Co-occurring Disorders: Understanding the Interplay of Mental Health and Substance Use, Lecture notes of History

Download Co-occurring Disorders: Understanding the Interplay of Mental Health and Substance Use and more Lecture notes History in PDF only on Docsity! Co-Occurring Disorders Multiple Choice Identify the choice that best completes the statement or answers the question. 1. Chapter 1: Introduction Early studies conducted in substance abuse programs typically reported that _____ percent of clients had some type of co-occurring mental disorder while studies in mental health settings reported that between _____ percent of their clients had a co-occurring substance use disorder. A. 20-45%; 10-30% C. 50-75%; 20-50% B. 35-60%; 15-45% D. 60-85%; 25-55% 2. In the research of co-occurring disorders, not only was a link between substance abuse and mental illness found, but also the impact that the complicating presence of substance abuse may have on the course of mental illness treatment was discovered. A. True B. False 3. The terms dual disorder and dual diagnosis may be confusing because although they are used commonly to refer to the combination of substance use and mental disorders, they can also refer to other combinations of disorders such as mental disorders and mental retardation. A. True B. False 4. Several important agencies have collaborated in a series of national efforts designed to do all of the following EXCEPT: A. Foster improvement in treatment by emphasizing knowledge of both mental health and substance abuse treatment when working with clients where each is relevant C. Reduce the stigma associated with both disorders and increase their acceptance as a standard part of healthcare information gathering B. Eliminate the classification of treatment settings and explore other options to promote and facilitate systematic planning and integration D. None of the above 5. Many people believe that individuals with mental illness are dangerous and pose a risk of violence, and studies have shown that the actual risk is even greater than the public’s fear. A. True B. False 6. Which of the following statements is true regarding individuals with co-occurring disorders (COD)? A. With new knowledge and treatment developments, individuals with substance use and mental disorders rarely appear at facilities that are not prepared to treat them C. Fortunately, COD are not common in the general adult population B. Compared to people with mental illness or substance use disorders alone, people with COD are less likely to be hospitalized D. Rates of mental disorders increase as the number of substance use disorders increases, further complicating treatment 7. With pharmacological advances and support from better medication regimens, many people who once would have been too unstable for substance abuse treatment, or institutionalized with a poor prognosis, have been able to lead more functional lives. A. True B. False 8. In December of 2002 the Department of Health and Human Services provided Congress with a comprehensive report on treatment and prevention of co-occurring substance abuse and mental disorders which included all of the following EXCEPT: A. The report emphasizes that people with co-occurring disorders usually will not recover even with appropriate treatment so support services need to always be in place C. The report identifies the need for various involved parties to work together to create a system in which both disorders are addressed as primary and treated as such B. It states there are many longstanding systemic barriers to appropriate treatment and support services for people with co-occurring disorders D. It outlines a 5-year blueprint for action to improve the opportunity for recovery by increasing the availability of quality prevention, diagnosis, and treatment for people with COD 9. Chapter 2: Definitions, Terms, and Classification Systems for Co-Occurring Disorders In describing co-occurring disorders, it is very important to use psychotherapeutic terminology as a way of acknowledging each client’s individuality. A. True B. False 10. Substance abuse-as defined by maladaptive pattern of substance use manifested by recurrent and significant adverse consequences related to the repeated use of substances-is more serious than substance dependence. A. True B. False 11. It is recommended that counselors working with antisocial personality disordered clients: A. Confront antisocial behavior and dishonesty gently as not to alienate the client C. Use peer communities to confront behavior and foster change B. Hold clients responsible for the behavior and its consequences D. Both B and C above 12. Cluster A Personality Disorders include which of the following: A. Avoidant, dependent, and obsessive-compulsive personality disorders C. Paranoid, schizoid, and schizotypal personality disorders B. Antisocial, borderline, histrionic, and narcissistic personality disorders D. None of the above 13. In addiction treatment populations, the most common anxiety syndrome seen is social phobia. A. True B. False 14. Integrated interventions are specific treatment strategies or therapeutic techniques in which interventions for co-occurring disorders are used. These include: A. Integrated screening and assessment processes C. Individual recovery groups in which recovery skills for each disorder are discussed separately B. Individual recovery mutual self-help meetings D. All of the above 15. In most mental health systems, services are provided for a wide range of mental disorders, but in many publicly financed mental health programs, the priority is on acute crisis intervention and stabilization and on the provision of ongoing treatment and rehabilitative services. A. True B. False B. Diagnosis is established more by current symptom presentation than by history D. None of the above 32. In working with COD clients, for each disorder or problem, interventions have to be matched not only to specific diagnosis, but also to stage of change, and the interventions should be consistent with the stage of treatment for each disorder. A. True B. False 33. The Substance Abuse Treatment Scale (SATS) is a case-manager scale with eight items identified by the degree of the clients engagement in treatment. These items include: A. Change and motivational enhancement C. Both A and B above B. Remission and relapse prevention D. None of the above 34. In the process of matching individual clients to available treatment, the variables that need to be considered are acute safety needs, strengths and skills, level of care, and ___________ A. History of mental illness C. Medication management B. Motivational enhancements D. Diagnosis 35. Chapter 5: Strategies for Working With Clients With Co-Occurring Disorders In a study of clients with opioid dependence and psychopathology, fewer than _____ percent of those with weak therapeutic alliances completed treatment, while more than _____ percent of those with strong therapeutic alliances completed treatment. A. 15%; 65% C. 25%; 75% B. 20% ; 70% D. 30%; 80% 36. Achieving a therapeutic alliance with clients with serious mental illness and substance use disorders can be challenging as many people who abuse substances also may have some antisocial traits. A. True B. False 37. In maintaining a recovery perspective, it is important for a clinician to remember: A. It is generally recognized that recovery refers solely to a change in substance use C. Much of the recovery process is therapist-driven and occurs typically within the professional environment B. Markers such as improved health and better ability to care for oneself and others are indicators of progress in the recovery process D. None of the above 38. Which of the following is an important consideration in dealing with countertransference with patients with COD? A. The clinician should be aware of strong personal reactions and biases toward the client C. The clinician should obtain further supervision when countertransference may be interfering with counseling B. Clinicians should have formal and periodical supervision to discuss countertransference and the opportunity to discuss these issues at clinical meetings D. All of the above 39. Persons with mental disorders are at _______ greater risk for suicide than the general population, and of the adults who commit suicide, _______ have a mental disorder. A. 10 times; 90 percent C. 12 times; 80 percent B. 5 times; 85 percent D. 15 times; 75 percent 40. It is very important that clinicians encourage clients with COD to have an optimal amount of free time in order to minimize treatment burnout., especially during the weekend after an intense week of treatment. A. True B. False 41. The various stages of change for clients with COD include the contemplation stage, the preparation stage, the action stage, and: A. the consolidation phase C. the effective phase B. the commitment phase D. the maintenance phase 42. Motivational interviewing strategies have been applied successfully to the treatment of clients with COD in all of the following areas except: A. Assessing the client’s perception of the problem C. Expanding the clients assumption of responsibility for change B. Examining the client’s desire for continued treatment D. Exploring the client’s understanding of the therapeutic process 43. Cognitive Behavioral Therapy is a therapeutic approach that seeks to modify negative of self-defeating thoughts or behaviors and teaches clients to cope by thinking and acting differently. A. True B. False 44. Various approaches to relapse prevention have many common elements and they generally focus on the need for clients to do all of the following EXCEPT: A. Have a broad repertoire of cognitive and behavioral coping strategies to handle high risk situations and relapse warning signs C. Limit access to self help groups in order to learn coping mechanisms that can be used when others are not available B. Make lifestyle changes that decrease the need for alcohol, drugs, or tobacco D. Increase healthy activities in everyday life 45. Which of the following is important to keep in mind in dealing with cognitive limitations that clients with COD often have: A. Role-playing real-life situations is a useful technique when working with clients with cognitive limitations C. Therapists should have lengthier discussions with these clients to ensure that clients understand concepts B. Clinicians should be less concrete and more abstract in communicating ideas D. Symptoms almost always persist for long periods 46. Dual recovery mutual self-help approaches are becoming increasingly common in most large communities to assist COD clients. A. True B. False 47. Chapter 6: Traditional Settings and Models Any substance abuse treatment program that serves a significant number of clients with COD should: A. Expand standard staffing to include mental health specialists and to incorporate consultation into treatment services C. Have a psychiatrist on staff or establish a collaborative relationship with a mental health agency to provide those critical services B. Add a master’s level clinical supervisor with strong diagnostic skills and expertise in working with clients with COD D. All of the above 48. Although psychoeducational classes on mental illness and substance use disorders are important in some clinical settings, they are not recommended in most COD programs because they take valuable time away from other more important treatment strategies. A. True B. False 49. Generally, it is best to increase the emotional intensity of interpersonal interaction in COD group sessions in order to help the clients gain skills that will help them function in non-treatment settings. A. True B. False 50. Which of the following is an accurate statement about the background and effectiveness of outpatient substance abuse treatment programs for COD clients: A. Typically, treatment includes group counseling and referrals to appropriate community services only C. Treatment for substance abuse occurs most frequently in outpatient settings B. Deinstitutionalization and other factors are decreasing the prevalence of persons with COD in outpatient programs D. None of the above 51. Evidence shows that substance abuse treatment outpatient programs can help clients, many with COD, who remain in treatment for at least: A. Three months C. Nine months B. Six months D. One year 52. Clients with COD leaving an outpatient substance abuse treatment program have a number of continuing care options including: A. Mutual self-help and relapse prevention groups C. Both A and B above B. Continued individual counseling and mental health services D. None of the above 53. Funding resources for substance abuse treatment remain significantly lower per client than those available for mental health services. A. True B. False 54. Which of the following is NOT an example of an Assertive Community Treatment (ACT) intervention: A. Outreach/engagement C. Crisis intervention B. Practical assistance in life management D. Open monitoring 55. Intensive Case Management (ICM) is a precisely defined term that is used to describe an alternative to both traditional case management and ACT. A. True B. False 56. Historically, residential substance abuse treatment facilities have provided treatment to clients with more serious and active substance use disorders but with less serious mental illness. A. True B. False 57. Once accepted into a residential program, the client goes through an assessment process that should include substance abuse evaluation, mental health evaluation, health and medical evaluation, client status, and: A. Motivation level C. Decision making ability B. Entitlements D. Functional level 77. Much of substance abuse treatment is particularly targeted to those with Antisocial Personality Disorders, but substance abuse treatment alone has not been particularly effective for these disorders. A. True B. False 78. About ____ percent of individuals with a substance use disorder have an affective or anxiety disorder at some time in their lives. A. 30 % C. 50 % B. 40 % D. 60 % 79. In treating a Substance Abuse client with Bipolar Disorder, it is very important that the counselor take a detailed history, attempt to establish the linkage between co-occurring disorders, and appreciate the client’s understanding of the relationship between the two. A. True B. False 80. Counselors working with schizophrenic COD clients should be aware of the following: A. There is a clear pattern of drug choice among clients with schizophrenia which may make treatment more manageable C. For clients with co-occurring disorders involving psychosis, a short-term approach is imperative to keep the client engaged B. What looks like resistance or denial may in reality be a manifestation of negative symptoms of schizophrenia D. None of the above 81. Approximately ____ percent of adults with Attention Deficit/ Hyperactivity Disorders have histories of alcohol abuse or dependence, and approximately _____ percent have other drug abuse or dependence histories. A. 25%; 15% C. 33% ; 20% B. 29%; 18% D. 36%; 23% 82. Most women with Post Traumatic Stress Disorder and a substance abuse problem experienced childhood physical and/or sexual abuse while men with both disorders typically experienced crime victimization or war trauma. A. True B. False 83. Which of the following is NOT an accurate statement about substance abuse and eating disorders? A. Substance abuse is more common in anorexia nervosa than in bulimia nervosa C. Several studies have suggested that the presence of co-occurring substance-related disorders does not affect treatment outcome adversely for bulimia nervosa B. Many individuals alternate between substance abuse and eating disorders D. Studies in inpatient substance abuse treatment centers suggest that approximately 15 percent of women and 1 percent of men had an eating disorder in their lifetime 84. Chapter 9: Substance-Induced Disorders Substance-induced disorders are distinct from independent co-occurring mental disorders in that all or most of the psychiatric symptoms are the direct result of substance use. A. True B. False 85. Diagnoses of substance-induced mental disorders will typically be provisional and will require reevaluation. A. True B. False 86. Which of the following is included in the criteria for diagnosis of substance-induced mood disorders: A. The disturbance is better explained by a C. The symptoms cause clinically significant mood disorder distress or impairment B. A prominent and persistent disturbance in mood predominates, characterized by a depressed mood or an elevated or irritable mood D. Both B and C above