Addiction Counseling: Questions & Correct Answers
Who invented the trans-theoretical change model? Right Ans - Prochaska
and DiClemente
What can the trans-theorretical change model treat? Right Ans - ED (eating
disorder)
SUD
weight management
medication adherence
Is the change model linear? Right Ans - No, it is not linear, a person can
jump from stage to stage
Stages of the trans-theorretical change model Right Ans - pre-
contemplation
contemplation
preparation
action
maintenance
termination
Pre-contemplation stage Right Ans - person does not see the problem
not open to feedback
get upset with feedback
defensive
Contemplation stage Right Ans - ask that they have a problem with
Substance abuse
not sure if they need to make a change
ambivalent
struggling with opposing values
Preparation stage Right Ans - made decision to change substance use
need help to make concrete plans to change
explore treatment options
Action stage Right Ans - actively involved in treatment plan
change lifestyle
,change social settings to decrease substance use
decrease substance use
maintenance stage Right Ans - continue to maintain behavior change
explore relapse prevention
contiue with treatment plan
AA groups, counselling, groups
termination stage Right Ans - problem behaviour resolved
may need decrease treatment contact
some may require on going monitoring
some may not require any treatment
what stage is this patient in? "I will cut down on my drinking to two glasses of
wine at night because I know it may be making my mood worse" Right Ans
- contemplation
what stage is this patient in? " i use coke for my refractory depression. it is the
only thing that improves my mood" Right Ans - pre-contemplation
what stage is this patient in? "I have been clean from heroin and alcohol for
about nine years and do not need any treatments. I am now fine." Right Ans
- termination
concurrent disorder Right Ans - presentation of psychiatric illness and
substance use disorder
what are neg impacts for clients with concurrent disorders Right Ans -
poverty
homelessness
victimization
crime
mental prblm
what are negative outcomes for clients with concurrent disorders? Right
Ans - violence
homicide
suicide
non-med compliance
,increased hos
drop out of treatment
eps/nms/td
how many bipolar clients abuse alcohol? Right Ans - 43-70%
self medication hypothesis Right Ans - people have an + risk and use
substance to control symptoms
ex. smoke weed to decrease voices associated with schizophrenia
super-sensitivity model Right Ans - pts who have psych illness are more
sensitive to drugs and their effects increase
iatrogenic model of concurrent disorders Right Ans - something induced by
a physician or the treatment. The model states that the treatment causes the
person to use drugs
secondary models with concurrent disorders Right Ans - the mental illness
comes first than the drugs come second
kenneth minkoff beliefs Right Ans - co-morbidity is an expectation not an
exception
treatment requires welcoming, empathic approach
provide ***long term continuous treatment***
provide case management
both disorders should be seen as primary *biological disorders*
*treat both disorders at the SAME TIME*
what kind of treatment stages do you want to provide with concurrent
disorders? Right Ans - stage wise treatment (contemplation, pre
contemplation and pre interactions etc..)
what kinds of treatment should be used with concurrent disorders Right
Ans - motivational counselling
CBT
long term case mangement
12 step
proper pharmacological treatment
community treatment ex. act
, fam education and counselling
volunteer work
integrated treatment
Mental illness and concurrent disorders often have what? Right Ans - poor
response to treatment
increased TD risk
Increased akathisia risk
increased postural hypotension
1st gen antipsychotics increase use
clozapine - substance use in CD clients
Olanzapine decreases drug urges and alcohol and cocaine use
what med should be avoided with CD Right Ans - benzo's due to abuse
potential
**monitor use closely**
why are 2nd gen antipsychotics the first choice to treat CD? Right Ans -
because 1st gen has TD, NMS and EPS
what MI has the highest risk of abuse potential? Right Ans - bipolar
what in bipolar may increase abuse potential Right Ans - mania
what increases mania Right Ans - substances
substance abuse decreases effectiveness of _____ and mood stabilizers Right
Ans - lithium
lithium is shown to ___ drug cravings and urges in studies Right Ans -
decrease
are antidepressants safe to use with substance use and depression? Right
Ans - yes, if there is a balance
what antidepressant is safer to use with substance abuse? Right Ans - SSRI
what antidepressant should you avoid with susbstance abuse? Right Ans -
TCA and MAOI ***(contraindicated with beer and wine due to thyamine)***
Who invented the trans-theoretical change model? Right Ans - Prochaska
and DiClemente
What can the trans-theorretical change model treat? Right Ans - ED (eating
disorder)
SUD
weight management
medication adherence
Is the change model linear? Right Ans - No, it is not linear, a person can
jump from stage to stage
Stages of the trans-theorretical change model Right Ans - pre-
contemplation
contemplation
preparation
action
maintenance
termination
Pre-contemplation stage Right Ans - person does not see the problem
not open to feedback
get upset with feedback
defensive
Contemplation stage Right Ans - ask that they have a problem with
Substance abuse
not sure if they need to make a change
ambivalent
struggling with opposing values
Preparation stage Right Ans - made decision to change substance use
need help to make concrete plans to change
explore treatment options
Action stage Right Ans - actively involved in treatment plan
change lifestyle
,change social settings to decrease substance use
decrease substance use
maintenance stage Right Ans - continue to maintain behavior change
explore relapse prevention
contiue with treatment plan
AA groups, counselling, groups
termination stage Right Ans - problem behaviour resolved
may need decrease treatment contact
some may require on going monitoring
some may not require any treatment
what stage is this patient in? "I will cut down on my drinking to two glasses of
wine at night because I know it may be making my mood worse" Right Ans
- contemplation
what stage is this patient in? " i use coke for my refractory depression. it is the
only thing that improves my mood" Right Ans - pre-contemplation
what stage is this patient in? "I have been clean from heroin and alcohol for
about nine years and do not need any treatments. I am now fine." Right Ans
- termination
concurrent disorder Right Ans - presentation of psychiatric illness and
substance use disorder
what are neg impacts for clients with concurrent disorders Right Ans -
poverty
homelessness
victimization
crime
mental prblm
what are negative outcomes for clients with concurrent disorders? Right
Ans - violence
homicide
suicide
non-med compliance
,increased hos
drop out of treatment
eps/nms/td
how many bipolar clients abuse alcohol? Right Ans - 43-70%
self medication hypothesis Right Ans - people have an + risk and use
substance to control symptoms
ex. smoke weed to decrease voices associated with schizophrenia
super-sensitivity model Right Ans - pts who have psych illness are more
sensitive to drugs and their effects increase
iatrogenic model of concurrent disorders Right Ans - something induced by
a physician or the treatment. The model states that the treatment causes the
person to use drugs
secondary models with concurrent disorders Right Ans - the mental illness
comes first than the drugs come second
kenneth minkoff beliefs Right Ans - co-morbidity is an expectation not an
exception
treatment requires welcoming, empathic approach
provide ***long term continuous treatment***
provide case management
both disorders should be seen as primary *biological disorders*
*treat both disorders at the SAME TIME*
what kind of treatment stages do you want to provide with concurrent
disorders? Right Ans - stage wise treatment (contemplation, pre
contemplation and pre interactions etc..)
what kinds of treatment should be used with concurrent disorders Right
Ans - motivational counselling
CBT
long term case mangement
12 step
proper pharmacological treatment
community treatment ex. act
, fam education and counselling
volunteer work
integrated treatment
Mental illness and concurrent disorders often have what? Right Ans - poor
response to treatment
increased TD risk
Increased akathisia risk
increased postural hypotension
1st gen antipsychotics increase use
clozapine - substance use in CD clients
Olanzapine decreases drug urges and alcohol and cocaine use
what med should be avoided with CD Right Ans - benzo's due to abuse
potential
**monitor use closely**
why are 2nd gen antipsychotics the first choice to treat CD? Right Ans -
because 1st gen has TD, NMS and EPS
what MI has the highest risk of abuse potential? Right Ans - bipolar
what in bipolar may increase abuse potential Right Ans - mania
what increases mania Right Ans - substances
substance abuse decreases effectiveness of _____ and mood stabilizers Right
Ans - lithium
lithium is shown to ___ drug cravings and urges in studies Right Ans -
decrease
are antidepressants safe to use with substance use and depression? Right
Ans - yes, if there is a balance
what antidepressant is safer to use with substance abuse? Right Ans - SSRI
what antidepressant should you avoid with susbstance abuse? Right Ans -
TCA and MAOI ***(contraindicated with beer and wine due to thyamine)***
