CBIS II (13-24)
What fraction of TBI patients receiving rehab for TBI or substance abuse have hx of both? -
2/3
What percentage of patients 16 and older entering rehab were using illicit drugs in the month
preceding their injury?
% of alcohol use?
was it higher or lower in younger age groups? -
12%
23%
higher for younger people
What is the likelihood a person will resume substance misuse after injury? -
10x
.....the consumption of alcohol, and illegal drugs and the use of Rx drugs exceeding the
prescribed amount or use of another person's Rx drugs.
What is the disorder that involves continued use despite health, psych, or social consequences
-
Substance misuse
Substance abuse disorder
A hx of at least one TBI typically indicates what about severity of substance misuse?
Age of first substance use?
Higher likelihood of what? -
*Increased severity* of of substance misuse
*earlier age* of first substance use
Higher likelihood of *other disorders*
What percent of general population has a dx of substance use disorder? -
10%
Best method to interview an individual about substance misuse is the use of what type of
questioning and what type of listening? -
Open ended
Reflective (try to rephrase their statement to show you're listening)
Four signs of alcohol dependence
1|Page
,C
A
G
E
what number is warranted for further assessment -
Have you felt you should *C*ut down
Have people *A*nnoyed you about your drinking
Have you felt bad or *g*uilty about it
Have you ever needed an *e*ye opener first thing in the morning to calm the shakes
2/4
The 4 Quadrant Model of Opportunities for Substance Misuse Intervention with Persons with
a TBI:
Acute medical setting and primary care for TBI
Substance Misuse Addressed by screening and Brief
Interventions
What is the quadrant and what is the severity -
Quadrant I
Low severity for both
The 4 Quadrant Model of Opportunities for Substance Misuse Intervention with Persons with
a TBI:
TBI rehab programs and services setting
Substance Misuse Addressed by Education, Screening, Brief interventions, and Linkage
What is the quadrant and what is the severity -
Quadrant II
Low severity SUD
High Severity TBI
The 4 Quadrant Model of Opportunities for Substance Misuse Intervention with Persons with
a TBI:
TBI Addressed by screening, accommodation and linkage
2|Page
,Substance use Disorder Treatment Setting
What is the quadrant and what is the severity -
Quadrant III
High severity SUD
Low Severity TBI
The 4 Quadrant Model of Opportunities for Substance Misuse Intervention with Persons with
a TBI:
Specialized TBI and SUD services and integrated programming
What is the quadrant and what is the severity -
Quadrant IV
Both high severity
What treatment and prevention methods are present that effectively reduce substance misuse
among persons with moderate to severe TBI? -
None
Physical and mental changes that occur after brain injury DO or DO NOT alter a person's
legal rights in a rehab program?
What if they are unable to exercise those rights? -
DO NOT
A legal representative may exercise those rights for the individual as allowed by the state
This type of law is developed from court decisions -
Common law
Based on the constitution of the US and the state constitution where the person lives -
Constitutional Law
Enacted by Congress or a state legislature in the form of individual statutes which together
form a code -
Statutory law
These types of laws are created by administrative agencies such as Dept of Health & Human
Services, statute, Congress or the state legislature. Authorizes an agency to create laws
known as rules or regulations -
Administrative law
What did the case of Youngberg v. Romeo determine on the use of restraints? -
A basic liberty under the Constitution is to be free from undue bodily restraint
3|Page
, When does Joint Commission and Commission on Accreditation or Rehabilitation Facilities
mandate use of restraints in most states? and what does this mean as far as documentation and
state of the individual? -
Use of restraints is only to be used as a measure of last resort....meaning less
restrictive procedures have been documented as unsuccessful and the person or others are in
immediate danger
When are restraints never allowed? -
For staff convenience, for retribution, or to make up for shortcomings of the
treatment program (such as inadequate staffing, inadequate training of staff, poor professional
insight, lack of treatment planning, or other factors)
What are some examples of medically prescribed restraints -
vests (to prevent falls out of bed), helmets, lap belts, lap trays, other devices that
promote the safety and function of the individual
A legal term that describes a person's mental ability to understand the nature and effect of
one's decisions and acts. Generally the law presumes that an adult individual is competent
until proven otherwise. State Law provides the process to determine this -
Competency or Capacity
This piece of legislation prohibits discrimination on the basis of disability in programs
conducted by agencies in the executive branch of the federal government and entities such as
schools, hospitals and nonprofit organizations receiving federal financial assistance. -
Rehabilitation Act of 1973
Legal enforceable arrangement under which one person has the legal right and duty to care
for another (a ward) -
Guardianship
What is a plenary Guardian -
A Guardian who is both of the Person and the Estate as opposed just one
A document in which a competent person (the principal) appoints another (the agent) to act
for him or her in a legal and financial matter -
Power of Attorney
What happens when the power of attorney is durable? -
The appointment cannot be changed when the principal becomes disabled or
incompetent
Under state law who can override or revoke the power of attorney -
The Gaurdian
A durable power of attorney for health care is also known as a ..... -
medical power of attorney or health care proxy
The right of the patient to prevent disclosure of health care information by a health care
provider -
4|Page
What fraction of TBI patients receiving rehab for TBI or substance abuse have hx of both? -
2/3
What percentage of patients 16 and older entering rehab were using illicit drugs in the month
preceding their injury?
% of alcohol use?
was it higher or lower in younger age groups? -
12%
23%
higher for younger people
What is the likelihood a person will resume substance misuse after injury? -
10x
.....the consumption of alcohol, and illegal drugs and the use of Rx drugs exceeding the
prescribed amount or use of another person's Rx drugs.
What is the disorder that involves continued use despite health, psych, or social consequences
-
Substance misuse
Substance abuse disorder
A hx of at least one TBI typically indicates what about severity of substance misuse?
Age of first substance use?
Higher likelihood of what? -
*Increased severity* of of substance misuse
*earlier age* of first substance use
Higher likelihood of *other disorders*
What percent of general population has a dx of substance use disorder? -
10%
Best method to interview an individual about substance misuse is the use of what type of
questioning and what type of listening? -
Open ended
Reflective (try to rephrase their statement to show you're listening)
Four signs of alcohol dependence
1|Page
,C
A
G
E
what number is warranted for further assessment -
Have you felt you should *C*ut down
Have people *A*nnoyed you about your drinking
Have you felt bad or *g*uilty about it
Have you ever needed an *e*ye opener first thing in the morning to calm the shakes
2/4
The 4 Quadrant Model of Opportunities for Substance Misuse Intervention with Persons with
a TBI:
Acute medical setting and primary care for TBI
Substance Misuse Addressed by screening and Brief
Interventions
What is the quadrant and what is the severity -
Quadrant I
Low severity for both
The 4 Quadrant Model of Opportunities for Substance Misuse Intervention with Persons with
a TBI:
TBI rehab programs and services setting
Substance Misuse Addressed by Education, Screening, Brief interventions, and Linkage
What is the quadrant and what is the severity -
Quadrant II
Low severity SUD
High Severity TBI
The 4 Quadrant Model of Opportunities for Substance Misuse Intervention with Persons with
a TBI:
TBI Addressed by screening, accommodation and linkage
2|Page
,Substance use Disorder Treatment Setting
What is the quadrant and what is the severity -
Quadrant III
High severity SUD
Low Severity TBI
The 4 Quadrant Model of Opportunities for Substance Misuse Intervention with Persons with
a TBI:
Specialized TBI and SUD services and integrated programming
What is the quadrant and what is the severity -
Quadrant IV
Both high severity
What treatment and prevention methods are present that effectively reduce substance misuse
among persons with moderate to severe TBI? -
None
Physical and mental changes that occur after brain injury DO or DO NOT alter a person's
legal rights in a rehab program?
What if they are unable to exercise those rights? -
DO NOT
A legal representative may exercise those rights for the individual as allowed by the state
This type of law is developed from court decisions -
Common law
Based on the constitution of the US and the state constitution where the person lives -
Constitutional Law
Enacted by Congress or a state legislature in the form of individual statutes which together
form a code -
Statutory law
These types of laws are created by administrative agencies such as Dept of Health & Human
Services, statute, Congress or the state legislature. Authorizes an agency to create laws
known as rules or regulations -
Administrative law
What did the case of Youngberg v. Romeo determine on the use of restraints? -
A basic liberty under the Constitution is to be free from undue bodily restraint
3|Page
, When does Joint Commission and Commission on Accreditation or Rehabilitation Facilities
mandate use of restraints in most states? and what does this mean as far as documentation and
state of the individual? -
Use of restraints is only to be used as a measure of last resort....meaning less
restrictive procedures have been documented as unsuccessful and the person or others are in
immediate danger
When are restraints never allowed? -
For staff convenience, for retribution, or to make up for shortcomings of the
treatment program (such as inadequate staffing, inadequate training of staff, poor professional
insight, lack of treatment planning, or other factors)
What are some examples of medically prescribed restraints -
vests (to prevent falls out of bed), helmets, lap belts, lap trays, other devices that
promote the safety and function of the individual
A legal term that describes a person's mental ability to understand the nature and effect of
one's decisions and acts. Generally the law presumes that an adult individual is competent
until proven otherwise. State Law provides the process to determine this -
Competency or Capacity
This piece of legislation prohibits discrimination on the basis of disability in programs
conducted by agencies in the executive branch of the federal government and entities such as
schools, hospitals and nonprofit organizations receiving federal financial assistance. -
Rehabilitation Act of 1973
Legal enforceable arrangement under which one person has the legal right and duty to care
for another (a ward) -
Guardianship
What is a plenary Guardian -
A Guardian who is both of the Person and the Estate as opposed just one
A document in which a competent person (the principal) appoints another (the agent) to act
for him or her in a legal and financial matter -
Power of Attorney
What happens when the power of attorney is durable? -
The appointment cannot be changed when the principal becomes disabled or
incompetent
Under state law who can override or revoke the power of attorney -
The Gaurdian
A durable power of attorney for health care is also known as a ..... -
medical power of attorney or health care proxy
The right of the patient to prevent disclosure of health care information by a health care
provider -
4|Page
