Term
| What are some (5) of the general challenges that individuals with coexisting conditions may experience? |
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Definition
1. type and severity of substances used and psychiatric disorder
2. ego strength
3. overall psychological functioning (cognitive functioning, coping skills, strengths and resiliency)
4. motivation to change
5. availability of social and family support |
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Term
| What are the (3) subgroups combinations of coexisting conditions amongst people with dual or coexisting disorders? |
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Definition
1. those with a primary mental illness whose chemical dependency causes problems serious enough to warrant treatment
2. those with primary chemical dependency who experience psychiatric disorders or symptoms which can interfere with the recovery
3. those whose histories are so complex that it is difficult to determine which diagnosis is the primary one |
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Term
| How are disorders shaped or developed? |
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Definition
1. evolved over time and across developmental milestones
2. genetically and biologically
3. environmental exposures and stressors
4. nature vs. nurture |
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Term
| What are the (8) patterns of relationship between disorders mentioned in the text? |
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Definition
1. chemical dependency increases risk of developing psychiatric illness
2. psychiatric illness increases risk of developing chemical dependence
3. psychiatric symptoms may affect the onset, duration or response to treatment of chemical dependency
4. chemical dependency affects adherence to psychiatric treatment and clinical outcomes
5. psychiatric symptoms may arise as a direct result of chronic substance abuse or withdrawal
6. symptoms of psychiatric illness may result as the indirect consequence of chemical dependency
7. over time, symptoms of chemical dependency and psychiatric illness may become linked or interrelated
8. the dual disorders can develop independently at different times |
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Term
| What are the primary challenges related to client experience? |
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Definition
1. higher rates of disability, dsm diagnosis, days in hospital, er visits, use of substances and psychiatric services
2. higher rates of unstable housing, homelessness, medical problems, hiv infections, sti's, violence, legal problems, incarceration, social problems including family burdens
3. poorer treatment response, lower rates of adherence to treatment, higher relapse and re-hospitalization
4. higher depression and suicide |
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Term
| What are the primary challenges related to family? |
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Definition
| adverse impact on the family system as well as individual members, including children |
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Term
| What are the primary challenges related to counselor? |
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Definition
1. recognize psych and chemical disorders in time to offer full range of treatment options
2. carry out functions including assessment, treatment, referral and advocacy
3. awareness of resources in community
4. familiar with voluntary and involuntary hospitalization
5. familiar with intervention strategies
6. familiar with own limitations
7. establish goals that are realistic and achievable
8. familiar with attitudes and perceptions
9. careful to not over or under diagnose |
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Term
| What are the recommendations for Substance Abuse Counselors when working with co-occurring conditions? |
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Definition
1. be aware of your own limitations
2. do not provide treatment if you lack knowledge or experience
3. be aware of your attitudes and perceptions
4. reexamine attitudes regarding use of medications
5. evaluate belief and attitudes regarding value of self-help programs
6. do not over or under diagnose |
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Term
| What are the professional enabling behaviors and attitudes? |
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Definition
1. failure to gather accurate or detailed history
2. failure to address chemical dependency or psychiatric illness in treatment plan
3. waiting for client to hit bottom or ask for treatment
4. assuming client must acknowledge psychiatric illness in order to benefit from treatment
5. oversimplified advice
6. assuming major or multiple problems must exist before client can be considered chemically dependent or psychiatrically ill
7. viewing chemical dependency as simply symptomatic of a psychiatric illness
8. excluding family members from assessment or treatment
9. assuming recovery is in motion simply because client stopped using
10. assuming that each of dual disorder require treatment by separate clinicians or programs
11. taking a rigid stance against use of medications |
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