PCB CRS EXAM Questions With Complete Solutions

PCB CRS EXAM Define Recovery. - ANS No single definition. Recovery = different things to different people at different times. Defining recovery from: - ANS 1. Physical illness 2. Trauma 3. Mental health 4. Oppression 5. Racism 6. Poverty SAMHSA Working Definition of Recovery: - ANS A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential. SAMHSA 4 dimensions that support a life in recovery: - ANS 1. Health: A) Overcoming or managing one's disease(s) or symptoms—for example, abstaining from use of alcohol. B) Making informed, healthy choices that support physical and emotional well-being. 2. Home: A stable and safe place to live. 3. Purpose: Meaningful daily activities, such as a job, school, independence, income and resources to participate in society. 4. Community: Relationships and social networks that provide support, friendship, love, and hope. The History of Addiction & Recovery from - ANS • 1750: 1st sobriety "Circles" are formed within Native American tribes. - Contemporary Native American Sobriety Movement: "talking circle." • 1774: Anthony Benezet's Mighty Destroyer Displayed is published. - It is the earliest American essay on alcoholism. • 1784: Dr. Benjamin Rush's says alcoholism = disease. - His work = beginning of Temperance movement: Driven by mainly women looking @ alcohol abuse; made pledges against drinking. • 1810: Dr. Benjamin Rush calls for creation of a "Sober House" for the care of the confirmed drunkard. • 19th century: Morphine, laudanum, & cocaine were newly discovered, unregulated, and freely prescribed. - These drugs were available in patent medicines and sold by traveling salesmen, drugstores, or by mail. - In U.S. Civil War, morphine was used freely. • 1875: opium dens were outlawed in San Francisco. The History of Addiction & Recovery from - ANS • 1906: Pure Food and Drug Act required labeling of patent medicines containing opium and some other drugs. • 1914: Harrison Narcotic Act forbade the sale of large doses of opiates & cocaine except by doctors. - Later, heroin was banned from the sale of medicines. • Later Supreme Court decisions made it illegal to prescribe narcotics to addicts. - Doctors who prescribed maintenance doses for treatment were jailed. • 1920's: use of narcotics and cocaine diminished. • 1919: the Eighteenth Amendment to the Constitution prohibited the use and distribution of alcohol. • 1933: Prohibition repealed. • 1930's: most states required anti-drug education in schools, but fear that knowledge led to experimentation caused trainings to end. • Mid 1930's: U.S. Federal Bureau of Narcotics (now the Drug Enforcement Administration) ran campaign to show marijuana as addicting drug that led to narcotics use. • 1950's: the use of marijuana increased again, along with amphetamines and tranquilizers. The History of Addiction & Recovery from 1960s-Present - ANS • 1960's: big increase in drug use and some increased social acceptance. • 1970's: some states had decriminalized marijuana and lowered the drinking age. • 1980's: cocaine and crack use soared. - U.S. troops invaded Panama and brought Manuael Noriega to trial for drug trafficking. The Foundation of the Recovery Process Transformation: - ANS The Civil Rights Movement (Civil Rights movements like African-American Civil Rights Movement, Voting, and Women's, Disability, Patient, HIV, and Prisoner Rights). The Recovery Process Transformation declares that: - ANS People in recovery have the same civil rights as any other citizen: Life, Liberty, and the pursuit of recovery. Legislation Enacted to Support Changes from the Recovery Process Transformation: - ANS 1. Americans with Disabilities Act, 1990 2. Olmstead Decision, June 22, 1999 According to the Americans with Disabilities Act of 1990: - ANS • Physical or mental disabilities in no way diminish a person's right to fully participate in all aspects of society • Society has tended to isolate and segregate individuals with disabilities • Discrimination persists • Often had no legal recourse To be protected by the ADA... - ANS One must have a disability or have a relationship or association with an individual with a disability. An individual with a disability is defined by the ADA as: - ANS A person who has a physical or mental impairment that substantially limits one or more major life activities, a person who has a history or record of such an impairment, or a person who is perceived by others as having such an impairment. The ADA does not specifically name all of the impairments that are covered. Are applicants or employees who are currently illegally using drugs covered by the ADA? - ANS No. Is testing for the illegal use of drugs permissible under the ADA? - ANS Yes. Are alcoholics covered by the ADA? - ANS Yes. 1999: Olmstead Decision: - ANS Upheld the ADA of 1990, and requires that people with mental disabilities be treated in the least restrictive, appropriate setting. History of Recovery Transformation - Deinstitutionalization: - ANS • Part of recovery transformation history, signifying the release of institutionalized individuals from institutions (i.e. psychiatric hospital) to care in the community. • Began in 1955 w/ developments of more effective meds, like Thorazine, & Enactment of Federal Medicaid and Medicare in 1965 History of Recovery Transformation - Community Support Programs: - ANS • Created in Mid to Late 1970's by the National Institute of Mental Health to show possibility that people w/ severe mental health issues can live in community w/ good resources & support (professional & peer). History of Recovery Transformation - Alcoholics Anonymous - ANS • 1935 by Bill W. and Dr. Bob • Sponsorship - people with lived experience give back and share with others • Peer-to-peer perspective • Person in recovery takes central role and uses non-professional peer supports in the community History of Recovery Transformation - Federal Government Support for Recovery Transformation - ANS • Surgeon General's Report on Mental Health (1999) and Supplement on Culture, Race & Ethnicity (2001) • New Freedom Commission on Mental Health Final Report: Transforming Mental Health Care in America (2003) • Federal Action Agenda (2005) History of Recovery Transformation - SAMHSA says... - ANS In order to get their funding, you need to be recovery oriented and offer recovery oriented services. Transformation definition: - ANS • The term was picked by the Commission to show that more reforms to the existing mental health system are insufficient. • It has implications for policy, funding, practice, attitudes, and beliefs. Do people addicted to alcohol and other drugs recover? - ANS Yes. More than 50% of people with substance use disorders recover. Do people with severe mental health diagnoses, such as schizophrenia, recover? - ANS Yes, and faster than people think. The 12 Guiding Principles of Recovery: - ANS 1. There are many pathways to recovery. 2. Recovery is self-directed and empowering (• Strength-based, • Person-first {Person before dysfunction}, • Person-directed {choice & decision-making power about one's own recovery}). 3. Recovery involves a personal recognition of the need for change and transformation. 4. Recovery is holistic. 5. Recovery has cultural dimensions. 6. Recovery exists on a continuum of improved health and wellness. 7. Recovery is supported by peers and allies. 8. Recovery emerges from hope and gratitude. 9. Recovery involves a process of healing and self-redefinition. 10. Recovery involves addressing discrimination and transcending shame and stigma. 11. Recovery involves (re)joining and (re)building a life in the community. 12. Recovery is a reality. As a person achieves more and more abstinence time... - ANS the likelihood that they will remain abstinent goes up. Treatment ≠ Recovery BECAUSE... - ANS 1. Recovery is larger construct. Treatment can be part of but is not equal to recovery. 2. Goal of treatment - absence of symptoms 3. Goal of recovery - holistic health 4. Treatment alone does not address challenges such as family, employment, housing, etc. 5. Recovery is different for each individual 6. Social determinants of health need to be addressed. MOTIVATION... - ANS plays a central role in recovery. • Motivation to change comes from "hitting bottom" • Motivation is increased when others stop enabling the individual or by intervention • Motivation to avoid pain Defining Peer Based Recovery Support Services (PBRSS). What Are PBRSS? - ANS • Help individuals and families initiate, stabilize, and sustain recovery • Non-clinical services that assist in removing barriers and providing resources to those contemplating, initiating, and maintaining recovery • Links to professional treatment and indigenous communities of support • They are not: • Professional addiction treatment services • Mutual aid support PBRSS... - ANS • Draw on the power of example and lived experience. • Draw on the desire to "give back." • Based on the idea that both people in a relationship based on mutuality and collaboration are helped and empowered PBRSS are Delivered... - ANS Across the full continuum of the recovery process, which includes: • Prior to treatment • During treatment • Post treatment • In lieu of treatment Recovery Support Integration Model - ANS Engagement Increasing Readiness Stabilizing Recovery Sustaining & Growing Recovery P-BRSS (Peer-Based Recovery Support Services) - ANS PIR's (Persons in Recovery) are "experts" on themselves PIR's dictate the direction of services Strengths- based, focus on long-term recovery Lived experience is key ingredient in service providers Support services often are provided out in the community Recovery Goals are identified by PIR Peer-provider is encouraged to share lived experience (self-disclosure) Tx Services (Treatment Clinical Services) - ANS Professionals are the "experts" Professionals dictate the direction of services Deficit based, focus on diagnosing & treating symptoms Education is key ingredient in service providers Treatment services often are provided within a facility Treatment Goals are identified by treatment provider Provider is discouraged from sharing lived experience 4 Major Types of Support - ANS 1. Emotional: Demonstrates empathy, caring, or concern to bolster person's self-esteem and confidence. Examples: Peer mentoring, support groups, & Recovery Coaching 2. Informational: Share knowledge and information and/or provide life or vocational training. Examples: Life/Job Skills Training & Educational Assistance 3. Instrumental: Provide concrete assistance to help others accomplish tasks. Examples: Assistance w/ Job Applications, Transportation & Community Services 4. Companion: Facilitate contacts with other people to promote learning of social and recreational skills, create community and acquire a sense of belonging. Examples: Recovery Centers, Sports Leagues, & Drug Free Socialization Core Competencies for Peer Workers - ANS 1) Recovery-oriented. 2) Person-centered. 3) Voluntary. 4) Relationship-focused. 5) Trauma-informed. 12 Core Competency Areas (SAMHSA) - ANS Category 1: Engages peers in collaborative and caring relationships Category 2: Provides support Category 3: Shares lived experiences of recovery Category 4: Personalizes peer support Category 5: Supports recovery planning Category 6: Links to resources, services, and supports Category 7: Provides information on skills related to health, wellness, and recovery Category 8: Helps peers to manage crises Category 9: Values communication Category 10: Supports collaboration and teamwork Category 11: Promotes leadership and advocacy Category 12: Promotes growth and development Multiple Pathways to Recovery (10) - ANS 1. Natural recovery (9%). No formal therapy or support. People stop using alcohol/drugs on their own, w/ friends/family support & education. 2. Mutual Aid Groups Type 1: 12-Step-based (45%). Examples: AA, NA 3. Mutual Aid Groups Type 2: Non-12-Step-based (9%). Examples: Women for Sobriety (based on 13 affirmations to meet women's psychological needs for emotional & spiritual awareness) and SMART Recovery (secular, 4-point approach, based on cognitive therapy & smaller programs that includes: 1) enhancing and maintaining motivation, 2) coping w/ urges, 3) problem-solving, 4) lifestyle balance). 4. Faith-Based Recovery (21%). Includes faith in a higher power, spirituality, & often religion. 5. Cultural Recovery (6%). Examples: traditional Native American sweat lodges 6. Criminal justice (12%). Examples: incarceration, drug court 7. Outpatient treatment (9%). Involves a mental shift gaining, control, self-esteem, & strength. 8. Inpatient treatment. Various lengths of stay & treatment approaches, therapeutic communities that use participative, group-based approaches, & halfway houses w/ a mix of treatment and housing support. 9. Bodywork (21%). Examples: Yoga, traditional Chinese medicine, & Addiction Energy Healing 10. Other therapies. Examples: Art or music and giving back 6 Stages of Change - ANS Stage 1: Pre-contemplation. Defining Characteristic: No awareness of problem or intention to make a change. Motivational Tasks: raise doubt and provide info to increase client's perception of risks and problems with current behavior Stage 2: Contemplation. Defining Characteristic: Ambivalence about change. Motivational Tasks: Tip the balance. Evoke questions about making a change & discuss risks of not changing, strengthen the client's self-efficacy to change current behavior, but no action. Stage 3: Preparation. Defining Characteristic: Window of opportunity when a client considers change & develops a commitment to action. Motivational Tasks: Help client determine the best course of action to take in seeking change. Focus on small but meaningful steps. Stage 4: Action. Defining Characteristic: Begins to implement the solution or plan. Motivational Tasks: Help client take steps toward change. Support initial steps towards change, provide corrective feedback. Stage 5: Maintenance. Defining Characteristic: Develops new behaviors to maintain changes and solution. Motivational Tasks: Help client identify & use strategies to prevent relapse, support success, and reinforce motivation & self-efficacy. Stage 6: Relapse. Defining Characteristics: Resumption of problem: normal & expected. Likely to abandon change if demoralized. Motivational Tasks: Help client renew process of contemplation, determination, and action, without becoming stuck or demoralized because of relapse. Appeals Committee - ANS Three PCB board members appointed to hear an appeal. Certified Professional - ANS A person who holds or applies for a PCB credential classification. Client - ANS Any person(s) who, either currently or in the past, has received or is receiving services Complainant - ANS A person(s) who files a complaint with the PCB against a certified professional under PCB jurisdiction. Ethics - ANS A standard of behavior by which certified professionals must abide. Ethics Committee - ANS A PCB standing committee charged with the responsibility to review, investigate and sanction as determined appropriate to those who breach the Code of Ethical Conduct. The committee is comprised of PCB board members and/or its designees. Hearing Panel - ANS A panel comprised of PCB Ethics Committee members with a responsibility to hear and make recommendations in accordance with the Code of Ethical Conduct. Hearing Officer - ANS The PCB Ethics Committee Chairperson or Co‐Chairperson who presides over an ethics hearing. Counselor Credentials - ANS Associate Addiction Counselor Level I and Level II, Certified Associate Addiction Counselor, Certified Alcohol and Drug Counselor, Certified Advanced Alcohol and Drug Counselor. Prevention Credentials - ANS Associate Prevention Specialist Level I and Level II, Certified Prevention Specialist. Clinical Supervisor Credential - ANS Certified Clinical Supervisor. Allied Credential - ANS Certified Allied Addiction Practitioner. Case Manager Credentials - ANS Certified Case Manager, Certified Case Manager Supervisor. Criminal Justice Credential - ANS Certified Criminal Justice Addictions Professional. Co‐Occurring Credentials - ANS Certified Co‐Occurring Disorders Professional, Certified Co‐Occurring Disorders Professional Diplomate. Recovery Credential - ANS Certified Recovery Specialist. Intervention Credential - ANS Certified Intervention Professional. Plagiarism - ANS An act of appropriating the language, ideas, or thoughts from another person and representing them as one's own original work. Public Reprimand - ANS A sanction that is a formal, written, published reproof or warning to a Respondent who the Ethics Committee has determined to have breached the Code of Ethical Conduct. Respondent - ANS A certified professional against whom an ethical complaint has been filed. Revocation - ANS A sanction resulting in the complete and permanent forfeiture of PCB certification. Score of Services - ANS The range of services deemed appropriate and necessary for an individual client. Such services may include but are not limited to prevention, intervention, outreach, information and referral, detoxification, inpatient or outpatient, extended care, transitional living, aftercare and clinical supervision. Suspension - ANS A sanction resulting in the temporary forfeiture of PCB certification for a period of time to be determined by the PCB Ethics Committee. Written Caution - ANS The least restrictive disciplinary action that a Respondent may receive due to breaching the Code of Ethical Conduct. This sanction is a formal, private, non‐published letter of warning to the Respondent that cautions the Respondent against certain conduct or behavior. THE 5 KEYS TO BEING A TRUE PROFESSIONAL - ANS 1. CHARACTER 2. ATTITUDE 3. EXCELLENCE 4. COMPETENCY 5. CONDUCT Confidentiality: - ANS Ensures that information is only accessible to those w/ authorized access. - Linked w/ ethical communication principle that's "privileged" & not shared w/ 3rd parties. - The responsibility for limiting disclosure of private matters. Authorized personnel: - ANS The power to determine, adjudicate, or settle disputes, jurisdiction, the right to control, command, or determine. - A power or right delegated or given, authorization - A person or group w/ authority as a government agency - Usually authorities, w/ legal power to make/enforce laws - An accepted source of information, advice, etc. Third Party: - ANS Person who pays for a patient's treatment that has a contractual relationship w/ the patient or their family based on eligibility for governmental benefits. Minimum amount of information: - ANS Information needed to carry out purpose of the disclosure Patient: - ANS Any person who has applied for, participated in, or received: - An interview, counseling or any other service - Anyone who is found a substance abuser after arrest to determine program eligibility - Includes deceased people Program: - ANS Three definitions, including: 1. Any individual or entity (not general medical care facility) who provides alcohol or drug abuse diagnosis, treatment, or referral for treatment. 2. Unit w/ in medical facility that provides alcohol or drug abuse diagnosis, treatment, or referral for treatment. 3. Medical staff in a general medical facility who primarily deals w/ alcohol or drug abuse diagnosis, treatment, or referral for treatment and who are identified as such providers. 42 U.S.C. 290dd-2 (Federal Law) - ANS Governs Confidentiality in Substance Abuse Field • Programs may not disclose any information identifying a patient as an alcohol or drug abuser unless: - The patient consents in writing, - The disclosure is allowed by a court order, or - The disclosure is made to medical personnel in a medical emergency or to qualified personnel for research, audit, or program evaluation 42 CFR II (Federal Regulations) - ANS Implement 42 U.S.C. 290dd-2 & Outline limited circumstances where info about treatment may be disclosed w/out person's consent. • The federal regulation at 42 CFR Part 2 pertains to any program that involves substance abuse education, treatment, or prevention and is regulated or assisted by the federal government. Purpose: these regulations impose restrictions upon the disclosure and use of alcohol and drug abuse patient records which are maintained in connection with the performance of any federally assisted alcohol or drug abuse program Effect: these regulations prohibit the disclosure and use of patient records unless certain circumstances exist. Scope of the Law: Restricts the disclosure and use of "patient identifying: information about individuals receiving, having received, or having applied to receive substance abuse treatment. HOLDER - ANS individual in possession of info may not release it except as authorized by the patient or otherwise permitted by the regulations SEEKER - ANS Anyone seeking information may not compel its disclosure except as permitted by the regulations RECEVIER - ANS Anyone who received information may not REDISCLOSE it Disclosure - ANS Communication of records containing "patient-identifying information" Disclosure Example: even if person receiving the information already has it ("I dropped off my wife earlier today. Is she finished with treatment today?") Records - ANS Any information, whether in writing, orally, electronically, or other means Patient-identifying information - ANS Identifies someone as: - Having past or current alcohol/drug problem. - Being a past or current patient in alcohol/drug program. - Includes name, address, ssn, fingerprints, photographs or other information by which patient's identity can be determined with reasonable accuracy/speed. - Does not include demographic data that doesn't reveal - directly or indirectly - that someone has/had alcohol/drug problem or is/was patient - Does not include aggregate data - Does not include information that someone receives/received services from mixed use facility - e.g., general medical facility, community mental health center that provides alcohol/drug treatment as well as other health services Patient - ANS Anyone who now or ever received - or even applied for - services from a Part 2 alcohol/drug program. - Example: John made appointment but didn't show up. He's a "patient." Who must follow 42 C.F.R. Part 2? - ANS To be covered by Part 2, a provider must meet the definition of "program" and be federally assisted. 3 Definitions of a Program - ANS 1. individual/entity other than general medical facility that provides alcohol/drug diagnosis, treatment, or referral for treatment Example: freestanding drug/alcohol treatment program 2. an identified unit within a general medical facility which holds itself out as providing and provides alcohol/drug diagnosis, treatment, or referral for treatment 3. Medical personnel or other staff in a general medical care facility whose primary function is the provision of alcohol/drug diagnosis, treatment, or referral for treatment and who are identified as such. "Federally assisted" - ANS 1. Allowed tax deductions for contributions by the IRS 2. Authorized to conduct business by the federal government, including programs: Certified as a Medicare provider Authorized to conduct methadone maintenance treatment Registered with the DEA 28 Pa Code §709.28 (State Confidentiality Regulation) - ANS • Licensing Code relating to two main issues: - Confidentially of client identify and records - Staff access to client records 4 Pa Code §255.5 - ANS (State Regulation -Management Information, Research, & Evaluation) • State regulations which are more strict that the Federal Regulations are followed • These regulations protect the client • Restrictions and The Big 5 • Documentation for everything that is released. 10 Reasons you can disclose - ANS 1) •Court ordered sentence conditioned upon client entering a program 2) •Probation or parole - assigned responsibility if conditioned upon being in treatment 3) •Judge has assigned to a project under pre-sentence, conditional release program 4) •To a judge in order to determine to initiate conditional release programs 5) •Attorney 6) •To employer about participation in project 7) •Benefits (medical) 8) •Governmental benefits 9) •Emergency situations 10) Must keep written record of all information disclosed Can only Release The Big 5 to CJ System. The Big 5 Informative Restrictions Include: - ANS 1. Is or is not in treatment 2. Prognosis 3. Nature of project 4. Brief description of progress 5. Short statement on relapse 71 P.S. §1690.108 (Act 63) - ANS State law relating to the Confidentiality of Records of Substance Abuse Treatment Services • State's Enabling Legislation • Minors in PA can receive treatment without parental consent - Differs that MH regulations - Minors control release of information 55 Pa Code §5100.37 - ANS (State MH Regs.) • Whenever information in a patient's records relates to drug or alcohol abuse or dependency, those specific portions of the patient's records are subject to the confidentiality provisions of section 8(c) of the Pennsylvania Drug and Alcohol Abuse Control Act (Act 63) and the regulations promulgated thereunder, 4 Pa Code §255.5 42 Pa Code §6352.1 (Act 126) - ANS • Allows for the release of drug and alcohol treatment and other records regarding a child who is alleged to be or adjudicated dependent or delinquent, or the child's parents, to an extent not permitted in other proceedings or anywhere else in Pennsylvania. • Still obtain releases! Redisclosure Statement - ANS This notice should accompany disclosure, each disclosure made with the patient's written consent must be accompanied by the following written statement: This information has been disclosed to you form records protected by Federal confidentiality rules (42 CFS, part 2). The Federal rules prohibit you from making any further disclosure of this information unless further disclosure is expressly permitted by written consent of the person to whom it pertains or as otherwise permitted by 42 CFR part 2. A general authorization for the release of medical or other information is NOT sufficient for this purpose. The Federal rules restrict any use of the information to criminally investigate or prosecute any alcohol or drug abuse patient. Redisclosure Statement - 9 Exceptions: - ANS 1. In the course of internal program communications, 2. In a communication with a Qualified Service Organization (an outside organization that provides services to the program, such as dosage preparation or lab analysis), 3. In medical emergencies, 4. In response to a crime against program personnel or on program premises (or threats to commit such a crime), 5. For research activities, 6. For audit and evaluation activities, 7. To report suspected child abuse or neglect, 8. In circumstances involving certain minors or incompetent patients, and 9. In response to a valid court order. 3 TYPES OF RECOVERY CAPITAL - ANS 1st Type. Personal Recovery Capital: Divided into physical capital and human capital. Physical Capital: Concrete things we need to survive & accomplish goals, including: • Physical health • Financial assets • Insurance • Shelter • Food • Clothing • Transportation Human Capital: Intangible & within oneself, such as: • Values • Knowledge • Education • Vocational/Problem-solving skills • Self-esteem 2nd Type. Social Recovery Capital: Things pertaining to relationships that support recovery. • Social relationships that support recovery - Family - Friends - Others in recovery • Access to participate in relationships that are recovery-friendly - Fellowships - School/work - Community organizations 3rd Type. Community Recovery Capital: Involve the larger recovery community & can be tangible (treatment or mutual aid resources) or intangible (community attitudes). • Advocacy efforts • Treatment resources • Recovery role models • Mutual aid and other recovery support institutions and services • Culturally-specific pathways to recovery Cultural recovery (e.g., traditional Native American sweat lodges) • Both availability and accessibility are key. Assessment of Recovery Capital ARC - ANS This is a 50 question tool that groups recovery capital into 10 different domains: Substance Use & Sobriety, Global Health (Psychological), Global Health (Physical), Citizenship/Community Involvement, Social Support, Meaningful Activities, Housing & Safety, Risk-Taking, Coping and Life Functioning, Recovery Experience. Each domain consists of 5 statements that the person rates their agreement with. The scores are tallied for each domain and then for the entire assessment. The total possible score on each domain is 25 and the total possible score for the entire tool is 250. What is a Recovery Plan? - ANS A Recovery Plan is a viable tool used to navigate one's Recovery and measure progress --- - Created by and a possession of the Recoveree. - Allows the Recoveree to choose the goals and the means by which they will be accomplished. The Development of a Recovery Plan: - ANS • Clearly identifies goals, potential challenges, and action steps (or strategies) to attain them. • Provides a viable tool for navigating and measuring the progress or challenges of one's recovery. • Helps build confidence and increases motivation as one achieves the goals they set. • Uses The Assessment of Recovery Capital (ARC) 5 PRINCIPLES OF STRENGTHS-BASED RECOVERY PLANNING - ANS 1) Focus on strengths, not deficits 2) Community contains resources 3) Based on self-determination 4) Community outreach preferred 5) People learn, grow, & change The Basic Elements of a Recovery Plan: - ANS •Domains. Same Domains as Assessment of Recovery Capital (ARC). Individuals chose how many they want to complete. •Goals. S.M.A.R.T. Recovery Plan Goals Specific Measurable Action-Oriented Realistic Timely •Resources/strengths/skills. Make up RECOVERY CAPITAL. •Barriers/challenges. Things that get in the way of achieving a set goal. Aligns w/ areas where individuals need help building recovery capital -use of ARC •Action steps. The concrete strategies describing how exactly the person plans to use the resources/strengths/skills to overcome the barriers/challenges and achieve their goal •Goal date. Substance use occurs on what continuum? - ANS USE - MISUSE - ADDICTION Enabling Defined - ANS An instinctive response to a hidden, chronic problem, motivated by love, caring, and compassion ‒ usually unconscious and well intentioned. It's any idea, activity, feeling, attitude, or behavior protecting the individual from the consequences of his or her behavior 2 TYPES OF CONSEQUENCES - ANS 1. Natural Consequences: Things that would or could happen without family's intervention 2. Imposed Consequences . Things families can actively do to respond to behavior they want changed DISCOVERY / RE-DISCOVERY - ANS Discovery/Re-discovery refers to recalling good things about relationships w/ ppl w/ SUDs Co-Occurring Disorders Definition - ANS Individuals who have at least one mental disorder as well as an alcohol or drug use disorder. While these disorders may interact differently in any one person (e.g., an episode of depression may trigger a relapse into alcohol abuse, or cocaine use may exacerbate schizophrenic symptoms), at least one disorder of each type can be diagnosed independently of the other. PERSON-FIRST LANGUAGE - ANS • To have an illness is not to BE the illness. • PERSON-FIRST LANGUAGE. The basic idea is to use a sentence structure that names the person first and the condition second, for example "people with disabilities" rather than "disabled people" or "disabled", in order to show that "they are people first". WRAP - ANS • Wellness Toolbox: list of things that help clients stay well or feel better • Daily Maintenance Plan: self-description when well, daily tasks, things must do, but don't • Triggers: identify, avoid & cope, early signs, when it gets bad, action plan for each stage • Crisis Plan: supporters, medical teams, meds, treatment, help from others • Post-Crisis Planning: what learned, changes to WRAP Process addiction: - ANS Psychological dependence on behavioral activity/process. Ppl w/ process addictions have same traits/behaviors as drug addicts (including withdrawals). Types of Process Addictions - ANS • Gambling • Shopping • Eating • Internet • Exercise • Work (workaholic) • Sex 4 TYPES OF SELF-DISCLOSURE - ANS Type One. Deliberate: Intentional, verbal or non-verbal disclosure of personal information Type Two. Unavoidable: Gender, age, physical appearance Type Three. Accidental: Unplanned encounters outside of the office, spontaneous verbal or non-verbal reactions Type Four. Clients' Deliberate Actions: Client initiated inquiries into provider such as a Web search How to Self-Disclose Effectively and Appropriately - ANS 1st. Follow the principle of Non-maleficence- do no harm. 2nd. Be thoughtful w/ self-disclosure: why you're self-disclosing = main question. 3rd. Always ask yourself some key questions before self-disclosing. Defining Self-Care - ANS A. The care of oneself w/out medical, professional, or other assistance or oversight. B. Individual behavior when a person functions on his or her own behalf in health promotion and prevention or in disease detection and treatment. Burnout: - ANS a state of dissatisfaction with one's work characterized by the following: - excessive distancing from clients/members - lowered energy level - increased irritability with others - impairment, depression, isolation, as a direct result from individual, social, societal, and work environments Compassion Fatigue: - ANS a state of tension and preoccupation with the individual or cumulative trauma of clients, which manifests in some of the following ways: - difficulty separating work life from personal life - dread of working with certain clients The Coping Index - ANS can help participants begin to see where their self-care strengths are and areas for improvement and growth. In this way, it's almost like the Assessment of Recovery Capital in that it gives people a starting point to assess their ability to cope with stressors. It can help you identify what areas you are strong in and what areas you might need some work. Collaborative Documentation (CD) - ANS Promotes engagement, trust, involvement. Used intentionally to engage person in developing objectives/goals Culture of addiction - ANS Has drug-specific subcultures that identify w/ symbols, rituals, relationships & lifestyles that meet personal needs of the newcomer Recovery Support Matching - ANS Matching individuals to particular groups & people (i.e. CRS), based on needs/preferences/shared experiences, like sharing cultural background. The Full Continuum of the Recovery Process Includes: - ANS • Before Treatment, • During Treatment • Post treatment, • In lieu of treatment Tolerance - ANS Reduced drug effect with repeated use of the same dose of a drug, or need for an increased dose to maintain the same level of effect. Alcohol Withdrawal Symptoms - ANS • Seizures • Anxiety/depression • Tremors • Hallucinations, delirium • Heart attacks, strokes • Can be life-threatening Prescription Opioids Withdrawal Symptoms - ANS •Seizures •Nervous/Tense • Confusion/Depression • Fear, Paranoia • Anxiety, Panic • Changed Senses • Shaking • Pain, stiffness, muscle aches, spasms • Flu-like symptoms • Sleep difficulties Opiates Withdrawal Symptoms - ANS • Extremely uncomfortable/frightening • Persistent • Recurring symptoms over a longer period of time than other detox because excretion more gradual Cocaine or Crack Withdrawal Symptoms - ANS • Can be fatal • High incidence of stroke, seizure, respiratory failure, MI, convulsions, death, aggression, suicide, hallucinations Marijuana Withdrawal Symptoms - ANS • Withdrawal is not dangerous • Increased appetite • Mood fluctuations Methamphetamines Withdrawal Symptoms - ANS • Similar to that of cocaine and other stimulants • Anxiety, sleep issues • Depression Barbiturates Withdrawal Symptoms - ANS • Unpredictable, frightening, may be life-threatening ADVOCACY WITH ANONYMITY & Ways to talk about recovery without referring to AA or Mutual Aid Group: - ANS 1st Way: Say, "I'm an advocate so my kids won't suffer w/ addiction like I did." 2nd Way: Say, "I'm (your name) and I am in long-term recovery, which means that...I'm now speaking out so that others can have the same." 3rd Way: Say, "I found recovery through a twelve-step group." STIGMA definition: - ANS "a mark of disgrace associated with a particular circumstance, quality, or person." BEING AN ADVOCATE: UNDERSTANDING ANONYMITY AND ADVOCACY - ANS - Being an ADVOCATE does not violate the traditions of 12 Step fellowship - You can speak about your own recovery and advocate for the rights of others, as long as you do not involve the 12 Step group by name - There is a long and extensive tradition of people in recovery speaking out as advocates for the individual rights of others. example of how to personalize your message - ANS I'm (your name) and I am in long-term recovery, which means that I have not used alcohol or other drugs for more than (insert the number of years that you are in recovery) years. I am committed to recovery because it has given me and my family new purpose and hope for the future, while helping me gain stability in my life. I am now speaking out because long-term recovery has helped me change my life for the better, and I want to make it possible for others to do the same. PCB CODE OF ETHICAL CONDUCT RULES - ANS Rule 1.1: Can't be arrested for any level of offense that impacts ability to provide services or is unbecoming of a professional. Rule 2.1: No sex/romance w/ clients, whether it's consensual or forced, or in person or electronic. Rule 2.2: No sex/romance w/ clients' friends & family in person or electronically, when there's risk of exploitation or harm to client. Rule 2.3: No sex/romance w/ former clients in person or electronically b/c of harm. - If CRS engage in such conduct, they assume full burden of showing that former client hasn't been exploited, coerced, manipulated, intentionally or unintentionally. Rule 2.4: CRS can't provide services to those they were formerly romantically/sexually involved w/ in person or electronically. Rule 3.1: A Certified Professional CANNOT: 1) present, cause to present, or proof false/fraudulent claim to be paid under contract or insurance 2) Prepare or subscribe to a false document, knowing that it's used for insurance payment 3) Present, cause to be presented, or proof in support of false claims, benefit applications, or fraudulent information that would affect a claim under employee benefit programs 4) Pressure employees to commit fraud or assist in commission or omission to aid fraud o FRAUDULENT CLAIM. INCLUDES: Charging clients or third-party payers for services not performed, or submitting a false or misleading charge. DOESN'T INCLUDE: Charging for cancelled appointments when contracts allow for such charges. Rule 3.2: Can't use misrepresentation in procuring certification/recertification or help someone else do so. - MISREPRESENTATION includes: Misrepresenting professional qualifications, education, certification, accreditation, affiliations, employment experience, the plagiarism of application and recertification materials, or the falsification of references. Rule 3.