lab 4 and 5- withdrawal, harm reduction, intro to psychotherapy

Question 1

history

things to know

Answer 1

• ask about substances in non judgemental way
• assume they are using something
• give wide range of numbers of days of use
• review other use of substances
• last use
• previous withdrawal experiences
• seizure history
• other health problems

Question 2

signs and symptoms

alcohol withdrawal

Answer 2

• sweating
• increased pulse/temp/BP
• tremors
• N+V
• anxiety/agitation
• tactile and auditory disturbances

Question 3

signs and symptoms

opiate withdrawal

Answer 3

• dilated pupils
• gooseflesh skin
• stomach cramps/diarrhea
• rhinorrhea
• light sensitivity
• myalgia
• restless
• increased pulse

Question 4

AWS (alcohol withdrawal syndrome)

diagnostic criteria (2), assessment tool

Answer 4

1. clear evidence of cessation of prolonged use
2. symptoms are not accounted for by a medical disorder
   - use CIWA to measure

Question 5

AWS (alcohol withdrawal syndrome)

scoring

Answer 5

less than 8: mild withdrawal
8-15: moderate withdrawal
greater than 15: severe withdrawal

Question 6

minor AWS

Answer 6

will last about 48 hours
- autonomic and motor symptoms

Question 7

moderate AWS

Answer 7

will last about 6 days
- illusions and hallucinations

Question 8

severe AWS

Answer 8

will last about 14 days
- delirium shows up at 48 hours
- paranoia and disinhibition

Question 9

seizures

Answer 9

occur primarily during early phase of withdrawal

Question 10

delirium

Answer 10

occur in late stages of AWS
- perceptual changes, confusion, changes in LOC
- agitation/hyperarousal

Question 11

alcohol withdrawal interventions

Answer 11

• seizure precautions
• encourage fluids
• CIWA q 1-4 hours
• antiemetics, electrolytes

Question 12

opiate withdrawal interventions

Answer 12

• decrease discomfort
• use COWS q 1-4 hours
• symptom management
• fluids
• suboxone

Question 13

4 pillars of healthy drug and alcohol policy

Answer 13

1. prevention
2. treatment
3. harm reduction
4. enforcement

Question 14

abuse

definition (substance)

Answer 14

person is misusing

Question 15

abuse –> addict

Answer 15

there must be a degree of tolerance and elements of withdrawal

Question 16

moral model

Answer 16

substance use is a moral weakness and is indicative of an individuals character

Question 17

drug-set-setting model

Answer 17

a way to think about how problems with drug use come about

Question 18

drug

drug-set-setting model

Answer 18

potency, action, delivery, legality

Question 19

set

drug-set-setting model

Answer 19

persons physiology, emotional state, motivation, cultural identity

Question 20

setting

drug-set-setting model

Answer 20

stress/support factors, people using with, social/cultural attitudes

Question 21

psychotherapy

definition

Answer 21

treatment using psychological methods through collaboration and conversation

Question 22

goal of psychotherapy

Answer 22

teach person skills to manage current and future problems in a healthy way
- improved self concept and increased sense of agency

Question 23

ways to develop competence in psychotherapy

3

Answer 23

• workplace learning
• structured courses
• certification program

Question 24

CBT

characteristics

Answer 24

problem oriente therapy that focuses on present and future
- structured short term format
- requires insight and self awareness

Question 25

CBT teaches person to

Answer 25

identify, and challenge dysfunctional patterns of thinking and behaving

Question 26

Becks negative cognitive triad

Answer 26

self, future, others/world

Question 26

CBT process

Answer 26

identify --> examine --> respond

Question 27

C in CBT

Answer 27

techniques designed to help people detect, evaluate, and modify inner thoughts as well as identify thoughts associated with emotional symptoms

Question 28

B in CBT

Answer 28

tracks how you behave when you have certain thoughts - actions connected to the way we feel

Question 29

most difficult thinking styles to change | 3

Answer 29

global, rigid, over generalized

Question 30

core beliefs

Answer 30

absolute rules for interpreting information related to self esteem - arent directly observable

Question 31

DBT | definition

Answer 31

follows CBT based approach but emphasizes psychosocial to help people who react in a more intense manner

Question 32

DBT characteristics

Answer 32

- used for patients with borderline personality disorder - balances change and acceptance with validation

Question 33

skills learned from DBT | important for final

Answer 33

- mindfulness - emotional regulation - distress tolerance - interpersonal effectiveness

Question 34

distress tolerance

Answer 34

getting through crisis without making things worse and accepting reality

Question 35

interpersonal effectiveness

Answer 35

maintaining relationships and increasing self respect

Question 36

when to use distress tolerance skills

Answer 36

when you cannot leave or change the situation - eg. snapping rubber band on wrist

Question 37

emotional regulation skills

Answer 37

logic or cognitive based techniques used to understand and change emotions

Question 38

interpersonal effectiveness skill

Answer 38

DEAR MAN - describe - express - assert - reinforce - mindful - appear - negotiate

Question 39

motivational interviewing | characteristics

Answer 39

- highly useful for people considering change - asking questions in a specific way to have person want to change certain things - about developing persons motivation to change

Question 40

motivational interviewing | definition

Answer 40

method for enhancing intrinsic motivation to change by exploring and resolving ambibalence

Question 41

conviction

Answer 41

importance of the change to the person - related to relevance and impact they feel it could have

Question 42

confidence

Answer 42

how capable a person feels to make change - related to their sense of control and previous experience with change

Question 43

interventions to increase conviction

Answer 43

- provoke expression of their benefits - reinforce emotional benefits of change - provide information on benefits of changing the behavior

Question 44

interventions to increase confidence

Answer 44

- remove barriers - help find strategies - build on prior success

Question 45

types of summaries | 3

Answer 45

- collecting - linking - transitional

Question 46

transitional summary

Answer 46

used to gather info that the client has given to you and then move them to next steps