
Do you drink/take drugs to RELAX , feel better about yourself or fit in
Do you ever drink/take drugs while you are ALONE?
Do any of your close FRIENDS drink/take drugs?
Does a close FAMILY member have a problem with drugs/alcohol?
Have you ever gotten in TROUBLE from drinking/taking drugs?
what is AUDIT?
Alcohol Use Disorders Identification Test
relapse prevention (goals)
The client will participate in 3 leisure interests by discharge * that does not involve drinking and are conducive to abstinence
The client will identify four factors in his/her environment that will support a clean and sober lifestyle
The client will practice 3 new coping skills that will assist in responding to cravings or high risk situations
The client will evaluate parenting skills and identify two stress management techniques to deal with the stress of parenting without drinking
Examples of treatment interventions
Leisure groups
Social skills training
Stress management
Communication skills training
Vocational planning
Expressive therapy
Task groups such as cooking

Note: I always prefaced this for clients with: “engaging in these activities clean and sober”
family group sculpture
Description of an exercise I commonly used for evaluation and/or treatment to gain more information about the family system of the client
post discharge planning
Community reintegration
Development of a strong support system
What is AA? What is Alanon? What is NA? What is Alateen?
what is co-dependency?
A pathological condition focusing on dependence on others
Not in DSM IV TR
Original term focused on persons whose lives were affected as a result of a strong involvement with someone else who was alcoholic or chemically dependent
what are the silent rules of co-dependency
don't talk
don't trust
don't feel
what are roles of co-dependency?
placator
martyr
rescuer
victim
ultimate enabler
what can be done?
Adopting new healthy behaviors
Re-parenting skills
Learning to take responsibility for self
Establishing personal values
Redefining roles
what is a gauge of healing?
Stops saying “How long will it take before I recover from this pain?”
Instead begins to say:
“What do I need to do to get myself better?”
“I have choices”
“I can set healthy boundaries”
health care professionals and co-dependency
Clark and Stoffel (1992)
Health care professionals are very prone to co-dependency habits due to the desire to help others
Burnout is high among health care professionals due to these need to help others
Taking care of yourself while you take care of others
what are co-occuring disorders?
Substance abuse can occur parallel to other psychiatric disorders
Often this is terms dual diagnosis
Sometimes dual diagnosis is referred to as developmental disabilities and psychiatric disorders
Resource article by Roush on treating co-occurring disorders and occupational therapy in resource folder
Note in the case study: Leonard has a family history of substance abuse