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CADC Exam > Treatment Planning, Collaboration, and Referral > Flashcards

Treatment Planning, Collaboration, and Referral Flashcards

1
Q

The boring client

A

Is often boring because they are scared. They desire attention but do not know how to get it. They want to participate but are afraid to take chances and rarely says anything important. Positive reinforcement should be used to encourage participation

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2
Q

The silent client

A

May be afraid of disclosing information, fear the inability to control the situation, or may be manipulative and trying to control the situation. Counselor can invite client to speak up or remove client if harmful to group

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3
Q

The self-righteous client

A

Must be right at all costs. May have had a disappointing life with little success. May be quiet in group settings until there is a chance to prove everyone else wrong. Counselor can help by informing other group members about this type of behavior and its causes

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4
Q

The monopolizing client

A

Demands full attention of counselor and may behave badly to keep counselor’s attention. May give impression that their problems are worse than everyone else’s. Counselor must address this problem before it becomes severe and remind group that listening is an important part of counseling

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5
Q

The hostile client

A

Hostility can be a cover for fear or result from high levels of stress due to unfair treatment or can feel threatened. Counselor can help the client handle the fear that causes hostility

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6
Q

A multidisciplinary approach

A

Takes the individual’s specific needs into mind

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7
Q

Integrated counselor competency

A

The ability of the counselor to combine attitudes, skills, ethics, values, and knowledge to provide appropriate care to clients with co-occurring disorders

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8
Q

Patient care guidelines for level of care

A

American Society of Addiction Medicine’s Patient Placement Criteria; The Level of Care Utilization System for Psychiatric and Addiction Services; Quadrants of Care

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9
Q

Level of care quadrants: Quadrant 1

A

Low level substance abuse problem, minor mental health problems; can be treated in outpatient settings for substance abuse or mental health

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10
Q

Level of care quadrants: Quadrant 2

A

Severe mental disorders, low level substance abuse problem, treated in the mental health system

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11
Q

Level of care quadrants: Quadrant 3

A

Very severe substance abuse problem and mental problems of low to moderate severity, treated in substance abuse treatment programs

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12
Q

Level of care quadrants: Quadrant 4

A

Patients with a serious psychiatric disorder and a severe substance abuse problem; patients with a severe substance abuse problem and a severe behavioral health problem such as suicidal or violent behavior; require intensive care in a residential setting for both mental health and substance abuse problems

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13
Q

Consultation is _____. The goal of consultation is to provide _____ for substance abuse.

A

Meeting with other experts to provide complete and quality care for the client; comprehensive treatment

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14
Q

Signs and symptoms of relapse

A

Positive memories, recalling the good times; neglecting negative effects; sudden behavior changes; complaints about the ineffectiveness or need for treatment; depression, suicidal ideation, withdrawing from others;; excessively fatigued, lacking sleep; increased levels of stress; increased irritability and moodiness; contact with old friends or environments; avoiding social interactions; decreased participation in treatment; lying; evidence of drug/alcohol use

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15
Q

Risk factors for relapse

A

Increased risk for relapse in the first 6 months of treatment; long history of substance abuse; history of relapse; lack of family or social support; family history of substance abuse; dual diagnosis; associating with others who use substances; boredom; physical pain; influx of cash; prescription of opioid drugs; believing in controlled use rather than abstinence; reminiscing about drugs/alcohol use and getting high; depression; access to drugs or alcohol; conflict with others; celebration; substituting addictions; failure to develop coping skills for triggers

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16
Q

Techniques to interrupt the relapse process

A

Limiting distractions; dealing with the truth of addiction; reinforcing the concept of addiction as a disease and relapse a part of recovery; encouraging family participation in therapy; maintaining rules of conduct and accountability; monitoring 12-step progress; intervening immediately when negative behavior happens; maintain a schedule; being alert to manipulation attempts; expecting the client to act responsibly and carry out assigned activities; avoiding pampering or coaxing the client; being honest; encouraging client to complete treatment; assigning clients to learn relaxation techniques; reviewing triggers and methods to avoid them

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17
Q

Detox is often necessary for using drugs in these categories

A

CNS depressants such as alcohol, opiates, cocaine

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18
Q

Withdrawals from alcohol

A

Sleep disturbances, tremors, sweating, hallucinations, agitation, high temperature, increased pulse rate, high blood pressure, seizures

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19
Q

Medications useful in treating alcohol withdrawal

A

Benzodiazepines, barbiturates, beta-blocking drugs

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20
Q

Withdrawals from other CNS depressants (sedatives, hypnotics, anxiolytics)

A

High blood pressure, convulsions, rapid heartbeat, agitation, headache, cognitive impairment. Abrupt withdrawal from these drugs can be life threatening and detoxing includes gradual reduction of the drug or substitution of a similarly acting drug

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21
Q

Withdrawals from opiates

A

Raised blood pressure, increased pulse rate, elevated temperature, excessive nasal discharge, nausea and vomiting, stomach cramps, muscle aches

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22
Q

Detoxification from opiates

A

Involves the substitution of another longer-lasting opioid, such as methadone, and then decreasing gradually

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23
Q

Withdrawals from cocaine

A

Sleepiness, depression, loss of ability to concentrate, paranoia, decreased energy level

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24
Q

Detoxification from cocaine

A

Involves stopping the binges. Users are treated in both inpatient and outpatient. Dropout rate is high

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25
Q

Individualized recovery plans include

A

Personal goals for recovery, steps required to attain goals, list of triggers, coping skills to deal with emotions, prevention strategies such as going to counseling and meetings, self-care activities, commitments that require sobriety such as custody of children, consequences for failure to carry out plan

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26
Q

4 classes of drugs to treat addiction: Agonists

A

Mimic the effects of the drug and are used to alleviate symptoms of withdrawal (methadone)

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27
Q

4 classes of drugs to treat addiction: Antagonists

A

Block the effects of the drug and prevent its psychoactive actions

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28
Q

4 classes of drugs to treat addiction: Antidipsotropics

A

Causes adverse reactions to the consumption of the drug (antabuse)

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29
Q

4 classes of drugs to treat addiction: Psychotropics

A

Controls the symptoms of withdrawals (anxiolytics, antipsychotics, antidepressants)

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30
Q

Stages of recovery: Initiation

A

The client makes a commitment to control the addiction and enters treatment or attempts to without help

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31
Q

Stages of recovery: Early abstinence

A

The first 90 days; Client may have withdrawal symptoms and is at risk for relapse because of physical and psychological cravings. The client needs to learn coping skills to avoid further addiction

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32
Q

Stages of recovery: Maintenance

A

After the first 90 days; The client should focus on avoiding relapse and learning about triggers; may need to improve relationships and anger management; this stage may last up to 5 years

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33
Q

Stages of recovery: Advanced recovery

A

The client has been clean for 5 years but must remain vigilant and attend AA/NA meetings, support groups, or counseling

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34
Q

Early remission

A

Substance abuse diagnosis criteria have been met but not fulfilled for at least three months but not more than one year

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35
Q

Sustained remission

A

Substance abuse diagnosis criteria have been met but not fulfilled for one year or longer

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36
Q

Maintenance therapy

A

A replacement medication that can be taken to avoid withdrawal symptoms (nicotine patches, methadone); The client could still be in remission from substances while on maintenance therapy

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37
Q

Residential programs

A

Require client to live onsite and is useful for those who need a stable environment or have a serious substance use issue

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38
Q

Inpatient hospital treatment programs

A

Residential treatment in a hospital setting

39
Q

Therapeutic community programs

A

Residential program that provides a highly structured environment and focuses on self-help. Ex-addicts are often employed as counselors

40
Q

Outpatient non-methadone treatment programs

A

Private clinics, mental health centers, private practice; clients are treated in the community

41
Q

Combined settings programs

A

Treating the client on both an inpatient and outpatient basis

42
Q

3 programs for people with co-ocurring disorders

A

Addiction only, dual diagnosis capable, dual diagnosis enhanced

43
Q

Addiction only programs accommodate _____

A

Only clients with substance abuse problems

44
Q

Dual diagnosis capable programs are _____

A

Set up to primarily deal with substance abuse problems but can also accommodate individual with mental health problems

45
Q

Dual diagnosis enhanced programs place an emphasis on _____

A

Treating mental disorders, the integration of mental health treatment services, and substance abuse treatment services

46
Q

Behavioral modification is a treatment approach that uses _____

A

Positive and negative consequences to shape behavior

47
Q

Medicaid

A

A federal and state run system that provides health care coverage for low income individuals

48
Q

Medicare

A

Is part of the social security system and provides coverage to individuals over the age of 64 and individuals with disabilities. Part A covers hospital care and hospice care. Part B provides supplementary services at cost and is not mandatory

49
Q

HMOs

A

Cover basic and supplementary care under a fixed, prepaid fee schedule

50
Q

A _____ is an organization set up to join different treatment programs and their associated services to work toward common goals

A

System; Substance abuse treatment centers may interact with organizations dealing with social services or with the justice system

51
Q

Substance abuse treatment systems are concerned with _____

A

Stabilization, treatment, rehabilitation, and relapse prevention

52
Q

Mental health systems provide _____

A

Crisis intervention, stabilization treatment, ongoing treatment, and rehabilitation support

53
Q

Rational Recovery

A

An educational company that publishes Addictive Voice Recognition Technique to aid substance abusers in self-recovery

54
Q

Addictive Voice Recognition Technique is based on the following ideas _____

A

Most people can recover with professional help or recovery groups; A commitment to abstinence can lead to abstinence; Recovery from addiction is easier than it is made out to be; The role of a counselor is to convince the individual that he/she can quit; A group setting is not the most effective way to quit drug use; Becoming intoxicated is a personal decision; An individual can learn to identify himself/herself as a non-user

55
Q

Moderate Management

A

Is a group that provides support for individuals who wish to cut back their drinking to a point where it no longer causes problems; MM is a self-help program and members are provided with information on managing alcohol use; This is a possible goal for those who drink too much but are not dependent on alcohol

56
Q

Women for Sobriety

A

Founded the New Life program; uses 13 positive statements to encourage women to learn a new lifestyle and to overcome alcoholism; Founded on the idea that female alcoholics are different from male alcoholics and need a different type of help

57
Q

Secular Organization for Sobriety or Save Our Selves or SOS

A

Welcome both drug and alcohol users; based on the idea that sobriety and religion are separate issues; The individual is responsible for his/her own sobriety and given credit for maintaining sobriety

58
Q

Self-Management and Recovery Training or SMART

A

Helps individuals who want to overcome any kind of addictive behavior; Addiction is not viewed as a disease but seen as a maladaptive behavior pattern

59
Q

Self-Management and Recovery Training or SMART uses the four points in the program _____

A

Maintaining motivation to stay clean, dealing with cravings, problem solving with rationality, creating a balanced lifestyle

60
Q

The Minnesota Model

A

Is an adaptation of the 12-step program used to treat both alcohol and drug abuse; highly structured system that includes detox, psychological assessment, group and individual meetings, lectures; 21, 28, or 60 day residential versions

61
Q

_____ recognizes that abstinence may not always be attainable so the goal should be to use substances more _____

A

The harm-reduction model; responsibly

62
Q

_____ focuses on what is observed rather than opinions

A

Objective documentation

63
Q

A _____ provides a chronological report of the client’s condition, treatment, and responses

A

Narrative

64
Q

_____ is a problem-oriented form of charting that establishes goals, expected outcomes, needs, and compiling a list of problems.

A

SOAP (subjective data - client’s statement of problem, objective data - observations, assessment - determination of possible causes, plan of action - short and long-term goals and immediate plan of care)

65
Q

_____ is a problem-oriented form of charting similar to SOAP but less complex. It combines the use of flow sheets with progress notes and a list of problems

A

PIE (problem, intervention, evaluation)

66
Q

_____ is focused charting that includes documentation about health problems, changes in condition, concerns or events, focusing on data about the condition, the action taken by the counselor, and the response

A

Focus/DAR (Data, action, response)

67
Q

Instead of simply noting a client engaged in an activity, the _____ of the activity should be noted, such as “exercised for 30 minutes”

A

Duration

68
Q

The _____ events occur should be accurately reported to help identify patterns of behavior, such as cravings occurring throughout the day

A

Time

69
Q

6 stages of counseling: During the _____, the counselor collects as much information as possible from as many sources as possible

A

Information gathering stage

70
Q

6 stages of counseling: The _____ includes assessing the nature of the problem, investigating contributing factors, and determining whether or not the client is a good match for the counselor

A

Evaluation stage

71
Q

6 stages of counseling: _____ involves providing information so the client can decide whether or not to continue treatment

A

Feedback

72
Q

6 stages of counseling: As part of the _____, the counselor and client agree upon the length of treatment, what to expect from each other, and the goals of treatment

A

Counseling agreement

73
Q

6 stages of counseling: The _____ involves working toward the stated goals

A

Changing behavior stage

74
Q

6 stages of counseling: The _____ occurs when the therapist and client agree that the improvements are evident and that the continuation of treatment is not necessary

A

Termination stage

75
Q

_____ ensures that the listener actually hears what is being said. It conveys interest in the speaker and makes him/her feel comfortable

A

Attentive listening

76
Q

_____ uses small phrases to encourage the speaker to continue

A

Minimal encouragers

77
Q

_____ is repeating the speaker’s words back to him or her to clarify statements

A

Parroting

78
Q

_____ is rephrasing the speaker’s statements to show the listener understands what the speaker is saying

A

Paraphrasing

79
Q

_____ is commenting on what was said and implied in a conversation to provide feedback for the speaker

A

Reflecting with interpretations

80
Q

_____ is pointing out discrepancies between the client’s true self and and view of himself/herself. These discrepancies can be seen by comparing the client’s verbal statements and nonverbal behavior

A

Confrontation

81
Q

_____: Ability to establish a trusting relationship with the client

A

Attending skills

82
Q

_____: Identifying variables relevant to the problem

A

Concreteness

83
Q

_____: Distinguishing between what the client says and what the client feels

A

Distinguishing content from feelings

84
Q

_____: Knowing how to conduct a session without leading the patient

A

Probing

85
Q

_____: Feeling what the patient is feeling

A

Accurate empathy

86
Q

_____: Remaining true to yourself

A

Genuineness

87
Q

_____: Treating the patient as a worthy individual

A

Respect

88
Q

Attending Skills: Physical attending skills

A

Keeping a comfortable distance, maintaining face to face and relaxed posture, keeping eye contact

89
Q

Attending Skills: Psychological attending skills

A

Observing the client’s physical characteristics and tone of voice, choice of words, and themes of conservation

90
Q

Attending Skills: Self-attending skills

A

Counselor’s awareness of the impression he or she is making

91
Q

Attending Skills: Responding skills

A

Responding appropriately and letting the client know the counselor is interested and listening

92
Q

_____ is the opposite of vagueness and involves stating problems and issues in specific terms

A

Concreteness: Encouraging the client to acknowledge “I slept in this morning and missed work” rather than saying “I always mess up”

93
Q

The three components of interpreting

A

Addressing the client’s ideas and restating them; adding counselor’s ideas to the client’s ideas; going over these ideas with the client

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