ADC Exam LATEST EDITION 2024 SOLUTION GUARANTEED GRADE A+

cocaine neurotransmitters primary buildup of dopamine (also serotonin and norepinephrine); people deficient in serotonin are at risk nootropics drugs designed to boost cognitive performance ex: Adderall, Provigil (sleep disorders), amphetamine cocaine abuse 1. experimental use 2. compulsive use 3. dysfunctional use -arterial constriction & hardening leads to cardiac arrest/stroke anabolic steroids -engage both opioid and dopamine neurotransmission systems -just as addictive as caffeine, nicotine, and benzos -withdrawal appears like cocaine (insomnia, headaches, restlessness, poor libido, dysphoria) screening & assessment screening: looking to determine if a problem exists assessment: more thorough for targeted matters of concern suicide rates IV users: 14x higher general population: 10x higher lowest for African American women & highest for American Indian and Alaskan Native males Substance Abuse Subtle Screening Inventory (SASSI) 67 clinical obvious & subtle items to detect truth when individuals are unwilling or unable to acknowledge problem; 15 mins to complete Michigan Alcohol Screening Test (MAST) alcohol screening tests available but no tools for truth Screening, Brief Intervention, and Referral to Treatment (SBIRT) quick & simple tool to ID substances for at-risk levels for those already experiencing substance use issues; no tools for truth Addiction Severity Index (ASI) tool for assessment & tx planning (NOT screening) readiness to change -clients who perceive the need for help w/ the process of change & when other options are perceived as comparatively less attractive -NOT always rock bottom; can also be motivated by external pressures -client and family's level of emotional pain Chemical Use, Abuse And Dependence (CUAD) Scale used in ax; derives a DSM dx of substance disorder; brief 5-30 min interview and requires little training. known for mentally ill pop'ns Symptom Checklist-90-R (SCL-90-R) ax broad range of psychological problems and pathology as well as client progress/treatment outcomes. 90 items on a 5-point scale to be completed in 12-15 minutes and produces an overview of symptoms Community Oriented Programs Environment Scale (COPES) measure actual, preferred, and expected treatment environment or social climate of community treatment programs by drawing on opinions of clients & staff Treatment Services Review (TSR) used in conjunction with ASI; ten-minute structured interview to ax nature and frequency of tx services CHEAP progress notes Chief complaint History Exam Assessment Plan SIGECAPS full eval of depression symptoms: Sleep, Interests, Guilt, Energy, Concentration, Appetite, Psychomotor Agitation, and Suicidal ideation CART progress note format: Client condition, Actions, Response, and Treatment plan CHART progress note format: Client condition, Historical significance, Actions, Response, and Treatment plan episode of treatment length of stay is not always critical; completion is more important; avoid high drop-out rate in first few weeks ideal group size process groups most effective w/ 6-8 members; psychoeducational ones can be larger co-occurring treatment severity none- moderate/severity: IOP (i.e. anxiety/mood dx) severe: dual-diagnosis (psychotic/personality disorders) Composite International Diagnostic Interview (CIDI) covers both DSM and ICD criteria for SA disorders; addresses consequences and onset of symptoms; primarily used for epidemiology MINI scale screens for major psych disorders based on DSM and ICD criteria; reliable dx in brief time frame PRISM instrument Psychiatric Research Interview for Substance Abuse and Mental Disorders; differentiates antisocial and borderline personality dx from SA; 1-3 hours/training required AASE Scale Alcohol Abstinence Self-Efficacy Scale; to ax level of client's confidence in being able to abstain from alcohol in 20 situations that include common drinking cues; no training req'd ASRPT Alcohol-Specific Role Play Test (ASRPT) uses role-playing scripts to evaluate client situations in taped responses by acting out; 20 mins/requires training SCQ Situational Confidence Questionnaire: 29 self-report items that explores self-efficacy in alcohol-related scenarios CBT not effective in group counseling Motivational interviewing (MI) counselor is coach/consultant, asking key questions for learning. nonjudgmental, collaborative style Motivational enhancement therapy (MET) incorporates structured assessments and follow-up sessions as adaptation to MI Matrix Model of treatment relapse prevention, family education, and early recovery skills groups (NOT stress management); very effective also neurobehav. tx Osher & Kofoed co-occurring treatment four stages: 1. engagement 2. persuasion 3. active treatment 4. relapse prevention symptom presentation most influential for counselor; alcohol use among adults 25+ lower in rural areas women have higher rate of alcohol use in rural areas Clinical/Rehabilitation model integrate clinical therapy + resource activities service coordination case management and advocacy are subsets defined as action framework by which a client is enabled to achieve goals in ID treatment plan Qualified Service Organization Agreement (QSOA) used when outside person/agency provided services directly to treatment #1 client changer ability to be empathetic communication 50% is nonverbal developmental stages age of significant SA use is when developmental stages were arrested/missed altogether programmed confrontation used to mobilize a substance user to accept treatment (usually by family member); trained in Unilateral Family Therapy community reinforcement training (CRT) used by families to hasten a user into treatment who seek help same-day ARISE method uses 3-level approach to motivate an addict to enter treatment network therapy builds an extended collection of involved persons Native Americans 20% report alcohol abuse Asians & Pacific Islanders fastest growing group in US client data reviewed annually; entered weekly transference client feelings onto counselor countertransference counselor feelings onto client treatment frame helps establish healthy boundaries DSM 11 symptoms recreational use occurs weekly-biweekly tolerance develops as body seeks homeostasis; for an otherwise legal dose of barbs only marginally increases and never exceeds twofold Hepatitis B inflames liver-- alcoholics susceptible to toxic effects as substance is metabolized by liver Magnon's syndrome chronic users of cocaine/ stimulants develop "bug crawling" sensation under the skin convergence theory SA rates among men & women are becoming more equal (1.6 men : 1 women) alcohol use in elderly #3 psych disorder; 1/2 - 1/4 suicide attempts involve alcohol; have better attendance rates and lower rates of relapse alcohol use onset 2/3 start in adolescence & young adulthood rates of receiving help 7.1 % will receive tx for co-occurring dx 32.9% only mental health tx 25% SA + MH? screening process can be affected by setting, instructions, and privacy GATE ax for suicide assessment information goals, objectives, action steps w/ reliable, clinical and valid info stages of change 1. precontemplation 2. contemplation 3. preparation 4. action 5. maintenance 6. relapse treatment planning principles Measureable Attainable Time-limited (short-term) Realistic Specific ASI most widely used; has teen and shortened versions DIG FAST full evaluation of mania discharge with continuing care SA requires long-term tx (not referred to "after care" or f/u) naltrexone can be effective for alcohol tx suboxone + naloxone can be used for opioid dependence ASAM levels of care .5 early intervention I: outpatient: 9 hours weekly II: IOP/partial hosp: 9+ hours weekly (2 subcategories) -minimum 90 days III: residential/inpatient (3 subcategories) IV: medically managed inpatient *enter lowest level possible four sequential stages of tx 1. tx engagement 2. early recovery 3. maintenance 4. community support group & individual therapy just as effective; individual is 30-50 min weekly with no discussion of conscious/subconscious issues group therapy: more complex and specialized than 12-steps group modalities psychoed: teach concepts time-limited: education @ onset of tx skills-development: refusal/relapse prevention support: work thru conflict interpersonal: single-interest of family/couples presented in sequential manner pharmacotherapy effective SA tx esp. in IOP; no effective meds for stimulants, cocaine, marijuana, inhalants or hallucinogen abuse core support concerns education, voc training, and employment do not constitute adjunctive therapies effective screening tools to detect SA disorder presence Center for Substance Abuse Treatment (CSAT) Simple Screening , combo of Alcohol Dependence Scale (ADS) and ASI subscale, and Texas Christian University Drug Screen remission early: 3-12 months sustained: 12+ (no longer partial/full) Minnesota Model of Treatment addiction is a disease; blending of professional and trained nonprofessional (recovering) staff; can involve 12-step facilitation CONTINUED...