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FOU-28 The Moment of Change: Intervention Approaches for Professionals - CAADAC licensees choose this
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Apply clinical skills from a broad range of professional core functions including alternative approaches to interventions, different therapy approaches and the mechanics of intervening

Cite advances in the field of addiction and intervention from practice innovations

Differentiate among key philosophies of intervention and integrate methods into practice

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Having completed the activity, please rate your ability to meet each of the following objectives:
Discuss the historic importance of intervention on the former First Lady
Explain how Mrs. Ford translated the success of this intervention, treatment and early recovery into the Betty Ford Center
Define treatment that is family/children focused
Summarize current demographics and cultural aspects of the crystal methamphetamine epidemic of importance to the interventionist
Discuss the neuropathology and concurrent medical conditions of importance to interventionists
Summarize current treatment modalities and explain the most effective uses of intervention
List barriers for women seeking treatment
Explain cultural differences between the treatment of men and women when seeking substance abuse treatment
Discuss ways society can stop stigmas in chemical dependency and co-occurring issues regarding women
List three culturally relevant techniques that will assist in the intervention process
Identify five types of clients that will require a culturally specific intervention
Explain the rationale and justification for identifying and managing your own cultural bias, and prejudices
Identify important concerns for codependent addicts in aftercare and the need for formal or informal monitoring, particularly for those who are in helping professions
Describe how psycho-social history may increase one’s initial vulnerability to substances, activities, or processes with addictive potential, complicate sobriety, and contribute to the risk of relapse
Discuss the transgenerational nature of addiction/codependence
Describe the components of a systemic family intervention and long-range benefits for the individual and family
Identify the benefits experienced by the treatment center staff working with patients coming from a respectful invitational "family focused process" versus high-risk confrontational "addict-focused event"
Describe the stages of adddict and codependent resistance

Identify various definitions and factors related to the concept of illness denial

Describe the adaptive and maladaptive consequences of denial of serious illnesses

Review strategies to assess and manage denial

Identify the five Stages of Change
Identify at least one clinically appropriate response to each of the Stages of Change
List three examples of LGBT people being present in history
Name four key categories of APA guidelines for Psychotherapy for LGBT Clients
Explain three areas that interventionists and other mental health providers must be aware of when dealing with LGBT clients
List major components of transference and countertransference
Summarize how transference and countertransference effect developing accurate empathy and holding unconditional positive regard
Discuss how objectives 1 and 2 either positively or negatively effect the intervention process
Explain the relationship of the autonomic nervous system and it's role in PTSD and addiction
Identify the different constituents of the HPA axis
Discuss effective ways to alter the autonomic nervous system response with patients including but not limited to reflex-biofeedback

Compare the terms "medical detox" and "medical treatment of addiction"

Identify indications for a variety of specific medications used for medical detox and substance abuse and addiction treatment

Explain the complex relationship between the physical, mental, social, spiritual, and emotional aspects of addiction

Describe the role specific medications and medication management can play in supporting clients’ efforts to acquire and maintain sobriety while engaged in all forms of recovery treatment

Explain the benefits and challenges of specific medications and best practices for including medications in conjunction with other treatments and programs

Cite controversial issues in medical management of substance abuse and addiction

Compare a variety of therapies that create new and synergistic healing for trauma survivors and addicts
Cite signs and symptoms that help identify trauma survivors with addiction or other compulsive behaviors
Explain how experiential therapy provides a framework for catharsis, or release, of stored visceral memory, often trauma memory
Identify symptoms of eating disorders in a chemically dependent population
Discuss current clinical research related to women with a co-occurring diagnosis of and Eating Disorder and Chemical Dependence/Abuse
Discuss the similarities and differences in the treatment of Eating Disorders and Chemical Dependence/Abuse
Discuss the demographics of trauma across the life span
Analyze the changes in brain structure and physical health as a result of trauma
Summarize the effects of sexual trauma in military service for women
Summarize the history of the Credentialing Board
Contrast the different levels of registration and their requirements
Describe the application process and fee schedule
List the symptoms and diagnoses for which EEG Biofeedback is empirically validated to be useful and effective
Discriminate between Peripheral Biofeedback and EEG Biofeedback
List the three different protocols utilized in EEG Biofeedback and the general purposes of each
Explain the difference between Acute and Chronic Pain
Summarize Opiate Induced Hyperalgesia
Discuss case studies illustrating management options without opiates
Differentiate between cognitive/didactic intervention techniques and experiential/psychodramatic techniques
Explain the benefit of a holistic and inclusive approach to the family system
List a number of resources and organizations available to practitioners to assist them in their work
Define “holistic” as it applies to alternative therapies used in the treatment of addictions
Identify areas of strength and dysfunction within the chakra system
Discuss case studies of a former patient
Summarize the “global approach” to assessing clients needs
Discuss the importance of aftercare strategies for both client and family following the intervention
Describe the benefits of combining ‘alternative’ and traditional treatment modalities in the intervention process
Describe the current intervention culture and whats necessary to build core competencies
List the assessment concepts necessary to build a responsible intervention case
Outline the core elements of the Field Model of Intervention
Describe the distortions and fears that hold family systems trapped in repetitive cycles of crisis and delayed individuation
List the most common causes of young adult failure to thrive syndrome
Discuss interventions that parents of a struggling teen or stuck young adult can practice alternative ways of participating with their child that reinforce the hostile dependency which underlies most of these family system constellations

Explain the seven stages of preparing for and mastering the ability to make changes without using

Identify tools for using client's history as clues for what in the past has provided addiction free passion

Practice discussing with a client a vision for a life where a passionate purpose has replaced their addictions

Identify the challenges of dual diagnosis, eating disorders,chemical dependency and trauma
Discuss the issue of what to treat first and priorities in dual diagnosis
Identify family dynamic with dual diagnoisis patients and possible solutions and treatment
Explain the difference between emotional process and problem solving and how to shift between them
Utilize tools to move clients away from simple insight to truly experiencing their essence and attachment needs
Discuss the paralyzing force of shame and fear and the positive power of validation and affirmation
Explain how verifying benefits helps to deliver insurance benefit information to family members prior to the Intervention process to support their financial responsibilities associated with treatment
Define Mental Parity
Differentiate between Residential benefits vs. Rehab benefits and the authorization process for in-network benefits vs. out of-network benefits
Identify the ideology of sexual disorders
Explain criteria for sexual addiction
Explain the cycle of addiction as it relates to sexual disorders
Discuss the use of cranial electro-therapy (stimulation CES) in a residential treatment center
Describe neurotransmitter testing and targeted amino acid therapy in a chemical dependency treatment program
Explain how to iintegrate SPECT imaging into a diagnostic phase of a chemical dependency treatment program
Discuss the propensity for addiction within multiple generations
Describe how the bio-, psycho- and social elements can be identified in the addict or alcoholic
Explain how success can occur even after multiple relapses
Discuss the high level of professional and social pressure under which lawyers operate
Describe how legal training changes fundamentally how a person addresses problems which might have bearing on the professional life
Cite intervention techniques that have been shown to be optimally responsive to lawyers' needs
State the key components in gathering full personal history from an adolescent
Summarize the legal rights when treating an adolescent
Discuss the value of the steps of Intervention, Family Treatment and Intervention
Assess whether an intervention is appropriate for a particular client
Explain the different legal risks of the intervention process and evaluate options to mitigate those risks
Compare the relative merits of a soft intervention versus a highly orchestrated intervention
Identify evidence from neuroscience that demonstrates the relationship between trauma and addiction
Explain why trauma is both physically and emotionally immobilizing
List self-healing strategies for trauma victims
List the individual needs of a client and their families within the context of the gender role of the individual
Plan strategies that utilize the client's gender strengths and tendencies to improving outcomes
Discuss socialization within the genders that effect addiciton patterns and recovery needs
Identify the family systems at work and how they affect the process negatively and positively
Compare the perspective of "Identified Patient" to "Complex Family System"
Describe how the complex family system can  evolve through shared intention
Summarize how we arrived at our present day system of categorizing drugs according to the DEA schedules
Explain how a commercial reagent based drug screen test works
Explain how a confirmation of drug screening by mass spectrometry test works
Describe the role of family in addiction and the importance of involving family and natural support system in order to achieve long-term positive outcomes
Compare treatment engagement outcomes and one year post ARISE Intervention treatment outcomes
Summarize the philosophy and principles of the ARISE Method as a continuum of care that focuses on long-term, individual and intergenerational family healing using Family Motivation to Change and the Recovery Message
Describe signs and symptoms of sex, love and relationship addiction and when these issues need to be considered in the intervention process
Discuss sex, love and relationship addiction and ways to help families deal with the stigma and feelings that are often present when addressing these issues
List considerations when finding appropriate placement for clients when sex, love and relationship issues are present, whether primary or secondary
Identify the particular needs of the affluent and visible client related to intervention and treatment
List the factors that must be addressed that are different with the affluent client
Describe the intervention process and how it is different for getting a client into and engaged in the treatment process
Describe the stages of change, listing the role of the clinician relative to each stage
List three techniques which can be used to facilitate change and motivate participation in treatment
Compare pre-treatment states with early recovery
Discuss different models of intervention style
Describe the oordination of treatment- from admission, to progress while in treatment, and from discharge to aftercare
Complare different methodolgies for treatment provider coordination
Post Test Questions
The Proportion of Native Americans admitted to inpatient chemical dependency treatment is greater for methamphetamine than for any other substances with the exception of Alcohol and Inhalents.
100% of Methamphetamine induced psychotic states will completely resolve in 2 weeks if the patient is given treatment and maintains abstinence.
There are currently no medications, for treatment of methamphetamine addiction, that clearly meet the FDA standards of efficacy and safety.
When should you explore whether cultural differences might impact the intervention process?
What are some of the differences that might be considered, if we were to expand our concept of cultural diversity?
What are some common cultural mistakes interventionists often make?
What is one reason or example of why women commonly use drugs?
What is one kind of internal barrier that typically prevents women from entering treatment?
What is the number one reason women do not seek treatment for their drug or alcohol addiction?
Codependence is an issue in all addictions.
Stopping drinking is all it takes to interrupt the transgenerational cycle nature and dynamics of codependency and addiction.
Sobriety is about abstinence whereas recovery is about dealing with the lack of connection (relationship) with self.
Despite resistance to change, the family system will make adaptations to maintain balance.
The family role that believes through sheer will power, control and balance will be achieved is called:
In order for recovery to be effective, the person must do all of the following EXCEPT:
Co-dependent chemical dependency counselors tend to be defined by their patients/clients
Motivational interviewing is a fairly common form of arguing with ones' patients/clients.

The Contemplation Stage of Change involves considering options.

 

What are the stimulus loci in acute and long term fight and flight response?
What is the target organ in the F and F response?
What are the two ways the stimulus loci communicates with the target organ?
Often overlooked in relapse prevention planning, which individuals are most critical to include in planning for the handling of a surgical or acute pain event:
The discomfort experienced during non-medically assisted detox acts as a relapse deterrent and improves abstinence outcomes.
Following completion of a traditional substance abuse treatment course such as residential or IOP, which of the following candidates would be least appropriate for Suboxone maintenance, but a better candidate for Vivitrol treatment?
Understanding LGBT history is important to the identity development of an LGBT identity.
The traditional null environment in therapy can actually be damaging to the therapeutic process for LGBT patients.
Homosecuality as a disorder was removed from the DSM in 1970.
Are acute pain and chronic pain caused by the same process within the brain?
Are Opiates required to manage chronic pain?
Have the number of deaths in the United States due to unintentional opiate3 overdose increased during the last 10 years?
Based on the research, routine screening for trauma exposure and PTSD should be conducted with all adolescents receiving mental health services so that treatment can be provided.
The National Center for PTSD indicated that among the physical responses to trauma among women can be:
In addition to PTSD the following are possible adaptations of trauma:
If the client has a trauma history an interventioniswt should consider a smaller group?
Process addictions exhibit the same diagnostic criteria as substance addictions (tolerance, loss of time, continuance in spite of negative consequesces)?
A process addiction is?
Which of the following most directly underlie the difficulties facing stuck young adults and their families?
In a wounded family system as described in the presentation, which is not a charachteristic of the family environment?
Most stuck young adults will successfully launch into a more independent and sustainable lifestyle when the correct psychiatric medications are prescribed.
Engaging an addict to find their true life purpose through residential treatment is an effective enrollment tool for both a therapist and interventionist.
It isn't possible to explore career possibilities while in the throws of detox in residential treatment.

If an interventionist is not in his/her passionate purpose, you cannot get people into treatment to find theirs.

 

Working with process involves examination of how one functions rather than why.
Relationship patterns developed in childhood are the result of insecure attachment.
Clients who are not aware of their emotions will not do well in experiential therapies.
The problem of sexual addiction stems from the individuals high libido.
It is important to have the sex addict disclose to their partner about their acting out behaviors early in treatment.
The emotion that motivates the sex addict to act out is anger.
Crainial electrotherapy stimulation treatment typically take:
Was Dr. Penniston's study on EEG Biofeedback for treating chemical dependency successful?
Is a SPECT scan a functional or structural brain scan?
Addiction is only genetic.
Bio/psycho/social are the three factors generally considered necessary for addiction to present itself.
Co-occurring psychological pathology is common in addicts and alcoholics.
Legal training and emersion in a judicial environment fundamentally affects how lawyers approach personal problems.
In a treatment environment, therapists need to tolerate a certain amount of debate from lawyers since this is how they are trained to discover what information is true and valuable and what information is not.
To insure the best behavioral health treatment, lawyers must be treated in lawyer-specific therapy groups only.
How many universal addictions are there?

Addiction to perfection is a universal addiction.

Whose work is Four Universal Addictions based on?
Identify two(2) coping methods that a patient can use when flooded by trauma memories.
Identify two (2) symptoms and behaviors that can be present in substance abusers with a childhood trauma history.
Identify two specific benefits of working a combined 12-step program for trauma and addiction.
Adolescents and Adults respond the same to drug and alcohol use/abuse.
The adolescent's family plays a large role in the success of the adolescent's long term recovery.
Most adolescents get a comprehensive evaluation before a diagnosis.
In 30 seconds you are perceived for your talents and faults.
If you have talent, most people could care less about how you dress.
When you leave your organization, you should leave with style and respect.
The involvement of families, friends and other members of an substance user's support network in addiction treatment is important because they:
Families struggling with addiction can often trace the origins of the addiction back to traumatic events that occurred within the family as many as 5 generations prior.
Studies of the ARISE Intervention conducted by NIDA and replicated in real-world settings found a more than 80% treatment engagement rate with AMA rates below 2%.
Love and relationships can be addictive and can be part of sex addiction.
Family members need to be educated to deal with feelings of shame because of the nature of sex addiction.
Sex, love and relationship issues need to be put on hold until after primary treatment for chemical dependency is addressed.
Did John Southworth discuss the Systemic Model of Intervention during the session?
During the presentation, John compared the Johnson Model of Intervention to which sport?
Co-dependency and enabling kill more people each year than addiction does.
Motivational Interviews and the LEAP approach:
Denial is influenced by:
Anosognosia is:
Transference is a sickness that you project onto someone else.
Positive transference supports positive outcomes.
Transference and counter transference are rooted in childhood and the collective unconcious.
If the client has a trauma history, an interventionist should consider a small group?
Process addictions exhibit the same diagnostic criteria as substance addictions (tolerance, loss of time, continuance inspite of negative consequences)?
A process addictions is?
Eating disorders fall cleanly under the category of addictive behaviors.
Given our current knowledge it's reasonable to suppose that women with co-occuring eating disorders and substance abuse may represent a distinct clinical sub group.
Eating disorders and substance abuse do not appear to be clinically related.
The first BRI credentials were issued during the MOC conference in 2006.
There are three levels of credentialing.
You can achieve a BRI credential through self study alone.
When mental disorders and substance abuse co-exists or eating disorders and substance abuse co-exist both disorders should be considered primary and integrated dual primary treatment is required.
Symptoms of mood disturbance must therefore be reassessed after partial or complete weight restoration.
Temporary psiquatric symptoms are not induced by substance avbuse.
A family is a comples ADAP time system.
An interventionist may wish to introduce chaos into a system.
Animal Hording is a DSM IV diagnosis.
The holistic approach is designed to consider the whole individual - mind/body/spirit.
Reward Deficiency Syndrome is a term that includes drug addiction, alcoholism, gambling addiction and other disorders.
Improving dopamine system efficiency cravings can eliminate or reduce cravings.
What is different about treating the affluent family?
Why is a holistic approach necessary?
Why is long term treatment necessary for the affluent client?
There are two kinds of neurofeedback: beta and alpha theta.
Neurofeedback teaches you hot to relax your whole body.
Neurofeedback can be effective in the treatment of PTSD.
The reason women most likely will leave treatment early is relationships.
A major treatment focus for women is creating boundries.
The two major reasons for men entering treatment are legal and employment.

Meperidine is an opiate.

A patient who is being prescribed oxycodone for pain management should always test positive for opiates, when using an antibody based screen.

Confirmation of a positive drug screen by mass spectrometry gives the health care practitioner the most reliable and dependable results available today.
Please answer the following:
Do you believe this activity was appropriate for the scope of your professional activities?
Was the educational content scientifically sound?
Was the educational content free of commercial bias?
Was the mode of education effective to learning?
How much did you learn as a result of this educational program?
What did you learn during this activity that you intend to integrate into your practice/professional activities?

What questions have arisen in your practice for which you need answers/strategies that you can implement?

What patient problems or patient challenges do you feel you are not able to address appropriately or to your satisfaction?
What problems are your patients communicating to you that need attention or follow up?

Are you interested in basic, intermediate or advanced level trainings?

What barriers might you have that would interfere with implementation of new information learned from this training?

How can this training (the overall meeting) be improved to better impact competence, performance and/or patient outcomes?

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