UW-Madison SOCWORK 453 - Exam 3 Review (5 pages)

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Exam 3 Review

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Exam 3 Review


A review session for exam 3

Lecture number:
Lecture Note
University of Wisconsin, Madison
Socwork 453 - Alcohol and Other Drug Abuse
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Soc Work 453 1st Edition Lecture 23 Outline of Last Lecture I Announcements II Recovery Follow Up III IClicker IV Harm reduction A pragmatic approach V Abstinence versus reduced drinking VI Opiate Overdose Prevention VII Needle exchange Infectious disease prevention VIII Housing First not contingent on sobriety Outline of Current Lecture II Review for Exam 3 Current Lecture Coping responses in families In the reading there is three different coping styles Tolerant coping which is acceptance of use Engaged which is attempting to changing the users behavior and Withdrawal coping which is family members who withdrawal from the user Meta models and models look at Mueser 2006 article Secondary substance use The psychiatric condition non substance related causes substance use disorders Reason for this would be self medication hypothesis There is hypothesis that relates to vulnerability people are more vulnerable to the effects of substance use Secondary psychopathology explain reasons why substance uses disorders cause psychiatric illnesses If you think about neurotransmitter effects most drugs and alcohol have depressant effects on the person Like alcohol is a depressant folks can experience depression from alcohol Common factors There is a common factor that leads to both psychiatric and substance use disorder Common factors we have talked about genetics trauma stress family environment etc It is not necessarily one causing the other but multiple shared risk factors or common causes All three explain essentially the relationship between substance use and psychiatric disorders Why is comorbidity so common Three major explanations for why health disparities exist Perceived stigma is related to social stigma It is the knowledge of the negative attitudes and the knowledge of potential discrimination The awareness that people with the same identity that you have yourself it can lead to stress or people wanting to conceal the stigmatized identity Internalized oppression When you start to believe bad things about yourself because of prior experiences with discrimination This typically results in depression shame and so forth Examples Structural stigma Health care providers making decisions that effect care Or policies that treat people with addiction differently People with marijuana offenses have reduced access to student loans Social stigma an awareness or witness of a discrimination of someone An awareness of negative activity directed toward the stigmatized group Individual stigma what is the result of you encountering social stigma and actual acts of discrimination Like feeling shame about yourself feeling guilty feelings of distress directed toward yourself because of experiences 4 processes of motivational interviewing Engaging Focusing Evoking Planning Engaging Having conversations with someone to establish trust and a common direction with a person Develop rapport Focusing identifying change talk focusing is trying to identify what the future conversations are going to talk about Focusing is trying to work with the person about what they want to work on and what is the most important to work on Establishing a focus for the conversation Evoking getting the person to talk about reasons that they want to change It can be arguments for how life would be better if they reduced their use Or negative effects substance use has had so far This is really building motivation Planning where you work with a person about goal and motivation You are eliciting from the individual that they feel they can accomplish this goal of reduced substance use Clinician working with a client with several problems client ready to change drug use but not drinking but not totally sure What process would you go with Focusing Tom and Adam experiences They expressed overtime their desire to drink went away This was after taking the medication No more pleasure effects from alcohol And generally reduces cravings and the desire to drink Reasons you wouldn t want to include partner significant others look near last paragraph of reading If there is an intimidating family environment violence resulting injury unfortunately mild acts of violence are common If there has been minor pushing this could be a goal of treatment But don t involve someone who is intimidating and violent It also talks about when is a good time to involve the family members If there is a big incident that may affect the family that may be a good time for whole family to go to treatment If threatening the integrity of the family important time to involve them When not involving family members if they are heavy users themselves should not involve all family members Want family if 1 absence of alcohol or drug problems in other family members 2 more severe alcohol or drug problem for identified client 3 some level of social relationship stability such as having a job and being in a committed relationship 4 coming to treatment after a crisis particularly one that has threatened the stability or integrity of the family Family shouldn t be involved if 1 significant domestic violence resulting in injury legal order that restrains the violent abuser from having contact with the victim and times when family is toxic so same therapy room inappropriate and those are 1 communicate in cruel and destructive ways that involving them would increase the user s negative experience 2 be unable to harness hostility enough to support the user s efforts at change 3 be largely unresponsive to the therapist s interventions to teach constructive communication skills 4 have significant alcohol and drug problems themselves that they do not want to change Difference between pretreatment factors and also during treatment factors Individual that is going to treatment as opposed to what happens during treatment Number 2 and Number 7 on the handout could also help answer this Also answer on the handout People were less likely to drop out if They had attended more religious services Had a stronger religious background Had prior 12 step involvement Had a stronger belief in the disease model Had more motivation Had more social involvement Were African American versus another racial or ethic group Considered themselves to be an addict Help families motivate the person bottom of page 6 Unilateral family therapies communication consequences of use and self care Teach families not to cover for person Mutual help programs that are in Madison Smart Recovery AA Narcotics Anonymous Al Anon

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