Chapter 18: Working with Substance-Related Disorders, Domestic Violence, and Child Abuse

Question 1

For some families, abuse is an entity from which they ____ recover

Answer 1

Never

Question 2

Family abuse or violence appears to be directly linked to both ____ and ____.

Answer 2

both general anxiety disorder // romantic relationship distress

Question 3

According to Gladding, what are the three forms of abuse discussed in chapter 18?

Answer 3

substance-related disorders
domestic violence
child abuse

Question 4

____ defined as “disorders related to the taking of a drug of abuse (including alcohol), to the side effects of medication, and to toxin exposure” are even more disruptive.

Answer 4

substance-related disorders

Question 5

How are substances grouped for diagnostic purposes?

Answer 5

into 11 classes
alcohol
amphetimines or similar acting sympathomimetic; 
caffeine; 
cannabis; 
cocaine; 
hallucinogens; 
inhalants; 
nicotine; 
opioids; 
phencyclidine (PCP)  
and sedatives, hypnotics, or anxiolytics”

Question 6

What are the two general levels or forms of alcohol use disorders?

Answer 6

alcohol abuse

alcohol dependency

Question 7

.____ alcohol problems, which includes two levels: alcohol abuse and alcohol dependency.

Answer 7

Alcohol use disorder

Question 8

____ “a problem pattern where the drinking interferes with work, school, or home life” in addition to other difficulties with the law and society

Answer 8

Alcohol Abuse

Question 9

____ in which the person is unable to control his or her drinking behavior even after trying.

Answer 9

Alcohol Dependency

Question 10

How are substance-related disorders considered to be family-based and supported?

Answer 10

• As a way of coping with a crisis or connecting with one another
• Family communication can also act as an enabler of the substance abuser

Question 11

How do families play a role in the development and maintenance of substance abuse

Answer 11

Family conflict and communication can reinforce undesirable behavior.

Question 12

How does substance misuse affect families and society?

Answer 12

• Causes deaths, illnesses, and disabilities than any other preventable health condition
• Affects families by undermining family life
• Affects the economy and public safety

Question 13

_____ falls sense of identity that an individual may create for themselves.

Answer 13

Pseudo individuation/ pseudo self

Question 14

Who does substance abuse disorder affect?

Answer 14

• Couples
• Families
• Individuals within them
• Society

Question 15

How do the behaviors of a person experiencing substance mise affect others?

Answer 15

• Behaviors permeate and penetrate into other relationships and affect the actions of everyone who comes into contact with the person who has the disorder.

Question 16

Society is affected by those that abuse substances, in what ways?

Answer 16

• Substance abuse costs the U.S. more than 400 billion annually in crime, health, and lost productivity.

Question 17

Families may try ____ or ___ methods initially when dealing with a family member with a substance abuse disorder.

Answer 17

unhealthy

dysfunctional

Question 18

What is a consequence of a couple or family dealing with a substance-related disorder when the non-abusing members of the couple/family shield the substance-related abuser from the negative consequences of his or her actions?

Answer 18

The abuser does not get a true picture of the seriousness of his or her actions

Question 19

What is a consequence of a couple or family dealing with a substance-related disorder through denial and pretending that the disorder is not present in their household and non-abusing members make excuses for the abusing member?

Answer 19

The couple/family does not acknowledge the “elephant in the room” and shields the abuser from the consequences of his or her actions.

Question 20

What is a consequence of a couple or family dealing with a substance-related disorder through the expression of negative feelings?

Answer 20

The family except for the abuser experience a plethora of unpleasant emotions, such as fear, anger, shame, guilt, resentment, insecurity, confusion, and rejection.

Question 21

___ a role that an individual may take on in a family with a substance abuser to allow them and others to survive.
A spouse or other family member on whom the substance abuser is most dependent and who allows a substance abuser to continue and become worse.

Answer 21

Enabler

Question 22

___ a role that an individual may take on in a family with a substance abuser to allow them and others to survive.
Adult or oldest child who functions to provide self-worth for the family.

Answer 22

Family hero

Question 23

___ a role that an individual may take on in a family with a substance abuser to allow them and others to survive.
Often a child who attempts to distract the family focus away from the substance abuser by acting out in a disruptive manner and being blamed for the family’s problem.

Answer 23

Scapegoat

Question 24

___ a role that an individual may take on in a family with a substance abuser to allow them and others to survive.
Usually, a child in the family who suffers from rejection and loneliness and offers a substance-abuser family relief.

Answer 24

lost child

Question 25

___ a role that an individual may take on in a family with a substance abuser to allow them and others to survive. Often the youngest member of the family whose function is to provide the family with humor and thus reduce tension?

Answer 25

Family clown

Question 26

What is a consequence of a couple or family dealing with a substance-related disorder through deterioration such as drinking or using substances together?

Answer 26

Children in these families grow into adolescents and the consumption of a harmful substance within a couple or family is centered on an adult or adults.

Question 27

What is a consequence of a couple or family dealing with a substance-related disorder through misuse or abuse of the family resources as well?

Answer 27

Everyone suffers physically because of a lack of money and effort to purchase essential necessities.

Question 28

Children who come from couples and families with substance-related disorders may behave in a confused way about their self-identity and self-worth, what are the consequence of their lack of identity and self-worth?

Answer 28

They may become controlling in their interpersonal relationships as a way of gaining security. May develop social and emotional problems Low school achievement and trouble with the law. Fell less attached and bonded to others have more difficulty with intimate relationships ex: marriage.

Question 29

____ is an especially effective intervention for treating adolescent drug use when compared with nonfamily-based interventions.

Answer 29

Family Therapy

Question 30

What is considered the most difficult and critical part of the process for providing substance-related disorders in families and can become especially difficult when working with families of minority populations?

Answer 30

Getting the family to agree to therapy

Question 31

A method for getting the family engaged in the therapy process is when a family member has a substance-abuse disorder that involves spouses, relatives, or children of the substance abuser or dependent person.

Answer 31

Concerned Significant Other (CSOs)

Question 32

____ where family members meet with a substance abuser in a surprise meeting and the abuser is confronted by the family about all of the problems that his/her behaviors have caused.

Answer 32

Intervention

Question 33

Widen "the focus of attention from providing therapy once a family brings itself to the clinic to considering that the treatment begins prior to the first clinic visit" How does this help engage a family in the treatment process?

Answer 33

Deemphasis is placed on the therapist as the ally of the family member who made the initial call.

Question 34

What are developmental issues that may present themselves most blatantly in the early stage of treatment?

Answer 34

The status of the identified patient in the family system.

Question 35

___ an extremely powerful member of the family whose development has been arrested and who is generally resistant to therapy because to engage in the process is to agree to someone else's agenda and weaken the position of power.

Answer 35

Identified patient

Question 36

What is a way for a therapist to engage a substance-related disorder family to its fullest?

Answer 36

Call the person in the family who is the most disengaged.

Question 37

Many families are affected by ______ that involve taking a drug of abuse. This is often considered a family systems problem.

Answer 37

substance-related disorder

Question 38

Treatment for substance-related disorder families must address issues such as: ____, ___, and _____, and ____.

Answer 38

relapse the environment intrapersonal(emotions) interpersonal (social) relations

Question 39

Which way are useful in working with substance-related disorder families: 1. ___ 2. ___ 3. ___ 4. ___

Answer 39

1. structural- strategic family therapy 2. Bowen family therapy 3. Behavioral family therapy 4. Multifamily therapy

Question 40

What are community resources that can be utilized by families with a substance-related disorder as a part of therapeutic treatment?

Answer 40

AA or Al-Anon and prevention activities

Question 41

What are the types of violence against spouses?

Answer 41

physical sexual psychological economic

Question 42

Violence in families stems from a _____.

Answer 42

power imbalance

Question 43

What are the two levels of violence in families?

Answer 43

1. common couple violence | 2. SPV or IPV

Question 44

How is the assessment of domestic violence best done?

Answer 44

In an open manner with an emphasis on how the family is hurt rather who is to blame

Question 45

Each year ___ children are victims of child abuse.

Answer 45

1 million

Question 46

What are the different types of child abuse:

Answer 46

Physical Sexual Psychological Neglect and Abandonment

Question 47

____ or ___ abuse is the most long-lasting and damaging.

Answer 47

Emotional/ Psychological

Question 48

Why is the treatment of child abuse complicated?

Answer 48

It involves legal, developmental, and psychological issues

Question 49

Treatment of child abuse and neglect may focus on ___ and on current issues

Answer 49

historical

Question 50

What are the common therapeutic approaches used to treat child abuse and neglect?

Answer 50

Bowen and behavioral family treatments peer groups of children and parents

Question 51

___ an evidence-based treatment approach for working with adolescent substance abusers. Recovery in this model is a process that occurs in and with systems support and in stages

Answer 51

Community reinforcement approach (CRA)

Question 52

___ the physical aspects of a family's life, such as getting the substance abuse behavior stopped.

Answer 52

Environmental influences

Question 53

___ home-based family counseling based on social ecology. Individuals are viewed as nested within a complex of interconnected systems that encompass individual, family, and extrafamilial factors. The behavior is seen as the product of reciprocal interplay between the family.

Answer 53

Multisystemic therapy

Question 54

_____ treatments are based on the recognition that substance use and other related problem behavior derive commonly form many sources of influence and occur in the context of multiple systems

Answer 54

multisystemic

Question 55

____ Treatment should initially address excessive drinking or other forms of substance abuse in order to get it stopped. EX: inpatient detoxification, enrolling in support program (AA) After abuse ends, treatment based on clear thinking and a drug free mind. Can be used with multigenerations and minority. populations.

Answer 55

Structural-strategic family therapy

Question 56

A technique for working with families who have individuals who are substance-related abusers. The idea behind this therapy is to treat several families at the same time.

Answer 56

Multi-Family therapy

Question 57

Which of the following is not a factor of multi family therapy? A. Not cost effective B. Reported to have high success rate C. A person may experience dynamics in other families D. Helpful for substance abuser gaining different perspective

Answer 57

A. Not cost effective

Question 58

___ are prime beneficiaries of multi family therapy.

Answer 58

Women

Question 59

In what way do women have pressure alleviated off them by attending multi family therapy.

Answer 59

Women may typically feel pressure to leave treatment before they are ready because of family obligations by attending this therapy, the family gives the client permission to stay in treatment and demonstrates that its members are managing at home without client.

Question 60

____ from substance-related abuse is dependent on which of the following? A. Keeping a person abusing the substance B. Replacing old behaviors with non productive C. Keeping a person or family from engaging in the habitual activity. D. Keeping the family from engaging in the habitual activity

Answer 60

C. Keeping a person or family from engaging in the habitual activity.

Question 61

Which of the following is a prevention method used to prevent adolescents from using alcohol? A. Giving young people accurate information about alcohol use in an objective way B. Presenting information through a “teen-respected” source C. Using parent networking D. All of the above

Answer 61

D. All of the above

Question 62

___ are aimed at keeping substance-related abusers free from the resumption of the habits that harmed their family lives

Answer 62

12-step programs

Question 63

__ assist family members in both understanding the dynamics involved in substance-related abuse and finding ways of not enabling the abuser to resume his or her destructive behavior. A. Al- Anon B. Interventions C. 12-step program D. General offering groups

Answer 63

A. Al-Anon

Question 64

___ Is effective family therapy for alcohol abuse. Is especially helpful as a component in implementing a program that deals with codependency treatment.

Answer 64

Bowen Family Therapy

Question 65

What is a feature of Bowen family therapy in which one reaches a balanced state of being gain from the therapeutic process?

Answer 65

Learn to distinguish between subjective feelings and objective thoughts to become more flexible, adaptable, and independent.

Question 66

Which methods are implemented within Bowen family therapy for treatment?

Answer 66

Genogram s I position statements Reconnections of emotional cutoffs

Question 67

What is something that individuals receiving therapy from the Bowen family therapy model? A. Have a greater sense of self by attending support groups B. Stop behaving in ways that make them dependent C. Greater freedom to change how they relate to others D. Both B&C

Answer 67

D. Both B &C

Question 68

___ a form of treatment for families with a substance-abuser that involves getting the entire family in treatment. The treatment itself should initially address excessive drinking or other forms of S/A in order to get it to stop. May involve inpatient treatments

Answer 68

Structural-Strategic family therapy

Question 69

__ Refers to “Aggression” that takes place in intimate relationships, usually between adults. Is the willful intimidation, assault, battery, sexual assault, and/or other abusive behavior perpetrated on one intimate partner or another.

Answer 69

Domestic Violence (D/V)

Question 70

In which types of populations is d/v higher?

Answer 70

Military with mental disorders, veterans with PTSD than general population

Question 71

What is the worst form of D/V that includes severe physical assault or risk of serious injury?

Answer 71

Battering

Question 72

___

Answer 72

Intimate Partner violence

Question 73

Who developed the typology that created a classification system that identifies batters as Pitbulls and Cobras?

Answer 73

John Gottman including Neil Jacobsen

Question 74

A type of batterer that was identified by assessing the relationship of violent behaviors, and physiological makers such as heart rate and marital conflict. __ Heart rate increases as they become more verbally aggressive with their partners.

Answer 74

Pitbulls

Question 75

A type of batterer that was identified by assessing the relationship of violent behaviors, and physiological makers such as heart rate and marital conflict. Heart rates decreases as they become more verbally aggressive and who engage in antisocial and violent behavior with just about everyone.

Answer 75

Cobras

Question 76

Relationships that develop between partners in domestic violence situations mimic___ with the victim losing his/her sense of autonomy as the perpetrator asserts increasing degrees of physical, psychological, and sexual control.

Answer 76

Those of hostage and captor

Question 77

Which of the following is a reason that one may decide to remain or leave an abusive relationship. A. Fear B. Rationalization C. Finances and Children D. All of the above

Answer 77

D. All of the above

Question 78

What is a common barrier that impedes the assessment of the degree of domestic violence that couples and families experience?

Answer 78

Legal | Psychological

Question 79

___ a barrier that may impede the assessment of the degree of domestic violence that couples and families may experience that involves court orders that mandate separation of family members from one another.

Answer 79

Legal

Question 80

___ a barrier that may impede the assessment of the degree of domestic violence that couples and families may experience that involves stigma that surrounds abuse of this nature.

Answer 80

Psychological

Question 81

What are the two levels of violence?

Answer 81

Common Couple violence (CCV) | Severe Abusive Violence (SAV)

Question 82

___ low level violence initiated by either women or men that is infrequent and non injurious.

Answer 82

Common Couple Violence

Question 83

__ known as battering or “patriarchal/ intimate terrorism,” is often physically injurious, meant to intimidate and largely perpetuated by men against women.

Answer 83

Severe abusive violence (SAV) aka intimate partner violence (IPV)

Question 84

Families in which there is considerable violence will go to almost any length to keep this secret __.

Answer 84

Hidden

Question 85

Physical VIOLENCE sexual ___ Making and/ or carrying out threats to do something to hurt her, Threatening to leave her, to commit suicide, to report her to welfare, making her drop charges, making her do illegal things

Answer 85

Using Coercion and threats

Question 86

Physical VIOLENCE sexual ___ making her afraid by using looks, actions, gestures: smashing things, destroying her property, abusing pets, displaying weapons

Answer 86

Using intimidation

Question 87

Physical VIOLENCE sexual ___ putting her down, humiliating her, calling her names, playing mind games, making her feel guilty, making her think she’s crazy, making her feel bad about herself.

Answer 87

Using Emotional Abuse

Question 88

Physical VIOLENCE sexual ___ Making light of the abuse and not taking her concerns about it seriously, saying the abuse didn’t happen, shifting responsibility for abusive behavior, saying she caused it.

Answer 88

Minimizing, Denying, and blaming

Question 89

Physical VIOLENCE sexual ___ controlling what she does, whom she sees and talks to, what she reads, where she goes, limiting her outside involvement, using jealousy to justify actions.

Answer 89

Using Isolation

Question 90

Physical VIOLENCE sexual ___ making her feel guilty about the children, using the children to relay messages, using visitation to harass her, threatening to take the children away

Answer 90

Using Children

Question 91

Physical VIOLENCE sexual ___ treating her like a servant, making all the big decisions, acting like the master of the castle, being the one to define men’s and women’s roles

Answer 91

Using male privelege

Question 92

Physical VIOLENCE sexual ___ preventing her from getting or keeping a job, making her ask for money, giving her an allowance, taking her money, not letting her know about or have access to family income.

Answer 92

Using Economic Abuse

Question 93

An assessment conducted in an open manner that usually results in obtaining the most information where blame is not a primary emphasis and the therapist emphasizes that the expression of violence in the family hurts the entire family rather than just one person is called a(n)___.

Answer 93

Open Assessment

Question 94

In open assessment the focus of the assessment centers on dynamics ___ the family.

Answer 94

Within

Question 95

Non-violence and equality that promotes positive behaviors ___: seeking mutually satisfying resolutions to conflict, accepting change, being willing to compromise

Answer 95

Negotiation and Fairness

Question 96

Non-violence and equality that promotes positive behaviors ___: talking and acting so that she feels safe and comfortable expressing herself and doing things.

Answer 96

Nonthreatening behavior

Question 97

Non-violence and equality that promotes positive behaviors ___: listening to her non judge mentally, being emotionally affirming and understanding, valuing opinions.

Answer 97

Respect

Question 98

Non-violence and equality that promotes positive behaviors ___: accepting responsibility for self, communicating openly and truthfully, admitting being wrong, acknowledging past use of violence

Answer 98

Honesty and accountability

Question 99

Non-violence and equality that promotes positive behaviors ___: supporting her goals in life, respecting her right to her own feelings, friends, activities,and opinions.

Answer 99

Trust and Support

Question 100

Non-violence and equality that promotes positive behaviors ___: sharing parental responsibilities, being a positive nonviolent role model for the children

Answer 100

Responsible parenting

Question 101

Non-violence and equality that promotes positive behaviors ___: mutually agreeing on a fair distribution of work, making family decisions together

Answer 101

Shared responsibility

Question 102

Non-violence and equality that promotes positive behaviors ___: Making money decisions together, making sure both partners benefit from financial arrangements

Answer 102

Economic partnership

Question 103

___ therapy that involves seeing the couple together in which the primary concern about the wisdom of couples therapy is the woman’s safety

Answer 103

Conjoint therapy

Question 104

Concern of the woman’s safety in conjoint therapy may undergo an assessment, consisting of which categories?

Answer 104

``` Frequency Severity of violence Presence of weapons Alcohol or other substance abuse Jealousy Possessiveness Obsession with partner ```

Question 105

__ includes the ethical context of abuse and violence in intimate relationships that encompasses three ethical dimensions and nine ethical concepts. Encourages therapists to confront, challenge, explore,and educate clients about abuse of power in emotional systems Akin to solution-based approaches Explores experiences, empowerment, disempowerment, and abuse of power in one’s family of origin. Effective for couples who voluntarily enter therapy.

Answer 105

Intimate justice theory

Question 106

___ cognitive-behavioral model of treatment Premise: people learn violent behaviors because they are reinforced and therefore they can unlearn them through CBT EX: education Effective in producing rehabilitation in perpetrators if they are long lasting, or the span of 1 year Participants must be held accountable for their actions

Answer 106

Duluth Model

Question 107

____ involves the act of commission.

Answer 107

Child abuse

Question 108

___ involves the acts of omission.

Answer 108

Child neglect

Question 109

___ most common form of family violence. Is attributed to having parents who are not emotionally responsible.

Answer 109

Sibling abuse

Question 110

___ manifested in everything from skin injuries, physical traumas, broken bones, soft tissue swelling, bleeding, to death.

Answer 110

Child Physical abuse

Question 111

``` Many children who are physically abused become: A. Distrustful of others B. Delinquent C. Severely depressed D. All of the above ```

Answer 111

D. All of the above

Question 112

Jared a twelve year old, is a child who has difficulty forming close, lasting relationships with peers, has cognitive problems, poor school performance, has been seen with physical marks more frequently lately and has also had a broken arm in the previous month. What type of abuse is he experiencing?

Answer 112

Physical abuse

Question 113

Tiffany has recently reported to her mother that her uncle’s friend has been making unwanted sexual remarks to her, has been caught sneaking outside of her bedroom, and has also propositioned her for sexual favors, citing that “she shouldn’t tell anyone, because it is their secret.” What type of abuse is she experiencing

Answer 113

Childhood sexual abuse (CSA)

Question 114

What is the longest range type of abuse that is more constant in nature and more damaging throughout life?

Answer 114

Psychological abuse or emotional neglect

Question 115

Treatment of child abuse and neglect becomes complicated because it involves what?

Answer 115

Legal Developmental Psychological issues

Question 116

___ to report child abuse usually constitutes unprofessional conduct that can lead to disciplinary action by a regulation board, possible conviction of a crime, and a civil lawsuit for damages.

Answer 116

Failure

Question 117

When working with a child that has endured sexual abuse that was discovered in childhood, which approach is most effective and why?

Answer 117

Trauma-Focused Cognitive behavioral therapy Is structured to include child only sessions and parent only sessions, and joint family sessions.