Term
| What is the percentage of the population that is believed to have a substance use disorder? |
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Definition
| estimated that about 30% will have a diagnosable Substance Use Disorder at some point in their life time. |
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Term
| What are the societal consequences for undiagnosed substance use disorders? |
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Definition
-approx. 6 million children come from homes where 1 or both parents have SUD
-54% of prison populations have had a SUD at some point in their lives
-89% of supported child abuse cases with children under 1 yr. involve families with substance abuse. |
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Term
| Do most of the counselors clients with SUD come in for help with their problem? |
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Definition
| NO, that is why counselors must be able to assess and diagnose a SUD. |
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Term
| How did earlier DSM versions characterize SUDs? |
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Definition
DSM I Alcoholism and Drug Addiction
DSM II gave subdivisions for different substances but did not differ between abuse and dependence.
DSM III & IV continue to specify disorders into different classes. Gradually improved to specified classes |
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Term
| How does DSM IV divide the Substance Related Disorders? |
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Definition
-divides Substance Related Disorders into 2 groups: SUDs and Substance Induced Disorders
-Counselors should be familiar with with the symptoms of the Substance induced disorders |
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Term
| How does the DSM IV describe Substance dependence? |
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Definition
-must present in three realms of functioning: cognitive, behavior and physiological.
-the symptoms are the result of continued use despite substance use problems
- must be a pattern of self-administration that leads to tolerance, withdrawal and compulsive drug taking.
-to be diagnosed must have three or more in a 12 month period
-craving is also usually present in most individuals who suffer from Substance Dependence |
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Term
| How many classes of substances are classified as possible areas of dependence in the DSM IV? |
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Definition
| 11 plus poly substance dependence for those clients who are not 'faithful' to one class of substance (must use at 3 to by poly substance) |
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Term
| What are the two specifiers for noting dependence in a diagnosis? |
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Definition
1) with physiological dependence (evidence of tolerance or withdrawal)
2)without physiological dependence (no evidence of tolerance or withdrawal)
**WITH Physiological may require medical intervention to stabilize during detox. |
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Term
| What specifies 'early full remission'? |
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Definition
| at least 1 month and no less than 12, no criteria for substance abuse or dependence have been met |
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Term
| What is 'early partial remission' |
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Definition
| early partial remission for at least 1 month and no less than 12 months one or more of the criteria for substance abuse or dependency have not been met. |
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Term
| What are the specifications for 'sustained full remission' |
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Definition
| infers that no criteria for substance abuse or dependency have been met during a time period of 12 months or more |
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Term
| What are the specifications for 'sustained partial remission'? |
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Definition
| means the full criteria for substance dependency has not been met, however one or more of the criteria for dependency has been met. |
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Term
| What is meant by 'agonist therapy' |
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Definition
| Is used when clients are on medication (methadone)and meet no criteria for dependency or abuse with that medication. Those who use antabuse also qualify for this (pg. 71 book) |
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Term
| What is specified by 'in a controlled environment' |
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Definition
| if the client has been incarcerated, or in-patient unit where in theory they are not exposed to drugs |
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Term
| What is meant by 'substance abuse' in the DSM and how does a client qualify for diagnosis? |
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Definition
-ABUSE precedes DEPENDENCE on the SUD continuum (but not necessary to have a diagnosis of ABUSE to get one of DEPENDENCE)
-maladaptive patern of substance use that causes impairment or distress in one of the major realms of functioning: social, legal, vocational or educational in last 12 months,
_DOES NOT INCLUDE TOLERANCE OR WITHDRAWAL
- |
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Term
| How does a counselor conceptualize or assess a client for a SUD? |
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Definition
(Fong) behavioral observation, intake interviewing and the ability to complete a mental health exam.
-must use more than one assessment instrument to make a diagnosis of SUD |
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Term
| What should a counselor remember when taking information from a client regarding diagnosis of a SUD? |
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Definition
| One is getting info from a distressed person, possibly under duress. So the info may not always be truthful or accurate. |
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Term
| What are some of the assessments instruments available for counselors to use? |
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Definition
CAGE (cut back, annoyed, guilt, eyeopener)
SCID (structured clinical interview for DSM)
ASI (addiction severity index) |
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Term
| From what is the CAGE derived? |
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Definition
| The Michigan Alcoholism Screening Test |
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Term
| What are some common lab tests that can enhance the accuracy of diagnosis with SUD? |
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Definition
-saliva, hair, blood or urine tests
-blood analysis can determine damage to various systems from substance use.
-results can be used on Axis III |
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Term
| What are some defense mechanisms that counselors should be aware of as they work with a client who may have substance use disorder? |
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Definition
| -denial. A person who abuses prescription pills may answer 'no' to a question like 'have you ever used drugs before'. Must handle language carefully. Should ask about 'medicine' they are taking too. |
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Term
| What can a counselor do if they suspect a client is not being truthful about use? |
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Definition
| Ask the client to describe someone else's use of the particular substance and watch for behavior changes. Always be aware of body language, levels of agitation, face flushing, loss of eye contact. |
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Term
| What is key information for a counselor to have regarding substance information? |
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Definition
| Information regarding the 11 types of abused substances, signs of physical or behavioral tolerance |
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Term
| What are key counseling skills and qualities that must be used during substance use disorder evaluations? |
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Definition
-ability to ask direct questions
-to be aware of counter transference
-aware of their own beliefs on the counseling relationship
-to self disclose and clarify appropriately |
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Term
| What are key areas of the client's life that a counselor will want to explore in an assessment? |
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Definition
-family history
-social and relationship history
-physical history |
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Term
| What is a helpful protective behavior a counselor can employ to cut down on frustration and burnout when working with clients who have been diagnosed with Substance Use Disorder? |
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Definition
-seek supervision to avoid burnout and increase level of job satisfaction
-also supervision helps with correct diagnosis and appropriate interventions |
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Term
| What is one of the most helpful things a counselor can do to help a client undergoing substance use disorder? |
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Definition
-help the client receive an early and accurate assessment.
-diagnosing at an earlier time helps give clients the best possible option for recovery
-symptoms of withdrawal and intoxication from a substance mimic other mental disorders; early diagnosis helps discern what is happening for client. |
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