Substance Abuse and Addiction: Understanding Drugs, Treatments, and Behavioral Therapies, Exams of Advanced Education

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Abuse - Correct Answer-regular; may use several times per week. May begin during the day. May use alone rather than with friends. dependency - Correct Answer-Daily use, continuous substance use disorders - Correct Answer-patterns of symptoms resulting from use of a substance which the individual continues to take, despite experiencing problems as a result substance-induced disorders - Correct Answer-Disorders, such as intoxication, withdrawal, substance-induced mental disorders that can be induced by using psychoactive substances. mild substance use disorder - Correct Answer-2-3 symptoms moderate substance use disorder - Correct Answer-4-5 symptoms severe substance use disorder - Correct Answer-6+ symptoms assessment - Correct Answer-Uses diagnostic instruments and processes to determine an individual's needs and problems. It is an essential first step in determining the possible causes of addiction for the person and the most appropriate treatment modality for his or her needs. Patient-treatment matching - Correct Answer-One of the five critical components for a comprehensive treatment approach. Ensuring appropriate type of treatment, based on background, mental condition, and the extent and duration of substance abuse determined by the assessment. Comprehensive services - Correct Answer-include the range of services needed in addition to specific alcohol or drug treatment. The needs of addicted persons are very complex, including health problems, financial and legal issues, psychological problems, and many others. Relapse prevention - Correct Answer-is important because addiction is a chronic and relapsing disorder. Strategies for coping with these when they occur and are then developed Relapse prevention strategies are based on - Correct Answer-assessing an individuals triggers

Triggers - Correct Answer-situations, events, people, places, thoughts, and activities that re-kindle the need for drugs Accountability of a treatment program is - Correct Answer-crucial for determining the success of specific approaches and modalities. The need for the program, its integrity, and it's results, including abstinence, social adjustment and reduction of criminal behavior of those treated in the program, must be evaluated Five critical components of effective treatment - Correct Answer-1) Assessment

2. Patient-Treatment Matching
3. Comprehensive Services
4. Relapse Prevention
5. Accountability Sensory reception - Correct Answer-the process of receiving data about the internal or external environment through the senses The process of stimulus and response occurs in three stages - Correct Answer-sensory reception, interconnection, motor response interconnection - Correct Answer-the stimuli creates an electrical message that is then transmitted from one part of the system to another motor response - Correct Answer-an appropriate response is triggered such as a muscular contraction, as a result of a message being sent back to a body part by a nerve center nervous system - Correct Answer-the brain, spinal cord, and the peripheral nerves CNS - Correct Answer-composed of the brain and the spinal cord. psychoactive drugs have their primary effect on the central nervous system peripheral nervous system - Correct Answer-consists of all the nerves that branch out from the central nervous system and connect the system to other body parts, including hands and feet psychoactive drugs act on the axon or the dendrites? - Correct Answer-synapse, with the exceptions of local anesthetics that act on the axon. the electrical impulse must cross a narrow space or gap, called the synaptic cleft the crossover process is accomplished by - Correct Answer-a chemical transmission not an electrical impulse. depressant drugs thicken the medium, stimulant drugs tend to thin the medium, and marijuana fill the gap - Correct Answer-depressant drugs thicken the medium slowing

down the transmission, stimulant drugs causing a rapid transmission, preventing the transmission from occurring neurotransmission - Correct Answer-the process of transmitting a nerve impulse across a synapse between two cells in the nervous system, mediated by neurotransmitters medulla oblongata - Correct Answer-the continuation of the spinal cord within the skull, forming the lowest part of the brainstem and containing control centers for the heart and lungs. pons - Correct Answer-the pons is the rounded bulge on the underside of the brainstem which connects the medulla to the midbrain. relays impulses among the cerebrum, cerebellum, and spinal cord Ascending Reticular activating system - Correct Answer-consists of the afferent fibres running through the reticular formation that influence physiological arousal midbrain - Correct Answer-a short segment of the brain located just above the pons. control visual and auditory reflex as well as head movement. Psychedelic drugs work here to create visual and auditory hallucinations cerebellum - Correct Answer-the "little brain" at the rear of the brainstem; functions include processing sensory input and coordinating movement output and balance. alcohol = lack of balance and corrdination Thalamus - Correct Answer-the brain's sensory switchboard, located on top of the brainstem; it directs messages to the sensory receiving areas in the cortex and transmits replies to the cerebellum and medulla Subthalamus - Correct Answer-A *located beneath the thalamus and above the midbrain *interacts with the cerebellum to control movements Hypothalamus - Correct Answer-A neural structure lying below the thalamus; it directs several maintenance activities (eating, drinking, body temperature), helps govern the endocrine system via the pituitary gland, and is linked to emotion and reward. Prime site for many psychoactive drugs Limbic System - Correct Answer-Area where the cerebrum, thalamus, and hypothalamus interconnect. It functions in the regulations of emotions, fear, anger, pleasure, and sorrow. It has a significant effect on behavior, especially those aspects which promote survival. Amygdala - Correct Answer-A limbic system structure involved in memory and emotion, particularly fear and aggression.

Cerebrum - Correct Answer-Largest part of the brain; responsible for voluntary muscular activity, vision, speech, taste, hearing, thought, and memory. It is divided into two hemispheres and four lobes Frontal lobes - Correct Answer-the portion of the cerebral cortex lying just behind the forehead; involved in speaking and muscle movements and in making plans and judgments Parietal lobes - Correct Answer-sections of the brain located at the top and back of each cerebral hemisphere containing the centers for touch, taste, and temperature sensations Temporal lobes - Correct Answer-areas of the cortex located just behind the temples containing the neurons responsible for the sense of hearing and in the memory of visual scenes, music and other complex sensory impulses Occipital Lobes - Correct Answer-structures located at the back of the head that respond to visual stimuli CNS depressant - Correct Answer-alcohol Percent of drinking population dependent on alcohol - Correct Answer-10 % Alcohol Use - Correct Answer-The consumption of beverage alcohol within some socially prescribed ritualistic context Alcohol misuse - Correct Answer-unintentional or inappropriate use of beverage alcohol resulting in the impaired physical, mental, emotional or social well being of the user. Alcohol abuse - Correct Answer-Deliberate or unintentional use of beverage alcohol which results in any degree of physical, mental, emotional, or social impairment of the user, the user's family, or society in general. By definition any adolescent who drinks any form of alcoholic beverage is - Correct Answer-abusing the drug Acceptable to be driving out in public BAL - Correct Answer-.1 BAC Alcohol dependence - Correct Answer-psychological and or physical need for beverage alcohol characterized by compulsive use, tolerance, and physical dependence manifest my physical withdrawal syndrome distillation - Correct Answer-A process that separates the substances in a solution based on their boiling points. Increases the alcoholic content of the mixture Whiskey was a main form of barter - Correct Answer-revolutionary war

whiskey - Correct Answer-distilled fermented cereal grains Whiskey Rebellion - Correct Answer-1794 protest against the government's tax on whiskey by backcountry farmers The temperance movement - Correct Answer-Goal of "moderation" in the consumption of beverage alcohol Prohibition - Correct Answer-the period from 1920 to 1933 when the sale of alcoholic beverages was prohibited in the United States by a constitutional 18th amendment absorption of alcohol - Correct Answer-20 percent enters the walls of the stomach, where tiny blood vessels pick up the alcohol, while the rest passes through the stomach into the small intestines Distribution of alcohol - Correct Answer-- alcohol dissolves much more readily in water than in fat so it is distributed almost entirely in body water -Body water is the key to increasing BAC -the more body water, the more dilute the alcohol, the lower the rise in BAC -therefore women, with more adipose (fatty) tissues and less muscle (water) tissue, generally achieve higher BAC's and greater level of intoxication -The more an individual weighs, the lower the bac Elimination of alcohol - Correct Answer--LD- 50 (lethal dose) of alcohol is between 12- 19 ounces of pure alcohol -two to fiver percent of all alcohol is eliminated unchanged in urine, perspiration, and respiration -the remainder is eliminated through the detoxification and oxidation process -The metabolic rate for elimination is typically about 1/2 oz per hour Detoxification (Liver) - Correct Answer-the process of making chemical substances non poisonous Acetic acid is created Oxidation - Correct Answer-the process in which oxygen is combined with a chemical, creating heat .20 BAC - Correct Answer-Highly correlated with alcoholism .08 BAC - Correct Answer-Legal intoxication in United States; some countries have lower limits .5 BAC - Correct Answer-Deep Coma .6 BAC - Correct Answer-Death from respiratory failure

axons - Correct Answer-Carry impulses away from the cell body dendrite - Correct Answer-Branchlike parts of a neuron that are specialized to receive information. Synaptic knobs - Correct Answer-manufacture chemicals called neurotransmitters When electrical impulse reaches the end of the axon, tiny saclike structures known as synaptic knobs manufacture chemicals called neurotransmitters - Correct Answer-1. A nerve reaches the synaptic knob

2. A neurotransmitter substance is released into the synaptic cleft 3.The neurotransmitter substance is diffused across the synaptic cleft 4.The neurotransmitter reacts with the membranes of the dendrite on the other side of the cleft
3. The nerve impulse is reestablished in the dendrite and transmission is continued through the cell
4. The neurotransmitter substance breaks down to prevent continued stimulation of the dendrite Actylcholine - Correct Answer-an excitatory neurotransmitter released by axons Norepinephrine - Correct Answer-A neurotransmitter involved in arousal reactions and moods Dopamine - Correct Answer-a neurotransmitter found in the brain, associated with body movement and pleasure Serotonin - Correct Answer-A brain neurotransmitter associated with regulation of sensory perception , sleep and body temperature - alterations in the serotonin functioning have been found to be related to mental illness and certain drug induced hallucinations Gama-Aminobutyric Acid (GABA) - Correct Answer-an inhibitory neurotransmitter substance (one that blocks the transfer of a nerve impulse to an adjoining neuron in the brain) - when the normal function of GABA is disrupted, convulsions may occur Glycine - Correct Answer-an inhibitory neurotransmitter substance found in the spinal cord enkephalins and endorphins - Correct Answer-first discovered in 1975, both compounds have been extracted from the brain and pituitary gland-both compounds have pain killing properties that are more powerful than morphine, with endorphins being 40 times more powerful than enkephalins, and 100 times more powerful than morphine

Neurotransmission - Correct Answer-the process of transferring information from one neuron to another at a synapse Reticular Activating System (RAS) - Correct Answer--internal clock that knows when we need to wake up and be active, and for what period of time we need to maintain this activity -stimulated by alcohol, causes RAS to function improperly REM sleep is suppressed - Correct Answer-When drinking Blackout - Correct Answer-is amnesia-like period associated with heavy drinking Hangover - Correct Answer-A term used to describe the after effects of drinking too much alcohol that causes fatigue, combined with nausea, upset stomach, headache, thirst, depression, anxiety, general malaise, sensitivity to sound, and ill temper The "hair of the dog" method for treating a hangover consists of __________. - Correct Answer-taking a drink of the alcohol that caused the hangover alcoholism (alcohol dependence) - Correct Answer-third leading cause of death American Medical Association 1992 definition of alcoholism is scientifically valid, clinically useful, and understandable by the general public - Correct Answer-Alcoholism is a primary, chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. The disease is often progressive and fatal. It is characterized by impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences, and distortions in thinking, most notably denial. Each of these symptoms may be continuous or periodic. primary - Correct Answer-refers to nature of alcoholism as a disease entity in addition to and separate from other pathophysiologic states that may be associated with it. It suggests that as an addiction, alcoholism is not symptom of an underlying disease state. disease - Correct Answer-means involuntary disability Two Key issues that separate alcohol use/abuse from alcoholism - Correct Answer- Tolerance- the need for greater amounts of alcohol to obtain the same desired effect and Loss of Control- the inability to predict with accuracy what will happen when a person takes a drink. This does not mean getting drunk. Many alcoholics drink without getting drunk. It means not knowing if one drink will be all that is consumed, or if one drink turns into many sedative-hypnotic drugs - Correct Answer-A class of drugs that slow down the functioning of the central nervous system Largest category of drugs

Barbiturates - Correct Answer-A category of depressant drugs that reduce anxiety and produce sleepiness. CNS depressants. First barbiturate was synthesized in 1862 by Dr. AH Bayer Ultrashort acting barbiturates - Correct Answer-anesthesia for short surgical procedures, anesthesia induction, rarely abused Short-intermediate acting barbiturates - Correct Answer-Barbiturate used mostly as calming and sleep agents, have onset of effect from 15-40 minutes after oral administration; duration of effect may last up to 6 hours-highly abusable; sold in capsules, tablets, liquid form/suppositories long acting barbiturates - Correct Answer-have onset times up to one hour after use, but their duration effects is up to 16 hours. Their slow onset generally discourages abuse. These drugs are used as sedatives, hypnotics, and anti-convulsants LD-50 - Correct Answer-dose (material per unit body weight) of chemical that kills 50% of exposed population. alcohol and barbiturates - Correct Answer-A particularly dangerous (often fatal) combination of drugs. This combination is responsible for more overdose deaths than any other combination known minor tranquilizers - Correct Answer-depressant drugs used to treat anxiety and insomnia -more prescriptions are written annually for tranquilizers than all other prescription drugs combined -benzodiazepines Major Tranquilizers - Correct Answer-antipsychotic drugs Qualude (Methaqualone) - Correct Answer-sedative hypnotic, fast-acting drug that eventually induces sleep, 1970s most frequently prescribed hypnotic Narcotics/Opioids/opiates - Correct Answer--naturally occurring substances, and can also be manufactured synthetically -cause sedation and euphoria by depression of the CNS -used medically to relieve pain, suppress cough, and control diarrhea -heroin has no medical use and possession is illegal natural occurring compounds - Correct Answer-opium, morphine, and codeine semisynthetic compounds - Correct Answer--heroin, initially introduced as a "cure" for opium and morphine addiction -hydromorphone (dilaudid (derived by modifying the chemical produced in opium)

-oxycodone is chemically derived from codeine -Oxycontin contains 10-160 mg of oxycodone (time released tablet) (analgesic prescribed for pain) synthetic compounds - Correct Answer-made in entirely in lab, Demerol, methadone, and darvon , Meperidine (demerol) discovered in 1930s, methadone (dolophine) synthesized by a German chemist in 1943 as a substitute for morphine, which was unavailable in Germany during WWII, Buprenorphine- opioid partial agonist morphine - Correct Answer-narcotic drug derived from opium (isolated from opium in

Heroin - Correct Answer-acts primarily on the CNS and parasympathetic nervous system producing drowsiness, mental clouding, and reduced ability to concentrate speedballing - Correct Answer-combining heroin and cocaine "Joy Plant" - Correct Answer-Opium extracting opium was well known in - Correct Answer-the first centry AD Opium War - Correct Answer-a conflict between Britain and China, lasting from 1839 to 1842, over Britain's opium trade in China which resulted in widespread free trade of opium Fredrich Serturner - Correct Answer-isolated the principle active ingredient of opium and created morphine Codine was discovered in - Correct Answer-1832, great benefit as a cough suppressant Addiction to morphine in 1853 (invention of the hypodermic syringe) during the civil war

• Correct Answer-the soilder's disease federal food and drug act of - Correct Answer-1906, required that over-the-counter be labeled so the consumer was aware of the ingredients they contained Harrison Narcotic Act - Correct Answer-1914, established a mechanism of recordkeeping for the importation, manufacture, distribution, sale, and prescription of narcotic drugs -outlawed non-medical use of heroin, limited the amounts of opium, morphine, and cocaine used in over-the-counter products, placed many in the hands of medical science to prescribe in a responsible manner 1924 the Harrison Narcotic Act - Correct Answer-outlawed heroin creating a black market

Inhalants are - Correct Answer-large group of chemicals which includes solvents, aerosols, gases and nitrates Inhalants - Correct Answer-typically CNS depressants, rarely thought of as drugs, typically found over-the-counter, many adolescents use these drugs without raising the suspicion of their parents, can produce immediate death for the user, a term called "sudden sniffing death" syndrome Marijuana - Correct Answer-most frequently used drug in the US, The potency of the active ingredient in marijuana, THC, has increased dramatically since the early 1960s. Depressant, Stimulant, Analgesic, and even hallucinogenic effects. has four to 10 times the amount of tar and carcinogenic substance found in cigarettes, creating a high risk of lung damage. physical and psychological dependency potential. Does cross the placenta and create fetal effects. Considered a Psychedelic. Female buds - Correct Answer-contain highest concentration of THC Marijuana dates back to --- and was known as ---- a Chinese word that meant - Correct Answer-2700 B.C, Ma, valuable and endearing First cash crop - Correct Answer-marijuana Harrison Narcotic Act - Correct Answer-excluded marijuana from any control Reefer Madness - Correct Answer-Anti drug campaign aimed at drug abusers, attempt to reform laws regarding marijuana Marijuana Tax Act of 1937 - Correct Answer-banned the nonmedicinal possession and cannabis on a national level THC concentrations are -- to -- times more potent, which some forms of hashish are -- times more potent - Correct Answer-THC concentrations are 25 to 50 times more potent, which some forms of hashish are 100 times more potent benzopryene - Correct Answer-a cancer causing agent in marijuana amotivational syndrome - Correct Answer-"burn out", characterized by apathy, lack of concern for the future, and loss of motivation positive uses of marijuana - Correct Answer-glaucoma, nausea, and vomiting caused by chemotherapy, asthmatic conditions due to it's initial effect as a bronchodilator stimulant and depressants - Correct Answer-hallucinogenic/psychedelics, all-arounders Synesthesia - Correct Answer-describing one kind of sensation in terms of another ("a loud color", "a sweet sound")

Peyote (mescaline) - Correct Answer-A small, spineless cactus with mescaline as its main ingredient that causes psychedelic effect. Peyote can also be synthetic. Act on the CNS releasing the neurochemical norepinephrine, interfering with the filtering stimulus mechanism of the brain Morning Glory Seeds - Correct Answer-provide the drug ololiuqui in ancient mexico- cause LSD like symptoms, 1/10th as potent Nightshade - Correct Answer-five plants are members of the night shade family.

1. belladonna, 2. jimson weed, 3. henbane, 4.mandrake root, 5. Angel's trumpet Nightshade causes - Correct Answer-1. Wild delirium, disoriented, loud hallucinating, restless, and irritable or
2. Muttering delirium, confusion, stuporous, uncoordinated, and unable to concentrate or respond appropriately to outside stimulation DMT - Correct Answer-dimethyltryptamine, naturally occurring and has been synthesized since the 1960's, fast-acting drug that produces psychedelic effects of an extremely short duration Nutmeg - Correct Answer-is a commercial spice derived from the tropical evergreen Myristica fragans, 10 to 20 g to produce psychedelic effects, used by adolescents Mace - Correct Answer-the outer shell of nutmeg; has psychedelic qualities. less potent than nutmeg itself LSD - Correct Answer-is one of the most potent drugs known. lysergic acid diethylamide. Discovered in 1943 by Dr. Albert Hoffman and Dr. W.A Stoll. 1950's used to treat schizophrenia Dr.Timothy Leary and Richard Albert - Correct Answer-advocated LSD, harvard professors, "Turn on, turn in, drop out" PCP - Correct Answer-phencyclidine, analgesic and anesthetic properties, angel dust, PeaCe pill, associative anesthetic because it is a depressant, stimulant, analgesic, extreme violence MDMA - Correct Answer-designer drug, exstasy combination of amphetamine and mescaline Two categories of designer drugs - Correct Answer-narcotic analogs (related to fentanyl and merperidine) and hallucinogenic amphetamine analogs (MDMA, MDA, DOM) flashbacks - Correct Answer-a repeat of the drugs effects without taking the drugs. This occurs to 25% of users

Caffeine - Correct Answer-most widely used stimulant of the CNS, mild feelings of alertness to extreme nervousness and insomnia, produces tolerance as well withdrawal effects. physical and psychological dependence, psychological greater than it's physical effect Caffeine originated in - Correct Answer-Arabia 8 oz cup of coffee - Correct Answer-135 mg of caffeine Nicotine - Correct Answer-Found in tobacco products, is a powerful CNS stimulant, have chemicals that cause cancer, more physically addicting than cocaine and heroin tobacco farming - Correct Answer-is the fifth largest, legal cash crop in the US Advertising cigarettes - Correct Answer-was banned in in January 1971 National clearing house for smoking health in 1965 - Correct Answer-monitors, compiling, and reviewing medical literature that bears on the health consequences of smoking Nicotine is more addictive than - Correct Answer-heroin, cocaine, and alcohol acute physical effects of nicotine - Correct Answer-first stimulates and then depresses the CNS. Stimulation occurs due to the release of norepinephrine and because it mimics the action of acetylcholine Naturally occurring plant stimulants - Correct Answer-betel nuts, yohimbe, ephedra, KHAT Amphetamines - Correct Answer-strong CNS stimulants, synthetic substances formication syndrome - Correct Answer-symptoms of itching and feeling as if insects were crawling under skin, caused by cocaine and amphetamine Ice - Correct Answer-a smokable form of methamphetamine, odorless Cocaine - Correct Answer-most powerful and addictive cns stimulant (natural occurring), derived from the coca plant, producing temporarily increased alertness and euphoria, was in the soft drink, coca-cola Cocaine causes the release of the neurotransmitter, and than inhibits--- - Correct Answer-dopamine, the re-uptake of the neurotransmitters. They are not reabsorbed, they stay free at the synaptic cleft, thought to cause withdrawal and dysphoria

crack cocaine - Correct Answer-More potent form of cocaine, one of most highly addictive drugs known; absorbed immediately when smoked and enters the brain within several seconds; manufactured simply by mixing cocaine with baking soda and water; does harm in developing fetus Effects: increased heart rate, blood pressure, respiratory rate & body temperature; changes heart rhythm, dilates pupils, sweating, restlessness, excitement, euphoria Long-term: weight loss, dehydration, constipation, tooth decay, urinary tract problems biopsychosocial model - Correct Answer-addiction is effected by physiological, social, behavioral, and environmental relapse prevention - Correct Answer-approaches are recommended for helping individuals control or change their reactions to drug cues aversive conditioning - Correct Answer-a form of treatment that consists of repeated pairings of a stimulus with a very unpleasant stimulus Detoxification - Correct Answer-is not a treatment modality, the purpose is to stabalize Three main categories of abused substances that require detoxification - Correct Answer-1) alcohol and other CNS depressants 2) opiate drugs 3) cocaine Medication Assisted Treatment - Correct Answer-the use of approved medications with medical supervision, such psychotherapies are designed to be adjunctive to formal treatment and are not intended to be used as independent solo therapy agonists - Correct Answer-alleviates many of the withdrawal symptoms often experienced by person addicted to various psychoactive substances Antagonist - Correct Answer-when they are present the effects of the abused drug are blocked because they cannot act on the brain in the usual way Antidistropics - Correct Answer-Create adverse physical reactions (Antabuse for alcohol) Inpatient hospital treatment - Correct Answer-Minnesota model or Hazelden-type treatments, 28-day programs. These programs are appropriate for with concomitant psychiatric disorders, persons assessed to be suicidal, those addicted to one or more chemical, or persons with serious medical complications, or persons with serious medical complications. More effective for alcohol addiction than drug addiction therapeutic communities - Correct Answer-self-contained residential programs that emphasize self-help and rely heavily on ex-addicts as peer counselors, administrators, and role models. Highly structured milieu, with program stages through which members must progress;

Outpatient Nonmethadone Treatment - Correct Answer-Most appropriate for those motivated for treatment, able to discontinue use of drugs/alcohol, have a social support system, are employed, no medical conditions/psychiatric statuses, non-lengthy treatment history Two by Four Programs - Correct Answer-The individual is hospitalized first for a short time (usually two weeks). This ensures complete detoxification. This is followed by outpatient treatment. However, there is the option to return to inpatient care if he or she is unable to function in the less restrictive outpatient program Combined settings - Correct Answer-capitalize on both inpatient and outpatient AA (Alcoholics Anonymous) - Correct Answer-Promotes idea of belief in higher power, working the 12 steps, and complete abstinence for life. 1935. voluntary, self-run fellowship. -an admission of powerlessness -assessment of defects -overcoming shortcomings that contributes to addiction, learning the tools of non-drug centered living, and restructuring damaging relationships -commitment to a higher power Narcotics Anonymous (NA) - Correct Answer-formed in 1947 in Kentucky exploratory groups - Correct Answer-explore and interpret members feelings and help them develop greater ability to tolerate distressing feelings without resorting to mood- altering substances supportive groups - Correct Answer-help addicted members tolerate abstinence and assist them in remaining drug or alcohol free by enabling them to draw on their own resources Interactional Groups - Correct Answer-an environment of safety, cohesion, and trust, where members engage in-depth self-disclosure and affective expression interpersonal problem-solving groups - Correct Answer-teach an approach to solving interpersonal problems, including recognizing that a problem exists, defining the problem, generating possible solutions, and selecting the best alternative Educational Groups - Correct Answer-Provide information on issues related to specific addictions, such as the natural course and medical consequences, implications of intravenous drug use and availability of community resource activity groups - Correct Answer-provide occupational and recreational means for socialization and expression

despite the popularity of group treatment approaches - Correct Answer-few studies of effectiveness have been done family therapy is or nor is not sufficient for sole means of treatment for substance abuse

• Correct Answer-is not Three parts of the family system to include - Correct Answer-family of orgin, spouse, and children Behavior modification - Correct Answer-often incorporated in various treatment modalities. Behavior modification increases rewards for positive, pro-social behavior. Rewards may include praise, attention activities, and material items. For negative or anti-social behavior, responses that are unpleasant or withhold rewards may help extinguish the unwanted behaviors screening - Correct Answer-The process by which the client is determined appropriate and eligible for admission to a particular program. eligibility criteria - Correct Answer-1. goals and objectives, 2. target population, 3. funding requirements criteria related to the client might include - Correct Answer-1. age

2. sex
3. residence
4. legal status
5. veteran status
6. income level
7. referral source
8. physical condition
9. psychological functioning
10. outside support available
11. previous treatment efforts criteria related to the program - Correct Answer-1. environment and philosophy of the program,
12. Whether the program is, a) detoxification unit b) inpatient c) residential d) outpatient Counselor must use subjective criteria to determine - Correct Answer-1.) whether or not substance abuse is present 2.) the client's level of dysfunction

3. key issues and problem areas
4. degree of denial Screening is the first step in establishing - Correct Answer-rapport with a potential client •May be clients' first attempt to seek help •An opportunity to provide needed emotional support and guidance

Skills which help establish rapport: - Correct Answer-1. warm tone of voice

2. Encouraging prompts (tell me more about that...)
3. Non-threatening questions
4. appropriate self-disclosure
5. Clarifying confusing information screening form generally ask for - Correct Answer-1. Patient data
6. referral source
7. presenting problems
8. insurance availability
9. whether to accept into the program or refer elsewhere intake - Correct Answer-The administrative and initial assessment procedures for admission to a program. allow disclosure of information - Correct Answer-a. when the client has consented in writing b. in a medical emergency c.when the client commits or threatens to commit a crime on program premises or against program personnel d. to qualified persons conducting audit, research, or program evaluation e.if required by court order orientation - Correct Answer--the general nature and goals of the program -the rules governing client conduct and infractions that can lead to disciplinary action or discharge from the program

• in a nonresidential program, the hours during which the services are available -treatment costs to be borne by the client, if any -client's rights Assessment - Correct Answer-The procedures by which counselor/program identifies and evaluates and individual's strengths, weaknesses, problems, and needs for the development of the treatment plan How/when assessments take place - Correct Answer-emphasized strongly early in treatment, assessment is a continuing process, it is necessary to use a multidisciplinary approach in order to gain a broad spectrum of information Comprehensive assessment consists of consecutive stages - Correct Answer-- recognition of risk factors -initial screening -comprehensive assessment -appropriate interventions and -evaluation of process and outcome

screening refers - Correct Answer-to brief procedures used to determine the presence of a problem, substantiate that there is a reason for concern, or identify the need for further evaluation observable signs of drug use - Correct Answer--dilated or constricted pupils, abnormal eye movements, elevated or lowered vital signs, muscle rigidity, and observation of behavioral indicators of drug use, such as speech, affect, and appearance

1. verifying that the person's physical responses deviate from the normal
2. ruling out a non-drug-related cause of the deviation
3. Using diagnostic procedures to determine the category or combination of drugs that is likely to cause the impairment chemical testing - Correct Answer-Most accurate method of determining current or recent drug use Includes: Breath analysis saliva tests urinalysis blood analysis hair analysis The viper - Correct Answer-Visual identification of pupillary eye responses project created by NASA, measures involuntary eye movements associated with drug use impairment Telemetered Drug Use Detection - Correct Answer-evaluating the feasibility of a drug detection device worn on the wrist, noninvasive method of chemical testing for drug use Addiction Severity Index (ASI) - Correct Answer-It effectively assesses a client's status in several areas, and the composite store measures how a client's need for treatment changes over time. It has been used extensively for treatment planning and outcome evaluation packages for individual programs or for treatment. Adolescent Drinking Index - Correct Answer-24 item paper and pencil self report rating scale intended to measure the severity of drinking. It focuses on drinking-related loss of control and social, psychological and physical symptoms of alcohol problems. Adolescent drug involvement scale - Correct Answer-paper and pencil drug abuse screening instrument adapted from the Adolescent Involvement Scale Alcohol dependence scale ADS - Correct Answer-This is a 25-item multiple choice questionnaire to assess the alcohol dependence syndrome. It is derived from the alcohol use inventory. It yields an index of severity of alcohol dependence.

Alcohol Use Disorders Identification Test (AUDIT) - Correct Answer-The purpose of the Audit is to identify persons whose alcohol consumption has become hazardous or harmful to their health. The Audit screening procedure is linked to a decision process that includes brief intervention with heavy drinkers or referral to specialized treatment for patients who show evidence of more serious alcohol involvement CAGE questionnaire - Correct Answer-A self-report screening instrument consisting of 4 yes-no questions. Requires 1 minute to complete. Global Appraisal of Individual Needs (GAIN) - Correct Answer-The GAIN was developed to implement an integrated biopsychosocial model of treatment assessment, planning, and outcome monitoring that can be used for evaluation, clinical practice, and administrative purposes. It embeds questions for documenting substance use disorder, attention deficit/hyperactivity disorder... Michigan Alcohol Screening Test (MAST) - Correct Answer-Quantifies the severity of alcohol problems for adults, using a 24-item self-administered calling for yes and no responses Counseling (individual, group, and significant others) - Correct Answer-The utilization of special skills to assist individuals, families, or groups in achieving objective through -explorations of a problem and its ramifications -examination of attitudes and feelings -consideration of alternative solutions and decision-making Six Stages of Counseling - Correct Answer-1) Information Gathering - Counselor gathers as much info as possible to make a valid assessment and treatment plan

2. Evaluation - Nature and severity of the presenting problem, cause of the symptoms, relief of the symptoms, client's readiness for counseling, and client/counselor match
3. Feedback (identify the client's strengths that will help resolve the problems and weaknesses that cause the problem
4. Counseling Agreement - Practical issues which set limits (length of session, number of sessions, payment), expectations, goals
5. Changing Behavior- meeting goals and resolving problems
6. Termination - Is a stage in the counseling process, not the last session. B. Can be introduced by the client or the counselor Physical attending techniques - Correct Answer-A. Being at a comfortable working distance with no objects to act as barrier between counselor and client B. Counselor facing the client and maintaining a relaxed, open body posture C. The counselor maintaining eye contact - a client who seems uneasy when the counselor maintains eye contact, may have difficulty with interpersonal relationships Psychological attending skills - Correct Answer-A. Observation of the Client's Grooming, posture, speed of movement, and facial expressions B. Listening for the Client's

a.Verbalizations

1. generalizations
2. deletions
3. distortions C) tone of voice D) recurring themes E) Feelings F) Representational Mode a) People perceive the world through their senses b) Often one sense becomes the dominant way of perception-this dominance reflected in speech hearing and touch G) Good listening requires an objective attitude Self-attending skills - Correct Answer-a) awareness of counselor's own message - especially if the client's material is activating the counselor's personal issues b) awareness of counselor's own physical and emotional needs and ways to get them met outside the session so the focus remains on the client c) remaining center regardless of the client's material - by practicing relaxation techniques Responding skills to let the client know the counselor is listening - Correct Answer- minimal encouragers - examples: "uh huh" "go on" "oh" silence - indicates the counselor has the time to let the client proceed at his/her own pace and is not going to jump in with questions and comments Probing - Correct Answer-It is important not to turn a counseling session into a question and answer period a) Puts the focus on the counselor who is seeking the "right" questions to ask which will solve the problem b) client does not assume responsibility
4. the counselor is the authority with the "right"questions
5. The client is not given the opportunity to explore and find his/her own answers open-ended questions - Correct Answer-do not ask yes or no questions, include "are", "is", or "do". no why questions confrontation - Correct Answer-Pointing out discrepancies A) between a client's ideal and real self B) Between a client's verbal and nonverbal expression C) Between a client's view and the counselor's view of the client a common way to confront - is you say, but you do not an accusation Role-playing - Correct Answer-1. Is a process where participants pretend to be in particular situation- the situation is not real but the feeling that come up are real

Parroting - Correct Answer-Repeating in whole or in part the speaker's own words Paraphrasing - Correct Answer-rewriting or restating another person's ideas or thoughts into your own words with no interpretations reflecting with interpretations - Correct Answer-reflecting what was said and unsaid, and picking up on feelings and attitudes Interpreting - Correct Answer-Is a technique used by the counselor to present the client with alternative ways of looking at his/her situations Vicarious (group) - Correct Answer-1) Through observation and identification with learning, the group member a) sees and feels the struggle and resolution b) internalizes the message

2. Through observation of healthy behavior modeled by the leader and strived for by the members, the individual learns, remembers and can later initiate behavior that he/she has observed Direct (group) - Correct Answer-1) Support and acceptance by group of people provides a strong sense of belonging a) Helps to meet intimacy and relatedness need b) growth
3. Interactions with others in a safe environment a) promote the learning of healthy relationships b) allow the practice of new behavior before trying in in the "real" world c) Permit honest feedback that guides the individual Stages of Group Development - Correct Answer-(1) initial stage (2) transition stage (3) working stage (4) final stage Initial stage - Correct Answer-Participants learn expectations, get to know one another, may be preoccupied with how much to disclose, and are concerned with trust.
4. acceptance
5. Identity
6. Power
7. Intimacy Transition stage - Correct Answer-Focus shifts to a) Dominance b) control c) power Some members challenge leader

attack-withdrawal behavior among some members Working stage - Correct Answer-The group has emerged from its conflicts with a sense of openness and cohesiveness Final Stage - Correct Answer-Termination is an integral part of the counseling process and is an important force in the process of change because it prepares the members for post-group independence, emphasizing process not an event group process - Correct Answer-the continuing development of the individual member and the group as whole which involves many changes Compliance - Correct Answer-a) the new member decides to allow the leader and other members to help him/her b) He/she decides to join in the work of the group Identification - Correct Answer-As the new member starts to form relationships with the leader and other members, he/she begins to identify with their issues, concerns and solutions Internalization - Correct Answer-a) by working through emotionally-laden issues with the help of the group, the individual learns new attitudes, concepts, and behaviors - a client's ability to reorganize and identify feelings has a great deal of impact on other members of the group b) when he/she is able to reorganize harmful behaviors and self-correct them, he/she has transferred these lessons to the real word This person must have the majority of the counselor's attention. He/she does not seem to notice other member's negative reactions - Correct Answer-monopolizing client The family roles of sharon wegscheider-cruse are based upon - Correct Answer-a) position in the family b) gender c) age d) birth order e) ethnic custom f) social class The enabler - Correct Answer-a) Is assumed to be the person who is emotionally closest to the alcoholic, usually the spouse. b) Protects the alcoholic by making excuses, taking over responsibilities, rescuing the alcoholic from consequences. The hero - Correct Answer-a) usually the oldest child b) provides self-worth to the family

c) the hero knows something is wrong and feels obligated to "fix it"-tries to fix the problems between parents by achieving some thing that will make them proud and forget the problem The scapegoat - Correct Answer-a) Usually the second child b) Since the hero has the family's positive attention - this child's role is to take the attention away from the alcoholic by accepting blame for the family's trouble C) usually seeks acceptance from peers who are also having trouble with parents- frequently becomes involved with bad stuff d) beneath the hostile façade, the scape goat is hurt, lonely, and often ashamed of his/her actions e) often becomes the next generation of alcohol and drug abusers The lost child - Correct Answer-a child who helps the family maintain balance by not causing problems

1. needs are not attended
2. no praise for achievements Usually the youngest child The mascot - Correct Answer-Usually the third or middle child. Senses that something is wrong in the family but gets reassurance from other members that nothing is wrong. This causes anxiety and continual conflict for the child. Family roles of Claudia black - Correct Answer-1. Responsible one (oldest) 2.adjuster (adapts to the situation)

3. Placater - sensitive - makes others feel better
4. Acting out - draws negative attention Treatment planning - Correct Answer-Process by which the counselor and the client identify and rank problems needing resolution; establish agreed upon immediate and long-term goals; and decide upon a treatment process and the resources to be utilized. Case management - Correct Answer-Activities which bring services, agencies, resources, or people together within a planned framework of action toward the achievement of established goals. It may involve liaison activities and collateral contacts. crisis intervention - Correct Answer-Those services which respond to an alcohol and/or other drug abuser's needs during acute emotional and/or physical distress. Who commits suicide more often - Correct Answer-Men commit suicide more frequently than women though women attempt it more often Referral - Correct Answer-Identifying the needs of a client that cannot be met by the counselor or agency and assisting the client to utilize the support systems and community resources available.

Report and recordkeeping - Correct Answer-Charting the results of the assessment and treatment plan, writing reports, progress notes, discharge summaries, and other client- related data. Consultation - Correct Answer-Relating with our own and other professionals to assure comprehensive, quality for care for the client Psychodynamic theory - Correct Answer-therapy deriving from the psychoanalytic tradition that views individuals as responding to unconscious forces and childhood experiences, and that seeks to enhance self-insight Sigmund Freud was Id - Correct Answer-According to Freud, the primitive, instinctive component of personality that operates according to the pleasure principle. It is unconscious Ego - Correct Answer-a) the rational, reasoning part of the mind b) deals with reality c) Negotiator btw the want of the id and the rules of the super ego d) Use defense mechanisms to handle negotiations - it is partially conscious Super ego - Correct Answer-Freud; "moral watchdog"; governs behavior by reality and morality, often taught by parents, church and/or community; standards develop through interaction; unconscious; frequently in conflict with the id client-centered therapy - Correct Answer-a humanistic therapy, developed by Carl Rogers, in which the therapist uses techniques such as active listening within a genuine, accepting, empathic environment to facilitate clients' growth. (Also called person-centered therapy.) genuineness empathy. The view of humans as positive The client has the potential for becoming aware of problems and the means to resolve them. Gestalt therapy - Correct Answer-Fritz Perl's form of psychotherapy, which attempts to integrate conflicting parts of the personality through directive methods designed to help clients perceive their whole selves/ whole personality. Experiencing in the here and now to help clients accept their polarities. To challenge them accept responsibility for internal support as opposed to depending on external support Rational Emotive Therapy - Correct Answer-a cognitive therapy developed by Albert Ellis that helps clients identify and change the irrational assumptions and thinking that help cause their psychological disorder

Reality therapy - Correct Answer-Helping the individual get back in touch with objective and moral reality by making responsible choices (the client learns to act responsibly which leads to increased self-worth) William Glasser Transactional Analysis - Correct Answer-Eric Berne believes that people operate in three ego states and that awareness is an important first step in changing our ways of thinking, feeling, and behaving. Three basic needs are stimulus, recognition, and structure. Parent, Adult, Child The goal is to identify the type of transactions in which the client participates Classical conditioning - Correct Answer-a type of learning in which one learns to link two or more stimuli and anticipate events (Pavlov) operant conditioning - Correct Answer-a type of learning in which behavior is strengthened if followed by a reinforcer or diminished if followed by a punisher Skinner positive reinforcement - Correct Answer-Increasing behaviors by presenting positive stimuli, such as food. A positive reinforcer is any stimulus that, when presented after a response, strengthens the response. negative reinforcement - Correct Answer-Increasing behaviors by stopping or reducing negative stimuli, such as shock. A negative reinforcer is any stimulus that, when removed after a response, strengthens the response. (Note: negative reinforcement is not punishment.) Punishment - Correct Answer-a particular behavior is weakened by experiencing a negative condition (Given an unpleasant stimulus) (2) consequence of removing something desirable Extinction - Correct Answer-a particular behavior is weakened by the consequence of not experiencing a positive condition or stopping a negative condition systematic desensitization - Correct Answer-A type of counterconditioning that associates a pleasant relaxed state with gradually increasing anxiety-triggering stimuli modeling therapy - Correct Answer-a learning technique in which the subject watches and imitates models who demonstrate desirable behaviors Response shaping - Correct Answer-positive reinforcement technique used in therapy to establish, by gradual approximation, a response not initially in a person's behavioral repertoire

token economies - Correct Answer-a behavioral technique in which desirable behaviors are reinforced with a token, such as a small chip or fake coin, which can be exchanged for privileges Behavioral Contracting - Correct Answer-used to identify and agree on behaviors that are to be changed and to maximize the probability that these changes will occur and be maintained Assertiveness therapy - Correct Answer-Learning the open and appropriate expression of thoughts and feelings, with due regard to the rights of others. Used as an alternative to relaxation in the desensitization procedure and means of developing more effective coping techniques Biofeedback treatment - Correct Answer-Person is taught to influence his or her own physiological processes existential therapy - Correct Answer-a therapy that encourages clients to accept responsibility for their lives and to live with greater meaning and value. Rollo May. Approach to counseling and therapy rather than a firm theoretical model, it stresses core human conditions AA founders - Correct Answer-Bill Wilson Dr. (Bob) Robert Smith Cultural Sensitivity - Correct Answer-being aware that cultural differences exist and understanding that there is diversity a culturally sensitive individual has limited cultural knowledge and may think in terms of stereotypes cultural competence - Correct Answer-includes the ability to "examine and understand nuances" and exercise full cultural empathy." cultural proficiency - Correct Answer-highest level of cultural capacity. In addition to understanding nuances of culture in greater depth, the culturally proficient counselor is also working to advance the field through leadership, research, and outreach COD - Correct Answer-co-occurring disorder AIDS - Correct Answer-acquired immune deficiency syndrome, there is no cure. My have been started by the green monkey, 61% gay or bisexual, 24% IV drug users Wyatt vs. Stickney - Correct Answer-Appropriate treatment for those in institutions, for instance voluntary patients can refuse treatment