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Alcohol And Drug Counselor Exit Exam
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Culture-bound syndrome - CORRECT ANSWER >>> illness truly bound to specific culture;
refer to otherwise common mental or physical illnesses that are subsequently construed as unusual because of pathoplastic influence of clture (e.g, hallucinatory sx of schizophrenia could be due to demon possession)
pharmacological therapy and psychotherapy - CORRECT ANSWER >>> two key mental
health treatment paradigms of Western medicine (multimodal therapy)
racism and discrimination - CORRECT ANSWER >>> refer to attitudes, beliefs, and
practices that prejudge and denigrate individuals or gs based on disparate phenotypic characteristics (skin color, hair texture, facial features, etc) or ethnic minority group affiliation
What is the trend for cultural diversity in the US? - CORRECT ANSWER >>> increasing
rapidly and steadily; by 2025, 40% adults (48% children) will be from ethnic and racial minority gps.
HIV - CORRECT ANSWER >>> the viral agent that causes AIDS (Acquired
Immunodeficiency Syndrome), which is the final stage in the HIV disease process; most prevalent in men having sex with men and IV drug users; contributes to poverty, homelessness, an other medical problems
50% - CORRECT ANSWER >>> percent increase in the number of seniors needing
substance abuse treatment. 70% rate of increase in treatment
Limits to confidentiality - CORRECT ANSWER >>> 1. Client request for release of
information
- Court orders for release of information
- Danger to self
- Danger to others
- Suspected Child abuse/neglect cause by a client
- Grave disability
CAGE questionnaire - CORRECT ANSWER >>> Have you ever felt you should CUT DOWN
on your drinking? Have people ANNOYED you by criticizing your drinking? Have you ever felt bad or GUILTY about your drinking? Have you ever had a drink first thing in the morning to steady your nerves (EYE-OPENER)? - 4 - question on alcohol abuse
MAST - CORRECT ANSWER >>> Michigan Alcoholism Screening Test - yes or no to 25
questions to explore number of treatment issues; most accurate and oldest screening tool to identify drinkers with 98% accuracy
What is another cultural issues beyond the client's culture? - CORRECT ANSWER
>>> counselor's culture
Bookend term in substance abuse treatment means.. - CORRECT ANSWER >>> discussing
a trigger event with someone trusted before and after it occurs
Trigger events - CORRECT ANSWER >>> often crisis stressors or situations
CFR 42, part 2 - CORRECT ANSWER >>> confidentiality in areas of alcohol and substance
abuse. confidentiality restriction apply:
- to records, w/c may not be disclosed even in admin, civil, criminal, or legislative proceedings by any govt authority
- to communications, even if the person seeking information already has it, cold otherwise obtain it, is an official or law officer, has a subpeona or otherwise claims the right of information release not permitted in the CFR
- to acknowledgements, such as regarding the presence of a client (unless he/she is in a facility or facility area not dedicated solely to alcohol or drug abuse tx, ad no mention of drug or alcohol treatment is made)
How is subpoena will be valid for release of information? - CORRECT ANSWER >>> if a
court of competent jurisdiction also explicitly enters an order authorizing information release specific to the 42CFR part 2 regulations
What does HIPAA statues guidelines address? - CORRECT ANSWER >>> health privacy and
confidentiality standards; governs the management and release of protected health information (PHI); right to privacy for all adults and minors ages 12- 18
DHHS Privacy Rule 3 additional privacy protections - CORRECT ANSWER >>> 1)consent of
ROI must comply with 45CFR 2)clients gets copy of ROI 3)copy is kept for 5 yrs from its exp date
How does group therapy and 12-step program differ? - CORRECT ANSWER >>> Group
therapy - focuses on helping individuals to examine, understand, and interpret the intrapsychic and interpersonal influence and conflict that motivate and perpetuate substance abuse; denial is explored 12 - step prg - centered on drawing upon focuses such as affiliation, peer confrontation and support, and creating a culture of abstinence and the mutual accountability to sustain it; denial is confronted and broken down
What are the 5 primary group models used in substance abuse treatment? - CORRECT
ANSWER >>> 1) Psychoeducation - teach about substance abuse
- Skills development - hone on skills to break free of addiction
- Cognitive-behavioral - rearrange patterns of thinking/action that lead to addiction.
- Support group - Provide a forum where members can support constructive change.
- Interpersonal process group - enable members to rethink past problems/solutions that led to substance abuse
When does positive effects of treatment starts to emerge? - CORRECT ANSWER
>>> around 3 mos is the baseline duration for improved outcomes
3 most common recovery stages - CORRECT ANSWER >>> 1) early - entering treatment,
embarking on abstinence, and staying sober; relapse vulnerability remains high
- middle - lasts from 1-12 mos, greater confidence in abstinence grows, cravings persist but are recognized and deflected successfully; lifestyle and personality trait changes are progressing, relapse vulnerability persists but less significant
- late/maintenance - maintaining abstinence while improving life in other areas, addressing psychological or relationship issues that became apparent through abstinence, and continuing all relapse prevention behaviors and skills previously learned
CORRECT ANSWER >>> 25%. Although HIV continues to be predominantly affect men who
are sexually active with other men, women are susceptible to contracting HIV; Black and Latina acct for 4/5 of all HIV cases in women
What is the most likely period in life for substance abuse problem to begin? - CORRECT
ANSWER >>> adolescence, but it can fluctuate throughout life course
3 Types of Youth Substance Abuse Prevention Programs - CORRECT ANSWER >>> 1)
Universal - address both risk and protective facots in general community or school settings
- Selective - oriented to engage youth that possess specifically identified risk factors that increase their likelihood of developing a SUD
- Indicated - address issues relevant to youth who have already allowed substance abuse into their lives *central to all is education regarding the harms caused by substance abuse as such education has proven to reduce experimentation and lower rates of cont substance abuse in youth
Why is there a need for accurate documentation? - CORRECT ANSWER >>> it is essential
in determining a proper treatment plan and ensuring that the pan evolves appropriately as the CLT makes cont progress. Also, agencies req doc. to ensure that funds entrusted to the prog are being utilized as agreed upon
What are the essential information needed for intake assessment? - CORRECT ANSWER
>>> 1) psychoactive substance abuse hx and patterns of use
- psychological health and psychiatric tx hx
- current physiological health, nutrition, med hx
- hx and current meds
- basic demongraphics
- legal hx
- educ
- recreational act hx
- religion/spirituality
- sexual orientation
- high-risk sexual and substance use practices
- family hx and current support network
How often are treatment plans typically updated? - CORRECT ANSWER >>> 30 - 90 days or
as changes arise
progress notes - CORRECT ANSWER >>> charts the trajectory of the client's progress
towards the goals, objectives, and actions steps based on treatment plan; must be recorded w/in <14 days and reviewed when updating tx plan
How often should active client's charts be updated? - CORRECT ANSWER >>> no less than
a week
What are the required contents discharge summary? - CORRECT ANSWER >>> 1)whether
the program was or was not completed successfully
- reasons that resulted in CLT d/c
- d/c voluntary/involuntary
- transfer/referrals involved in d/c
- summary info on tx offerred and recovery lvl achieved
- clt's status in abstinence or cont substance use
- educational/voc accomplishments
- legal status
- cravings
- recurrent us leading to inability to fulfill major role
- recurrent us thought it is physically harmful
- recurrent use though it leads to social problems
drug tolerance - CORRECT ANSWER >>> the tendency for larger doses of a drug to be
required over time to achieve the same effect; decreased sensitivity to a drug over time
drug cue - CORRECT ANSWER >>> key euphoric memories that become connected to
sights, sounds, smells, people, and places previously associated to drug-uses; triggers
Wernicke-Korsakoff syndrome - CORRECT ANSWER >>> Organic brain syndrome resulting
from prolonged heavy alcohol use, involving confusion, unintelligible speech, and loss of motor coordination. It may be caused by a deficiency of thiamine, a vitamin metabolized poorly by heavy drinkers. 80-90% of Wernicke (poor muscl coordination, oculomotor, short-term cond due to yrs of alcohol; Vit B1 deficiency) --> Korsakoff (loss of older memories, psychosis)
Alcohol-related physical illness - CORRECT ANSWER >>> Alcoholic hepatitis - abdominal
pain, nausea, vomiting, and a swollen liven; jaundice and bleeding Steatosis - fatty deposits in the live that can be fatal Cirrhosis - scarring of the liver from alcohol damage Hepatic encephalopathy - reversible dementia, high blood toxins
Formication - CORRECT ANSWER >>> Hallucinatory behavior produced by chronic cocaine
or amphetamine abuse, in which the individual feels insects or snakes crawling either over or under the skin. (aka - magnon's syndrome, coke/crackbugs)
Most damaged organ due to cocaine abuse - CORRECT ANSWER >>> heart - arterial
narrowing leading to death
3 main types of Amphetamines - CORRECT ANSWER >>> Amphetamine sulphate - speed,
Benzedrine Destroamphetamine - dexedrine/Dexy's midnight runners Methamphetamines - Methedrine/meth, crank, speed, poor man's cocaine; greatest abuse risk doe to intense rush; generally pleasurable to most users; 2nd to marijuana as non-alcoholic drug most abused worldwide
- identification of variances between beh and personal goals
- deflection of confrontation or argument to more positive, goal-oriented dialogue
- redirection of CLT resistance to desires and goals than opposing
- nurturing optimism and sense of self-efficacy when confronted with obstacles, challenges, and negative expressions How many percent of individuals with co-occuring d/o will get treatment for both d/o, for
mental health only, and for substance abuse treatment only? - CORRECT ANSWER
>>> 7.4% both, 32.9 % mental health only, 3.8 substance abuse only
T/F: Certified Substance Abuse Counselor can diagnose and treat mental health d/o. -
CORRECT ANSWER >>> false, CSACs dont' have the credentials and training to do so. thus
impt to collaborate with other providers
GATE - CORRECT ANSWER >>> use to evaluate SI and behaviors by substance abuse
counselor working with at-risk clients G - gather information, screen for suicidality and observe warning signs A - access supv or consult T - take responsible action to protect CLT's wellbeing E - extending the action to secure f/up and monitoring Serious mental health sx (delusions, suicidality, hallucinations)that are resolved within 30 days
or less are most likely due to what... - CORRECT ANSWER >>> substance abuse-induced
d/o hat require cont abstinence... if cont to exist then most like there's underlying mental health issues and needs to be addressed/treated
CRAFFT - CORRECT ANSWER >>> 6 - item screen for alcohol or drugs in adolescents, 14- 18
(C=car, R=relax, A=alone, F=forget, F= family or friends, T= trouble)
AUDIT - CORRECT ANSWER >>> Alcohol Use Disorders Identification Test
MAST - CORRECT ANSWER >>> Michigan Alcoholism Screening Test - yes or no to 25
questions.
Screening - CORRECT ANSWER >>> to determine need for placement
ASAM's Assessment Dimension - CORRECT ANSWER >>> 6 dimensions
- Acute intoxication or withdrawal potential
- Biomedical cond and complications
- Emotional, behavioral or cognitive conditions and complications
- Readiness to change
- Relapse, cont use or cont problem potential
- Recovery environment
ASAM Levels of Care - CORRECT ANSWER >>> 5 Specific Levels of Care but only 4 Levels of
TX
0.5: Early Intervention - early intervention, education for at-risk behaviors but substance abuse diagnosis can't be confirmed 1: Outpatient Services - education counseling and beh change 2: Intensive Outpatient Services/Partial Hospitalizaiton - comprehensive biopsychosocial assessments and individualized tx plan 2.1 Intensive Outpt 2.5 Partial Hospitalization 3: Residential/Inpatient Services - planed regimen of care 24 hr live-in setting
CMRS scale - CORRECT ANSWER >>> use to determine CLT readiness for substance abuse
treatment; 18 likert-type response 4 Domains C - circumstance, external pressures influencing substance abuse change M - motivation, internal pressures driving change R - readiness, perception and acceptance of the need for treatment S - suitability, clt's perception of the appropriateness of tx modality or setting
Acronym for guiding treatment planning - CORRECT ANSWER >>> M - measurable
A - attainable T - time-bound R - realistic S - specific
How often should tx plan be updated for individuals with the criminal justice sys? - CORRECT
ANSWER >>> at all transition points
Addiction Severity Index (ASI) - CORRECT ANSWER >>> developed by DENS (Drug Eval
Network Sys) among the most widely used and reliable and valid assessment instruments in the field. 6 Problem Domains
- medical status
- employment and support
- alcohol and drug use
- legal status
- family and social relationships
- psychiatric status. It tells us which problem areas are the most significant and require attention. T-ASI (teen) and ASI-Lite (shortened)
Reliability - CORRECT ANSWER >>> consistency of measurement
Validity - CORRECT ANSWER >>> The ability of a test to measure what it is intended to
measure
SOCRATES (Stages of Change Readiness and Treatment Eagerness Scale) - CORRECT
ANSWER >>> assessment for motivation, 19-item self-report instrument with 3 main scales
(recognition, ambivalence, and taking step); 2 versions, 1 for alcohol use and 2nd for other personal drug use
Key Components of TX plan - CORRECT ANSWER >>> 1) problem statement, w/c are based
from assessments
- goal statements, from problem statements
- objectives, clt's responsibility
- interventions, counselor's tasks to support clt
SOAP note - CORRECT ANSWER >>> S: subjective
O: objective A: assessment P: plan
types of learning styles - CORRECT ANSWER >>> Aural/auditory - through sound
Visual - via images Verbal - through workd Physical/Kinesthetic - through touch Logical - mathematical, through logic Social/interpersonal - with others Solitary/intrapersonal- through self-study
Core treatment and recovery skill - CORRECT ANSWER >>> 1) Substance Abuse refusal
training - helps clts to practice and become comfortable with refusing addictive substances. 2) Stress mgt/relaxation training
- Assertiveness
Naltrexone - CORRECT ANSWER >>> Opioid antagonist that is given orally in alcohol
dependency programs; effective in treating opioid addiction
Naloxone (Narcan) - CORRECT ANSWER >>> shorter-acting agent similar to Naltrexone,;
used primarily in situations of opioid OD, also used in TX of alcoholism to lower cravings.
bupenorphine and bupenorhphine w/ naloxone - CORRECT ANSWER >>> tx for opiod
dependences
4 Sequential Stages of TX - CORRECT ANSWER >>> 1) Treatment engagement
- Early Recovery.
- Maintenance
- Community support
Treatment engagement - 1 of 2 Stages of TX - CORRECT ANSWER >>> - establish a tx
contract including goals and CLT responsibilities; resolve acute crises; develop a therapeutic alliance; prep tx plan
Early Recovery - 2 of 4 Stages of TX - CORRECT ANSWER >>> - cont abstinence; sustain
beh changes; terminate a drug-using lifestyle and develop drug-free alt; learn relase triggers and prevention strategies; identify and resolve contributing personal problems; begin 12-step or mutual self-help prg
Maintenance - 3 of 4 Stages of TX - CORRECT ANSWER >>> - solidify abstinence; deepen
relapse prevention skills; enhance emotional functioning; increase sober social networks; and address other problem areas
Community support - 4 of 4 Stages of TX - CORRECT ANSWER >>> - sustain abstinence and
a healthy lifestyle; establish treatment independence; extend social network ad support gp connections; pursue healthy community act; solidify impt outlet act and pursue new interests
What is the minimum duration of days in an Intensive Outpatient Treatment? - CORRECT
ANSWER >>> 90 days, but longer stay is better; >9 hrs for 3-5 days/wk
Which is more effective in providing relapse-prevention training, individual or group therapy? -
CORRECT ANSWER >>> Both are equal
List Types of Intensive Outpatient Treatment - CORRECT ANSWER >>> 1) Psychoed
- Skills development
- Interpersonal
- Family
- Support
