IL CADC Exam 2023 with complete solutions

Definition of Counseling - ANSWER-a professional relationship that empowers diverse individuals, families, and groups to accomplish mental health, wellness, education, and career goals Counseling is a.... - ANSWER-Co1laborative process sensitive to individual client characteristics, influence of significant others, and client cultural and social context Counselors help clients to - ANSWER-1. Explore and enhance their motivation to chance behavior 2. Set appropriate treatment goals 3. understand the structure, expectations, purpose, and limitations of the counseling process Counselors must continually evaluate the client's level of risk regarding - ANSWER-personal safety and relapse potential in order to anticipate and respond to crisis situations like high risk situations Counselor skill include knowing how to - ANSWER-individualize treatment plans, adapt counseling strategies to client charactistics and circumstances, apply culturally and linguistically responsive communication syles and practices The effectiveness of addition treatment is measured by - ANSWER-Client's improved functioning, reduced suffering, psysiological indicators, retention in treatment, enhances interactions with other people, work performance The connection between the client and the counselor is - ANSWER-the therapeutic alliance 3 components of the therapeutic alliance - ANSWER-1. relationship or bond b/w the therapist & client 2. consensus b/w the two regarding treatment techniques/methods 3. consensus b/w the 2 regarding treatment goals The collaboration occurs when the clinical knowledge of the counselor combines with the experiential knowledge of the client because - ANSWER-the client is the true expert in their life over 80% of positive treatment outcomes may be due to the therapeutic relationships contributing elements of - ANSWER-warmth, empathy, and respect for the client Motivational Interviewing (MI) - ANSWER-a directive, client-centered style for eliciting behavior change by helping clients explore and resolve ambivalence. The fuel for the chamce process is the client's motivation to make the change. Can enhance motivations starting at the screening and lasting through the treatment process Motivational style of counseling communication is based on the following assumptions - ANSWER-1. Ambivelnce about change is normal and creates a significant obstacle to the recovery process 2. Ambivalence can be resolved by working with the client's intrinsic motivations and values 3. The alliance b/w counselor and client is a collborative partnership to which each brings important expertise 4. An empathetic, supportive yet directive counseling style provides conditions under which change can occure 5. direct argument and confrontaion may tend to increase client defensiveness and reduce the liklihood of behavioral change 5 general principles of MI - ANSWER-1. Express empathy thru reflective or active listening 2. Develop discrepancy b/w client's goals or values and their current behavior 3.Avoid argument and confrontation 4. Adjust to client resistance rather than oppose it directly 5. Support self-efficacy and optimism Strategies based on 5 principles - ANSWER-1. Ask open ended questions to facilitate dialogue in a neutral way 2. Listen reflectively and provide a synthesis of content and process, which reduces the likelihood of resistance and cements the therapeutic alliance. 3. Summarize- to link the clients's positive and negative feelings to promote the perception of discrepancy 4. Affirm- to promote self-efficacy and validate client's feelings 5. Elicit self-motivational statements- that include problem recognition, concern about the problem, intention to change, optimism toward the future. The Spirit of MI is based on 4 key elements - ANSWER-1.Partnership/collaboration-avoid the expert role 2. Acceptance/Autonomy-respecting and accepting the clients autonomy, potentials, strengths, perspectives. (Four aspects of acceptance-worth, empathy, autonomy, affirmation) 3. Compassion-keeping client's best interest in mind 4. Evocation-The best ideas come from the client. The motivation for change is within so discussion of pro & cons of change vs staying the same Areas of Expectation counselor should address w/ client - ANSWER-1. Outcomes achieved? 2. What proportion of clients report that there initial problems have improved by the end of treatment 3. What will treatment involve? ie. making regular appointments, enforcing start & end times, maintaining confidentiality, canseling session if client shows up under the influence 4. What specific goals should the client expect to aim for The strength of the counseling relationship depends on... - ANSWER-The counselors facilitation qualities Strategies used to create a positive environment for exploration and change Facilitation Relationships are characterized by - ANSWER-1. Empathy-understand from another persons perspective 2. Genuineness- when your outside matches your thoughts and feeling on the inside 3. Respect- empowers the client. Belief that the client has the ability to make their own decisions and learn from the consequences 4. Self-disclosure-ability to disclose info about oneselg including the way one thinks and feels 5. Warmth-showing client you care. eye contact, smiling, sincere tone of voice 6. Immediacy- focus on the here & now and on reality to keep the process moving forward 7. Concreteness- ability to identify problems and steps to correct 8. Cultural Sensitivity-requires ongoing counselor self evaluation Active listening skills - ANSWER-1. Clear listening- w/o judgement or immed trying to correct client thoughts 2.Reflecting- Summarizing using statements in clear simple manner to clarify the issues 3. Ask open-ended questions- to promote exploration of why client thinks, feels, acts the way they do 4. Using effective body language- arms & legs uncrossed leaning forward making eye contact-shows interest 5. Watching for nonverbal cues. ie. foot tapping Models of Addiction - ANSWER-1. Medical Model- Chronic & progressive disease with physical causes 2.Spiritual Model- very influential. 12 step fellowships 3. Psychological Model- Deficits in learning, emotional dysfunction, or psycopathology that can be treated behaviorally . 4. Sociocultural Model- Building new social & family relations & skills & working w/in ones cultural infrastructure are avenues for change 5. Composite Biopsychosocial-spiritual model- Confirms some truth in each model and integrates the perspectives b/c of many interacting influences. Chronic diseases are best treated collaboratively and comprehensively Successful treatment may require more than one treatment experience - ANSWER-Cumulative impact Factors associated w/ clients staying in treatment - ANSWER-1. motivation to change 2. family support 3. pressure from criminal justice system 4. CPS 5. employers Features of modern day treatment practices - ANSWER-1. Focus on client competencies & strengths 2. Individualized client centered treatment 3. shift away from labeling "addict", "alcoholic" 4. Acceptance of new broad range of treatment goals. ie. reduction of use, improvement of health, employment stability 5. Adoption of recovery paradigm- shift from problem focused acute care model to solution-focused long-term model of recovery management regaining wholeness & connection to community 6. Integration of substance Abuse Treatment w/ other disciplines. ie. substance abuse treatment w/in criminal justice system, special services for those w/ co-occurring disorders 7. Evidence-based practices-proven to be successful through research methodology 8. Use of medication 9. Telehealth Technologies- continuing care by mobile phone, online chat 10. Technology-based care- multimedia...audio, video AA - ANSWER-ongoing recovery support thru self-help nontraditional self help groups - ANSWER-Rational recovery, women for sobriety AA and other self-help is - ANSWER-not for everyone, but helps develop a sociall support network, teaches skills needed to recover, helps indiv. take responsibility for their own recovery, and provides a sense of belonging and a new identity key features of 12 step groups - ANSWER-accessibility, anonymity, social support and aid, promotion of self-esteem and self-efficacy, introspection & insight, spiritual recovery, advocacy to promote social & legislative remedies AA main purpose - ANSWER-Stay sober and help other alcoholics to achieve sobriety. Belief that abstinence is the only treatment Three legacies of AA - ANSWER-1. Recovery (big book, 12 step, 12 step work) 2. Unity (12 traditions, ) 3. Services (every act toward the functions of AA message to others) Withdrawal Management involves 3 components - ANSWER-1. Evaluation- Drug testing 2. Stabilization- Medically stable, fully supported, substance free. May be medication assisted 3. Fostering the clients entry into treatment- Stressing the continuum of care Withdrawal Management may be delivered... - ANSWER-1. Ambulatory (outpatient) 2. Residential/Inpatient Two examples along the residential care continuum - ANSWER-1.Therapeutic community (TC) -highly structured residential program to help change lifestyles, abstain, eliminate criminal behavior, . Use a hierarchial model w/ treatment stages that refelct increased levels of indiv and social responsibility. Peer influence. Can be confrontational. lasts 6 mos.- 2years. Frequent modalith used for persons in criminal justice systems who are getting addiction treatment 2. Half-way house- clients live at the program receiving couseling while they work or attend school Medication assisted treatment (MAT) - ANSWER-Evidence based oractices that combine pharmacological (drug based) interventions w/ counseling, behavioral therapy, social support to achieve the best results in the shortest time. Medication can be used to manage withdrawal symptoms, reduce cravings, avoid relapse. Most meds require a script & supervision of dr When integrated into comprehensive treatment programs MATs can: - ANSWER-1. Improve rate of treatment retention 2. Decrease opioid & alcohol consumption 3. Increase abstinence 4. Decrease criminal activity 5. Increase employment 6. Improve mental health Addiction treatment drugs - ANSWER-Naltrexone (vivitrol) Opiate antagonist. Prevent effects, decreases desire to use. helps relieve cravings for alcohol Disulfram (antabuse) bad reaction to alcohol Acamprosate (campral) Reduces desire to drink Methodone- narcotic, synthetic opioid supresses withdrawal symptoms of heroin and reduces cravings Buprenorphine (subutex, suboxone-contains naltrexone- pHelps prevent withdrawal symptoms Meds for Opioids - ANSWER-Methodone, buprenorphine, naltrexone meds for tobacco - ANSWER-Nicotine replacement therapy, bupropion, varenicline (chantix) Alcohol meds - ANSWER-naltrexone- reduces craving Acamprosate- reduce protracted withdrawal symptoms such as sleeplessness, anxiety, restlessness, dysphoria Disulfiram - effects the degradation of alcohol making user sick Treatment modalities- levels - ANSWER-1. Individual counseling- privacy, flexible pace, more time on indiv unique issues 2. Group Counseling- Most effective way of treating SUDs because they learn about themselves through interactions w/ others and understand that they are not alone in their problems. Clients bond w/ the culture of recovery and engage therapuetic forces-peer confrontation. Effective in treating depression, isolation, and shame 3. Family counseling- addresses systemic issues, harmful interaction patterns, assist families in understanding substance use disorders. Family can address their own goals & issue 5 Group Models - ANSWER-1. Psychoeducational- educate about substance abuse 2. Skills development group- cultivate skills to sustain abstinance, cope w/ anger, or urges 3. Cognitive Behavioral Groups- alter thoughts and actions 4. Support Groups- pragmatic info managing day to day living 5. Interpersonal Process Group- The goal of EBP is to integrate - ANSWER-clinical expertise, scientific evidence, client values to provide high quality services reflecting the intrests, values, needs, choices of people served EVB - ANSWER-is supported by scientific evidence that proves they work to produce specific outcomes Examples of EBPs - ANSWER-Seeking Safety, MI, 12 step facilitation, CBT, DBT, Community Reinforcement Approach w/ Vouchers Succesful implementation of EBPs include - ANSWER-1. changes in professional behavior, changes in organizational structure in order to support changes in prof. behavior 3. Changes in relationships Implementation failure of EBP occurs when - ANSWER-fidelity does not occur. Fidelity checklist Examples of T