Addictions Counseling Midterm C 2006 B
ansi Times New Roman default ansi Times New Roman variable roman Buelow, Ch. 1 Buelow, Ch. 2 Buelow, Ch. 3 Buelow, Ch. 4 Concepts of Chemcial Dependency Ch. 27 Concepts of Chemcial Dependency Ch. 29 Concepts of Chemcial dependency Ch. 31 Concepts of Chemical Dependency Ch. 2 Concepts of Chemical Dependency Ch. 3 Concepts of Chemical Dependency Ch. 4 Concepts of Chemical Dependency Ch. 5 Concepts of Chemical Dependency Ch. 6 Concepts of Chemical Dependency Ch. 7 Concepts of Chemical Dependency Ch. 24 Concepts of Chemical Dependency Ch. 25 Concepts of Chemical Dependency Ch. 26 Concepts of Chemical Dependency Ch. 28 Concepts of Chemical Dependency Ch. 30 Concepts of Chemical Dependency Ch. 32 Concepts of Chemical Dependency Ch. 34 Concepts of Chemical Dependency Ch.1 Lecture Lecture May Ch. 1 Miller & Rollnick Name: ________________________ Class: ___________________ Date: __________ ID: C Name: ________________________ ID: True/False Indicate whether the sentence or statement is true or false. Modified True/False Indicate whether the sentence or statement is true or false. If false, change the identified word or phrase to make the sentence or statement true. Multiple Choice Identify the letter of the choice that best completes the statement or answers the question. Multiple Response Identify one or more choices that best complete the statement or answer the question. Yes/No Indicate whether you agree with the sentence or statement. Numeric Response Completion Complete each sentence or statement. Matching Short Answer Problem Essay Case Other Sam is a 37 year-old white male was encouraged to come to treatment by his wife. Sam describes that his wife gave him an ultimatum, “get help to stop drinking or she is leaving him.” He is serious about not losing his wife. Subsequently he states that he is willing to come to counseling. Sam reported that he wants to save and improve his marriage, but added that he believes that his wife is over sensitive about his drinking. He explained that she grew up with an alcoholic father who was emotionally and physically abusive father. Sam stated, “She has said on several occasion that she does not want to create a home that was like hers growing up.” He will do what ever is necessary to save his marriage, but is clear that he does not think he has a drinking or drug problem. He refuses to go through any alcohol or 12-step recovery programs. Mr. & Mrs. O have brought Jimmy to counseling to resolve his use of drugs and alcohol. Jimmy is a 16 year-old Asian American male. Both Jimmy and his parents note that he has been using marijuana and alcohol with increasing regularity over the past six months. This has effected intense conflicts between Jimmy and his parents. Jimmy admits also to using alcohol and marijuana, acknowledging that he has come home intoxicated or high on several occasions. It is evident in your assessment that Jimmy drinks to get drunk rapidly. He adds that he does this to simply have fun. “It is not a party without drinking or smoking marijuana,” Jimmy said. In addition he admits to feeling ‘a strong temptation’ to drink, which he would do more often if he could get his hands on booze more easily. Jimmy agrees that he does drink too much, but believes he will grow out of it some day. He simply does not want to give up his freedom “to cut loose and get blasted.” Despite this, he sees no need to change and only came to treatment because his parents made him. He adds that his use his only impacted his relationship with his parents, nothing else--as evident by his maintaining great grades. Jimmy’s two goals for counseling are to get out of coming to counseling and improve his relationship with his parents. Terry comes into therapy to address concerns about feeling more lethargic. When asked about his marijuana use, he confessed that his use has increased lately. He adds that he wonders whether he has a problem abusing marijuana. In working with Sam it would be best to question his resistance. directly confront this drinking. ignore his drinking habits totally and only address his concerns about his marriage. discuss his thoughts about wife’s concern about his drinking and marriage. D 1 What stage of change best reflects Sam’s motivation for working on his marriage contemplation decision or preparing to change maintenance precontemplation B 1 What stage of change is Sam in regarding his drinking? contemplation precontemplation action maintenance decision or preparing to change B 1 According Miller & Rollnick, some early temptations to avoid in doing motivational interviewing are question-answering, labeling, one down positioning. labeling, premature focusing, blaming, expert opinioning. taking sides, expert analyzing, directive supporting. conveying empathy, noting discrepancies, highlighting ambiguities. B Miller & Rollnick | p.55-63 | ch. 6 1 A thorough case conceptualization includes _____________ aspects of a person. physical, psychological, social, occupational & academic biological, psychological, social, specific, and spiritual biological, psychological, social, familial, & civil psychological, chemical use history, technical and spiritual B Buelow, p. 93 | Dr. Bj's comments in class 1 According to May, addiction uses up desire. replaces desire. uses up repression. replaces repression. A May | p. 13 1 Suicidal assessment and intervention with substance abusers is similar to other types of clients with several important distinctions which contribute to greater lethality. These distinctions are sense of hopelessness, elucidated plan, & available lethal means impaired judgement, depressive affect, low self-efficacy, experiences of hopeless, and drug interactions. impaired impulse control & judgement, labile affect, diminished cognitive abilities, & drug exacerbation of concurrent mental illness. There are no relevant distinctions between the two groups. impaired affect, poor judgement, drug interaction and exacerbation of functioning, poor family functioning and experience of hopelessness. C Beulow | p. 112-113 1 Chemical dependency is a primary progressive disease with pathological symptoms. medical disorder with bio/psycho/social causes & consequences. none of these apply. pathological disease with progressive bio/psycho/social & spiritual causes & consequences. A 1 Terry is in what phase/stage of change? determination action contemplation precontemplation C 1 The best approach with Terry would be to give advice regarding your concerns. direct him toward recognition of sobriety. develop his concerns and sway him toward a desire for change. sympathize with him regarding his struggles with marijuana. C 1 You conclude that Sally, a chemically dependent patient with no signs of serious withdrawal symptoms needs treatment for her addiction. She lacks a supportive drug free environment and is personally very susceptible to peer pressure and environmental influences to use. What treatment services would best serve Sally? intensive outpatient program hospitalization outpatient counseling residential D Buelow | p. 56 1 Jimmy is likely in what phase of use? experimentation progressive use regular use state dependent D 1 Which stage of change is Jimmy in regarding his drug/alcohol use? maintenance/relapse contemplation precontemplation action C 1 Jimmy’s desire to improve his relationship with his parents is indicative of what stage of change? precontemplation contemplation determination or preparing to change maintenance C 1 It would be best to practically and specifically do none of the these options. confront Jimmy about his abuse and the potential dangers. roll with his resistance and build on any discrepancies between his use and nonuse. build up his motivation for change. C 1 In regards to Jimmy’s goals it would be best to ignore them. work with his parents to help them understand how his use impacts them. work toward his parents’ goals. build his awareness of how his use impacts his relationship with his parents. D 1 An addict who does not consider the importance of maintenance in his recovery could be considered to be in what stage of change concerning his need for continued treatment maintenance to support sobriety? precontemplation maintenance/relapse action determination contemplation A Buelow | p. 124 1 A mental status exam is a current reflection of the client’s overall emotional, behavioral and cognitive functioning. a general and fluid assessment of the client’s mental state. always includes a chemical use history. need not consider suicidality or homicidality. A Buelow | p. 52 1 Which of the following lists are foundational throughout the process of motivational interviewing in facilitating an environment that is conducive to change? stimulating change talk, affirmation, open questioning, reflecting listening, summarizing. ambivalence, discrepancy, & motivation for change. accurate empathy, warmth and genuineness. none of the above. C Miller & Rollnick | p. 65-78 | ch. 6 1 Motivational Interviewing’s first phase seeks to _______________ then (second phase) ___________________. foster then promote ambivalence. create confidence then support change. diminish resistance then enhance cooperation. build then strengthen a desire for change. D Miller & Rollnick | p. 52 | ch. 6 1 Which statement below is most true according the May? “...repression attaches desire and fosters addiction.” “...addiction replaces the repressed desire for attachment.” none are true according to G. May “...repression stifles desire, addiction attaches desire.” D May | p. 3 1 The stage of change involving an inactivity, resistance or lack of awareness of change is precontemplation contemplation Maintenance decision Action A Buelow | p.16-25 1 Pattern usage, experimentation, and state dependent use are three __________________. phases or patterns of use gateways of usage dynamics of usage. types or styles of using drugs A 1 The stage of change that reflects an indecision or ambivalence about change is decision precontemplation contemplation action maintenance C Buelow | p. 16-25 1 The relapse dynamic is a set of feelings, beliefs, expectancies and behaviors that are set in motion by causative factors that are reciprocal and multiple cognitive, affective, & behavioral biological, psychological, & social none of the above A Buelow | p. 128 1 There are four general principles that underscore the practice of Motivation Interviewing. They are express empathy, develop discrepancy, roll with resistance, support self-efficacy. precontemplation, contemplation, action, & maintenance. accurate empathy, avoid ambivalence, support resistance, acknowledge treat efficacy. develop discrepancy, avoid ambivalence, encourage change talk, support change efforts. A Miller & Rollnick | p.36 | ch. 4 1 Research reflects directive confrontation, though increasing resistance, promotes change talk. that the amount of change is the same regardless of the length (amount) of treatment. that accurate empathy, but not genuineness warmth are conditions of change. all of the above B Miller & Rollnick | p. 4-10 | ch. 1 1 Which statement is most true? Motivation is a static state which is influenced primarily by outside factors. Motivation is a reactive phenomenon. Motivation is a variable state that is influenced by outside factors. Motivation originates within the person and is influenced by internal factors. C 1 Relapse often results from successes and failures in personal life. current treatment. problems that develop from present sobriety. past treatment. B Buelow | p.125 1 Resistance is expected. the focus of motivational interviewing. feedback that tx has failed. all of the above A Miller & Rollnick | p. 98 & 109 | ch.8 1 The first task in the clinical interview, according to Buelow & Buelow, is to outline the person’s drug use history. determine the stage of change the person is in. determine why the person is in the intake and assessment process. determine what the person has done in the past to make a change in his life. C Buelow | p. 46 1 Reframing, according to Miller & Rollnick, is the offering of a new & different meaning to what the patient presented. simply a reflection of what the patient stated, but with an intentional twist. changing what the client stated in a way that increases his ambivalence for change. all of the above A Miller & Rollnick | p. 103 | ch. 8 1 The primary objectives of motivation interviewing are be empathic & facilitate motivation. build motivation & strengthen commitment to change. create ambivalence & change. be empathic & strengthen commitment to change. B 1 The person who is successfully working toward change can best be described to what stage of change action determination contemplation precontemplation A Buelow | p. 16-25 1 The clinical interview contains five practical critical appraisals. These include assessing all of the following except ___________. assessment of dual diagnosis current sobriety client’s understanding of reality cultural and ethnicity family history of substance abuse E Buelow | p. 51 1 The are three main activities that make a sound treatment plan. These three main activities are ____________. testing, interview, and recommendations intake, assessment, and conceptualization interview, intake, and assessment none of the above B Buelow | p. 48 1 The motivational interviewer must be aware of genuineness the client’s resistance to change the client’s differential responses directiveness B Miller & Rollnick | p. 86 | ch. 7 1 Between 20-50% of all hospital admission are thought to be caused by accidents caused by alcohol abuse cancer caused by alcohol or drug abuse infectious diseases the effects of alcohol or drug abuse D p. 1 CofCD 1 Metabolic tolerance is best defined as the development of substance-induced liver disease. when the liver becomes less efficient at breaking down alcohol or a drug than it was when the patient was younger. when the body becomes more efficient at breaking down a compound such as alcohol. when the person no longer suffers from the side-effects of a drug. C p. 11 CofCD 1 All of the following are criteria for a diagnosis of alcohol or drug dependency, according to the DSM-IV-TR, except which of the following development of tolerance. use of the chemical at inappropriate times. preoccupations with further use of the chemical. using alcohol only during periods of peak stress. D p. 20 Cof CD 1 According to the Doweiko text the disease model is well researched, few areas of this theory are in dispute. the disease model for alcoholism has been proven to account for the phenomenon of alcohol addiction. the disease model rest upon the latest finding from human genetic research into how disease states affect people. no single model of addictions has come to dominate the field of rehabilitation as has the medical model. D p. 29 CofCD 1 The Final Common Pathway theory of addiction rests on the finding that: most of the drugs of abuse reach the brain through the circulatory system. all the drugs of abuse activate the brain’s reward system. the common drugs of abuse have similar chemical structures. all drug abuse ends at the same place. B p. 41 CofCD 1 One sign of addiction to chemicals is the individual’s: constant struggle to avoid tx or change efforts by others. preoccupation with further chemical use. by the person;s use of psychotic defenses in order to try and avoid sanity. none of these options are a sign of addiction. B p. 46 CofCD 1 For most of the drugs of abuse, the site of action is the site where the drug enters the body. Central Nervous System. the heart and cardiovascular system. the gastrointestinal tract. B p. 55 CofCD 1 As a general rule, the liver can metabolize __________________ in an hour’s time. three regular drinks or three 12 once beers. two regular drinks or two 12 once beers. two cans of beer or two mixed drinks either one regular drink or one beer. D p. 75 CofCd 1 According to the Doweiko text, to “enable” someone means to ____________ act in such a way as to protect another person from the consequences of his or her behavior. repeatedly reluctantly knowingly inadvertently C p. 320 CofCD 1 The theory of the co-alcoholic was ____________________ supported by research data, according to the Doweiko text. clearly never only partially rarely B p. 328 Cof CD 1 If a therapist were to say that he had a client that was “codependent”, you could expect what characteristics to exist in that client? (Doweiko) who knows? It is a “garbage can dx. excessive denial on the part of the addicted person. an addicted person who rationalizes a great deal. excessive guilt about his/her addictive behavior. A p. 328 CofCD 1 Surprisingly, as the dance of addiction continues, the family may come to: object loudly, and make plans for a formal intervention session. take away from the alcoholic’s power base by constantly pointing out to him/her how he/she is powerless within the family. restructure or center its activities so that it becomes easier for the addicted member to continue to use alcohol or drugs. back away from the possibility that they might also have a chemical abuse problem. C p.333 CofCD 1 The Damage Model is said to: automatically assume that children raised in alcoholic homes suffer a unique form of psychological harm. be too limited in scope, and should be expanded to apply to other forms of dysfunctional homes. take too long for a therapeutic intervention to work with people who suffer from this personality pattern. be far too expensive, and take too ling, before the individual notices any significant change. A p. 337 CofCD 1 According to your text, people tend to marry somebody whose alcohol and drug use is _________. somewhat the opposite of our own, because “love will conquer all” similar to our own known to be a certain duration and frequency conflictual B p. 331 CofCD 1 According to the Doweiko text, it has been claimed that ___________% of the population was raised in a dysfunctional home. 72% 55% 83% 96% This is the correct answer, but I think it is too low. (Dr. Bjorge) D p. 338 CofCD 1 The primary duty of the substance assessor, according to Doweiko, is to first determine whether or not there is evidence that a substance use problem exists. develop a treatment plan. start to plan how to break through the client’s denial. confront the client about his/her drug us problem. A p.341 CofCD 1 One of the most important aspects of an assessment process is to identify sources of collateral information, but do not talk with the informants. gather information from collateral sources about the person’s use/abuse patterns. assume that the client is being completely honest about his/her use/abuse. integrate the client’s emotional state into the understanding of his/her use/abuse. B p. 347 CofCD 1 Which of the following is not part of the CAGE? asking if the person has ever tried to reduce the amount he/she drinks. asking if the person has ever become irritated when confronted about his/her drinking, or if significant others have expressed irritation about his/her drinking. asking about feelings of guilt when the person thinks about his/her alcohol use. asking the individual about collusion within the family to hide the individual’s substance abuse problem. D p.349 CofCD 1 According to Doweiko and/or Bjorge, which of the following is not part the intervention session. a desire to help the person a desire for revenge for personal suffering the wisdom of not discussing certain issues, that might overly upset the client the need to express love and concern for the abuser B p. 357 CofCD 1 Counselors who are best able to help others are clients who are: themselves former addicts who are familiar with what it is like to live with someone who is dependent on drugs. individuals with good interpersonal skills. facing their own struggle with chemical dependency issues. individuals who are “adult children.” B p. 366 CofCD 1 Harsh confrontation designed to strip away the client’s denial ____________________. is often counterproductive. is often productive. works early in treatment. works well with teenagers. A p.366 CofCD 1 Detoxification from chemicals is not a form of treatment by itself. is enough to facilitate recovery. is always a treatment option. all of these options apply. A p. 370 CofCD 1 Doweiko notes that there is strong evidence that __________________ is helpful in alcoholism treatment. confrontation electro convulsive therapy social skills training psychoanalysis C p. 372 CofCD 1 Which of the following is the least intensive form of treatment? DWI school, Psychoeducational tx inpatient treatment intensive outpatient residential or therapeutic community A p. 375 CofCD & Class notes/discussion 1 Doweiko points out that research has suggested that there are significant differences in the percentage of “graduates” of outpatient programs who remain sober, as compared with inpatient treatment programs. outpatient treatment is more effective for the chronic or hardened addict. greater percentage of inpatient treatment programs will remain sober when compared to graduates of outpatient treatment programs. there is no significant difference between the success rates of inpatient and outpatient treatment programs. D p. 377 CofCD 1 Which of the following is a disadvantage of outpatient rehabilitation programs, according to the Doweiko text? they tend to work best with highly unmotivated patients who have had time to experience serious life consequences. they are unable to provide the same degree of support and structure as inpatient treatment programs. they tend to work best with highly motivated patients who have not had time to experience serious life consequences. none of these options apply. B p. 376 CofCD 1 During the precontemplation stage, one is likely to see: active chemical use, with vague plan to stop using. active use , without any plans to stop using. concrete efforts to stop using chemicals. none of these options apply. B p. 386 1 During the contemplation stage, one is likely to see: active chemical use, with vague plans to stop. active chemical use, without any plans to stop. concrete efforts to stop using chemical. none of these options apply. A p.387 CofCD 1 During the action stage, one is likely to see: active chemical use, with vague plans to stop using. active chemical use, without any plans to stop using. concrete efforts to stop using chemical. none of these options apply. C p. 387 CofCD 1 The theory behind Antabuse (disulfiram) is that it: inhibits the craving for alcohol. blocks the neurological reward mechanism of alcohol. prevents alcohol absorption. will make the person who has consumed alcohol quite ill, thereby promoting a chance to think about whether he/she really wants before he/she does so. D p. 417 CofCD 1 According to Doweiko, and Bjorge would agree, the commitment to enter treatment should not be confused with the ability to pay for treatment. the absence of family conflict over use. sound cognitive processes. the commitment to change. A p. 398 CofCD 1 Although AA is a ____________________ , it is not a _________________________, according to Doweiko (AA and many others). spiritual program--religious program treatment program--support group religious program--treatment program all these options apply. A p. 449 CofCD 1 The role of the AA sponsor is to principally: serve as a guide within the AA program. take charge of the sponsoreds recovery. be a spiritual mentor and advisor. all these options apply. A p. 452 CofCD 1