UW-Madison SOCWORK 453 - Final Exam Study Guide (21 pages)

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Final Exam Study Guide

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Final Exam Study Guide


A study guide going over all the points on the study guide given to us in class in detail.

Study Guide
University of Wisconsin, Madison
Socwork 453 - Alcohol and Other Drug Abuse
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Soc Work 453 Edition 1nd Exam 3 Study Guide Lectures 16 22 Lecture 16 Medical approaches Video This was a video about two case studies of men named Tom and Adam Disulfiram in treatment better if abstinent Acamprosate works on symptoms Naltrexone works if you are working to stay abstinent and you slip and have a drink Makes it easier to stop and prevent you for relapsing Topiramate a medication being tried now It reduces withdrawal symptoms from alcohol The nice thing about this drug is that you can take it while you still are drinking Tom and Adam both were described the off label drug Topiramate in order to reduce their withdrawal symptoms from alcohol They both described that in the first few weeks the drugs didn t work but then gradually it worked on reducing drinking The medicine was able to make both men feel comfortable about stopping drinking and they were able to take back control of their lives They both eventually stopped drinking completely Substance use disorders as chronic medical illness According to McLellan some arguments for drug addiction that make it a chronic medical condition are that It can be diagnosed There is a role of personal responsibility Genetic heritability Treatment response Drug dependence can be diagnosed through the DSM just like chronic illnesses Personal responsibility is about people who choose to go to treatment or not Substance use disorders are not too different from anything else For genetic heritability addiction risk can be up to 50 which is a very similar number to other chronic medical illnesses And then treatment response is about always having to recognize what the triggers for drinking or using are It is similar to other chronic illnesses because for chronic illnesses people have to do major lifestyle changes such as eating better exercising and keeping an eye on their disorder for the rest of their lives Addictive disorders as chronic medical illnesses Advantages Decreasing stigma More people may seek treatment Insurance more likely to reimburse people and pay medical providers for providing these services Can inform a research design if only acute we would only care how people are 6 months later Now we know we can investigate a new treatment we can look how people are looking 5 or 10 years later We should look at disorders across lifetimes Disadvantages Labeling Economic burden why should insurance pay for some of the treatment Attention focused to most severely affected Biologic aspects of addiction are emphasized o What about social psychological economic Label does not display optimism for change Increase health care premiums Calling substance dependence a chronic medical illness means looking at the top of the pyramid instead of taking into consideration all of the people who may be at the bottom of the pyramid as well 2nd Article said that if we consider the disorder on chronic medical condition than it means that we are only focusing on the most severely affected people and not on people who do not have as severe of an addiction It is mostly the word chronic that doesn t display optimism for change If we just labeled it medical illness maybe would be different But if you remove that chronic label it may take away message that you need to treat things over ones lifetime FDA approved medications for alcohol dependence Disulfiram Accumulates acetaldehyde Nausea flushing vomiting Begin after abstinence Acamprosate Reduce withdrawal symptoms including insomnia anxiety and other discomfort begin after abstinence Naltrexone Blocks receptors involved with craving decreases high from alcohol Better if started after abstinent Handout Notes Not Yet Covered There are many things that interfere with adherence to treatment and the outcomes of treatment chronic medical conditions These things include No time money or support Treatment stops at a certain point this can be hard for people There is much relapse potential There is no lifetime guidance A relapse or recurrence of symptoms of chronic medical conditions is often seen as a sign of a need for continued treatment In contrast relapse or recurrence of substance use disorder symptoms has traditionally been viewed as a sign of failed treatment Medications that require you to stop drinking before taking them are Disulfiram and Acamprosate You can still be drinking on Naltrexone and Topiramate Lecture 17 Motivational Approaches Motivational Interviewing involves attention to natural language about change with implications for how to have more effective conversations about it It is about having people talk themselves into change based on their own values and interests Motivational Interviewing lies between direction and following The helper is not trying to force the other person to change or fix that person People are ambivalent about changing which is the 1st step to change Change talk Person s own statements that favor change People learn their own attitudes and beliefs Motivational interviewing is a collaborative conversation style for strengthening a person s own motivation and commitment to change There are four interrelated elements in the spirit of motivational interviewing Partnership Acceptance Compassion and Evocation Partnership This is profound respect for the other person The purpose of this is to understand the life before you Acceptance This is acceptance of what the client brings It is giving inherent worth and potential to every human being Acceptance also has to do with a basic trust of the other person Acceptance has 4 key aspects to it Affirmation to seek and acknowledge the person s strengths and efforts Accurate Empathy an acute interest in and effort to understand the other person s internal perspective Autonomy honoring and respecting autonomy Absolute Worth The idea that every human being has worth and potential Compassion This is actively promoting the other s welfare and giving priority to the other s needs Evocation People already have within them much of what is needed to change The task of the helper is to evoke it out and call it forth The helper and the client need to find it together like ambivalence inside the person Change related speech An effective motivational interviewer will ask open ended questions and ask about feelings and thoughts Motivational interviewer should ask what ways does the client want to change need to change and should change Also have they been thinking about changing Have they tried to change and not been successful The

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