Treating Addiction, Second Edition: Addictions Exam 1 Notecards (#1) Flashcards


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created 3 years ago by Katie_Koo
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Treating Addiction, Second Edition
Chapters 1, 2, 4, 17, 20, 22
Foundations of Addiction Counseling- Exam 1 Notecards
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1

What is addictions counseling?

  • A relational process of change; a collection of services delivered by a professionally-trained helper
  • More than “treatment” or “intervention”
2

What is NOT addictions counseling?

  • detox
  • self help
  • medication provision/ dispensing
  • case management
  • urine drug screening
  • self guided activities
3

Detoxification

  • medically monitored service where they manage your withdrawal and help the substance get out of your system
    • Benzodiazepines and alcohol are the only substances that you can die from when in withdrawal
    • Delirium tremons- you are delirious and you have tremors
    • Seizures are another significant concern when you are detoxing
    • Withdrawal will heighten your already-existing seizure disorders
4

Common settings for addictions counseling

  • Outpatient
  • Inpatient/ residential
    • Hospital/ medical facility
    • Correctional facility
    • Addictions-specific residential treatment
    • Domestic violence facility
  • In client’s natural environment
    • Home
    • School
5

Expected formats of addictions counseling

  • Group
  • Individual
  • Couples and families
6

Naltrexone

Antagonist- blocks dopamine receptors in the brain; you don’t feel good from drinking. It’s the same as Narcan (which works but blocking dopamine receptors, meaning the addictive substance cannot be absorbed anymore)

7

Disulfiram

makes you sick when you consume alcohol; behavioral modification

8

Acamprosate

helps with withdrawal symptoms. It’s a sedative (probably a barbiturate)

9

ACA code of ethics

  • broad code that covers all counselors (according to Ohio law)
  • NADAC (national association of drug and alcohol counselor) code of ethics
10

Ethical code

  • Professional standards
  • Protection of clients
  • Way to make decisions
  • Way for outsiders to hold counselors accountable
11

Moral principles

  • our values as a profession. Underlie our code of ethics
  • autonomy
  • nonmaleficence
  • beneficence
  • justice
  • fidelity
  • veracity
12

Autonomy

- client to make their own decisions; right to use counseling in whatever way they want to

13

Nonmaleficence

  • do no harm
14

Beneficence

  • do good; efficacious treatments (treatments that work for a lot of people); work for the best interest/ good of our client
    • Effective- speaks to something that worked just for me (like 12 step)

Efficacious- speaks to something that works broadly

15

Justice

  • treat all clients the same; treating clients equally
16

Fidelity

– loyalty and support; honoring your commitments; not exploiting your clients

17

Veracity

  • being truthful with your client
18

ethical issues commonly faced

  • confidentiality
  • informed consent
  • multiple roles
19

confidentiality

  • Protect individual client privacy
  • Up to individual adult client (who is entitled) to decide how information relating to him/ herself is handled
  • There are standard exceptions
  • 42CFR- federal law that tells us what needs to ne included in an ROI. Consent must be signed for by client and can be revoked verbally at anytime.
20

informed consent

  • Formal, ongoing procedure conducted verbally and documented in writing
  • Three elements are client (1) competence, (2) comprehension, and (3) freedom of choice
  • Ongoing- remind client before potentially difficult scenarios (drug tests)
21

Multiple roles

  • Boundary violations
  • Not inherently wrong
  • May not be avoidable
  • Examples: professional counselor and…
    • AA member and/or sponsor
    • City council or school board member
22

Other ethical professional responsibilities

  1. Practicing according to qualifications and competencies
  2. Professional development and continuing education
  3. Not misrepresenting credentials
    • Chemical dependency counselor—CDCA is not a license but a certification
    • Academic degree is earned at time of commencement
  4. Maintaining clear, timely, and accurate documentation
  5. Receiving supervision (And documenting receipt of supervision and supervisor recommendations)
  6. Cautious self-disclosure that avoids identification with client
23

crossing vs violation

  • Crossing: Minor infringements
  • Violation: major transgressions
24

Crossing

  • Minor infringements
  • Not necessarily harmful to client
  • Not necessarily unethical
  • Likely reparative
25

Violation

  • Harmful to client
  • Unethical
  • May not be reparative
26

ethical decision making

  • What is or is not ethical is not always clear; can’t always know ahead of time what is or is not ethical
  • Ethical decision making isn’t a science and is always conducted in consultation
    • rule of thumb= don’t handle ethical dilemmas solo
27

Elements of ethical decision making

  1. ID the problem
  2. Examine relevant code of ethics and professional literature
  3. Consider eh 6 moral principles
  4. Consult
  5. Attend to your emotions
  6. Involve your client
  7. Consider cultural contexts
  8. ID desired outcomes and consider potential courses of action
  9. Consider potential consequences of all options and determine plan
  10. Evaluate the selected course of action
  11. Implement the selected course of action
28

what do most people with substance use disorders who are in treatment facilities present with?

TRAUMA- PTSD

29

applilication of ethical principles:

applied when you engage in client centered care

30

client centered care

  • Therapeutic empathy
  • Reflective listening
  • Fundamental counseling skills:
    • OARS: open questions, affirm, Reflect, Summarize
    • Ask permission
    • Promote autonomy

Staying focused

31

empathy

  • One of the strongest predictors of counselor’s effectiveness in treating SUDs (when client perceived empathy)
  • May exert more of an effect on client outcome in addictions counseling than in mental health counseling
  • Listen to clients
  • Accurately reflect back the meaning of what they said
  • Genuine attempt to understand and ID with client
  • Always tentative, always a guess, as to what client’s experiences might be like
32

conveying empathy

  • making connection with another
  • building a bridge to another
  • learning the language of another and then speaking in the language another can understand
  • takes practice!
33

Reflective listening

  • One of the most important and challenging skills in addictions counseling
  • Connection to/with what client has and has not said, and communicating this to client
  • Sensing what might be client’s feeling, meaning, experience and then…
  • Communicating that hunch, hypothesis to client in an accepting, nonjudgmental manner (including tone of voice)
    • Listening and responding empathically
    • Not asking questions (questions vs reflection)
34

OARS +2

  • they’re a tool for us that give us direction!!!)
  • open-ended questions
  • affirmations
  • reflective listening
  • summarizing
  • advice with permission
  • promoting autonomy
35

Open-ended questions

  • Not closed or multiple choice questions
  • They’re inviting, opening the door to exploration
  • Not arm twisting or coaxing
  • “How…” and “What…” questions
  • Also: “Tell me more…” and “Tell me about…”
36

Affirm

  • Statements that reflect client strengths, qualities
  • Purposeful commendations
  • Point the spotlight on client’s positive aspects
  • Designed to raise another person’s awareness of his or her own ability, instrumentality, or agency
  • Intended effect= client empowered to use existing strengths, capacities (e.g. past successes)
  • Must be genuine
37

Reflection (and reflective listening)

  • a statement that makes a guess as to what the speaker means, but the helper’s voice tone goes down at the end
  • Statements with a with a period, not a question mark
38

Summarize

  • Special application of reflective listening; organizing and making sense of information
  • Brief and concise
  • Done throughout conversation
39

purpose of summarizing

  • collecting (pulling together interrelated items for client consideration),
  • linking (connecting what client has said to an earlier statement),
  • transitional (highlights something important, shift to something new, moving to a new perspective)
40

advice only with permission

  • partnership I practice
  • routine check-in : “May I…?”
  • prevents prescription; proceed only with “green light”
41

promote autonomy

  • recognizing and reinforcing client’s
    • decision making
    • capabilities
    • confidence
    • motivation
  • encouraging what client already has
  • consulting client’s expertise