Therapeutic Community, case management & family

education
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1. Advocacy is is part of case management and may involve 8. Anemia is the insufficient function or number of red
what? coordinating with families, community what blood cells - is the most common red blood
agencies, legal systems, and legislative cell related problem in chronic alcohol
bodies in order to obtain a service, practical users. Red blood cells have the important
help, support from others, or information for job of picking up oxygen from the lungs and
clients. Examps are giving or receiving carrying oxygen to all of the other cells of
information regarding specific clients. the body.
2. Aftercare or Follows discharge and at this point case 9. The behavioral causal factors for continued drug use.
continuing managers help clients transition out of view suggests
care follows treatment and take responsibility for their the influence
what and is lives. The client may need housing, a source of both
what? of income, or a social support system. positive and
negative
3. Alcohol Infection - alcohol has a toxic effect that
reinforcement
affects the directly reduces white blood cell reserves.
as
white blood
cells, which 10. The biological alcoholic dependent parents and those of
are the view states non-dependent parents with respect to
bodies main that there is a genetic predisposition and/or biochemical
defense difference factors.
against what? between
children of
4. Alcohol can increasing respirations when low to moderate
also affect doses are used, and when larger amounts are 11. Case Finding Case finding refers to how treatment
the used, the respiration rate decreases and may and programs get clients. For example, the
respiratory cause death in cases of acute alcohol Pretreatment program may have a relationship with law
system by poisoning. enforcement authorities, public welfare
agencies, or managed care companies. At
5. Alcohol Central nervous System
this phase, the case manager tries to remove
effect what
barriers that would keep the potential client
more
from entering treatment. Examples of
profoundly
barriers to participating in some treatment
than any
programs are lack of transportation,
other part of
childcare, a co-occurring disorders or
the body?
money.
6. Alcohol Inflammation of the liver, metabolism is
12. Case Fitting services to the client rather than the
hepatitis is disrupted, jaundice in skin & eyes
management client to services - it is possible that some
what? It is reversible
activities clients do not need every aspect of a
7. All case as part of the client's record. should focus particular program.
management on fitting
activities what?
should be
13. Case Outcomes; clients who have received
documented
management clinical case management had better
where?
improves outcomes in terms of alcohol use, medical
what? status, employment, family relations, and
legal status at 6 months following treatment
than those who did not.
14. Case management is A coordinated approach to the 22. A community communal space, messages of right
what? delivery of health, substance abuse, environment with living and recovery displayed on the
mental health, and social services so shared what? walls, daily schedules, and the
that clients are linked with organizational structure of the
appropriate services to address community, and individual member's
specific needs and achieve stated names are displayed.
goals.
23. Community Child protection systems
15. Case management *Offers the client a single point of Resources case criminal justice institutions,
principals are what? contact managers (and primary health care providers
with the health and social services counselors) use are psychological testing services
systems. what? social service systems
* Is client-driven and driven by client family therapy services
need. housing programs
Involves advocacy. vocational rehabilitation programs
Is community-based. health insurance companies
Is pragmatic. self help groups
Is anticipatory.
24. Counselors provide Encouraging family involvement,
Must be flexible.
case management providing support, tracking
Is culturally sensitive
services for substance abuse relapse episodes
16. Case management Internal barriers, as well as external adolescent clients by following treatment, connecting the
techniques should be barriers that may doing what? youth with school, work, and
designed to reduce impede progress. community resources, and helping
the client's youth fulfill legal obligations
17. Chronic alcohol use Acute pancreatitis - the acute 25. Counselors records, Legal documents
is associated with inflammation of the pancreas. including electronic
what? Acute fatty liver files are what?
18. Cirrhosis is caused permanent, widespread destruction 26. Cultural norms affect drug behavior
when there is of liver cells, which are replaced with exposure to drugs
nonfunctioning scar tissue. The liver which in turn
cells are unable to perform their influence what?
necessary functions and while
27. The differences in aldehyde dehydrogenase, which
progression may possibly be slowed
one's ability to breaks down a by-product of
down by stopping the consumption
metabolize alcohol alcohol (acetaldehyde). Increased
of alcohol, it is irreversible and fatal
may affect the acetaldehyde may cause an
if alcohol is continued to be
individual's continued individual to feel sick and
consumed
alcohol use. Some experience alcohol-flush syndrome,
19. Clinical/rehabilitation In this model, the case manager is individuals are common among Asians, thus this
model is what? also the client's counselor. So the lacking the would not reinforce continued use.
counselor provides both the clinical enzyme______
help (therapy) and the resource
28. Disengagement is Ideally, it takes place over time. The
acquisition help (case management).
what? case manager and client can discuss
20. Collective formats Individuals attend groups, meetings, what the client learned from
for guiding individual seminars, and recreation with others. interacting with different service
change is where providers and be encouraged to
continue accessing the resources the
21. Community activities Preparing & serving meals, daily
client needs in life.
include what? groups, meetings and ceremonies
and rituals. Peer encounter groups 29. Drugs of abuse Mesolimbic dopamine system -
are used as well. stimulate the reinforcing pleasure is a result of its
"pleasure pathway" in effects of GABA neurotransmitters.
the brain, which is the
what?
30. The endocrine system, *the affect on the pituitary gland 40. Male children of alcohol- Four times more likely
made up of the glands *direct affect on the glands dependent biological
of the body and the themselves parents are how much
hormones they secrete *liver damage more likely than children
can be affected by of non-dependent parents
alcohol in three ways to develop substance
dependence?
31. Family coping styles are *Family hero
what? *Mascot 41. A malfunctioning liver testosterone and estrogen
*Scapegoat caused by alcohol-related levels that are present in men
*Lost Child damage can cause a & women; Women can gain
change in the ration male characteristics while
32. Female children of other disorders, such as
between the losing females ones. Men can
alcohol-dependent depression, but more research is
gain female characteristics
parents are more likely needed.
while losing man ones.
to develop what
42. Membership as role Each person models how
33. The goal of T.C.? for clients to be different by
models means what? change can occur.
participating in a community that
operates by different rules than 43. Membership feedback is peers observe each other and
the community from which they where offer authentic reactions to one
came; another
34. A guiding question for "What do others need to know to 44. MM or Moderate the alcoholic - its for those
deciding what to include respond therapeutically?" Things Management is not who have experienced minor
in the client's record is like release of information forms, intended for probs from drinking. Uses
what? notes of efforts to advocate for moderation and sometimes
clients, such as "met with school abstinence - depends on the
guidance counselor" person.
35. The idea of therapeutic DeLeon 45. Open communication personal information is shared
communities was means that to aid the individual's recovery
developed by whom? and the recovery of other
members.
36. Instead of jail, drug Education and rehabilitation
diversion programs programs 46. Other effects from heavy Arthritis
direct first time drinking are: osteoporosis and aseptic
offenders into what? necrosis
Jaundice
37. In the behavioral model, Provides escape from negative
Itching
drug use can be feelings (AKA tension reduction
Changes in hair distribution
negatively reinforcing or self-medication); or using to
Vessels in the skin are dilated
when it provides what? avoid unpleasant withdrawal
symptoms. 47. Participant roles are where members contribute directly to
all activities of daily life in the
38. It is estimated that ____ 80%
therapeutic community.
percent of parolees,
probationers and
criminal offenders have
a substance abuse or
dependence problem.
39. Levels of intervention Early Intervention (level .05)
are what? Outpatient Services (level 1)
Intensive outpatient or partial
hospitalization (level 2)
Residential or inpatient services
(level 3)
Medically managed intensive
inpatient services (level 4)
48. Physical signs Weakened overall appearance 53. Relationships the support of others provides
and hyper-pigmentation (unusual darkening of are important encouragement. All members are expected
symptoms of the skin) because to act as role models.
chronic Jaundiced skin
54. Retention of There is an inhibition in the production and
alcohol use Yellowish pigment to the whites of the eyes
access body output of the anti-diuretic hormone (ADH).
can include ataxia
water occurs
what? hoarseness in the voice
because
appearance of spider veins
dilated capillaries 55. Secondary The experimental, social/recreational, and
Acne like lesions on the face and body prevention habitual use and drug abuse from turning
nose may be enlarged and bulbous seeks to stop into addiction by acting when the
swelling of parotid glands in the face what? symptoms are first recognized. It
incorporates intervention, education, and
49. Positive drug use and its pleasant effects.
skill building to provide skills to avoid
reinforcement
future use and promote abstinence.
is when the
process 56. The Secular Accepts individuals regardless of what
experienced Organization chemical they are addicted to - promotes
becomes for Sobriety or one day at a time. Non spiritual, non
associated (SOS) or Save religious.
with Our Selves is a
what?
50. Primary Mainly for the young who have little or no
prevention is experience with drugs, and this approach 57. Shared norms members agree on what is correct
intended for tries to anticipate and prevent initial drug and values is behavior and right living.
who? use by: where
Promoting abstinence 58. (side note) Disease concept approach - some assert
Developing refusal skills Strength based may actually intensify problems for some
Educating the young about the dangers of model is an clients
drugs alternative to
Increasing the age of legal use (of alcohol & the what?
tobacco)
59. Skin infections liver dysfunction or abnormalities in the
Promoting viable alternatives, activities that
may be immune system.
do not include drug use.
indicative of
51. Primary At this phase, the case manager orients the
60. Social attitudes towards drugs, especially in
treatment is client to the program (whatever level of
pressures cultures where drug taking is linked to
what? intervention) and may help the client resolve
affect what? social/cultural traditions
immediate problems that would keep him
from focusing on treatment. The case 61. The includes stressful socioeconomic
manager makes a plan for resource sociocultural conditions and cultural differences in
acquistion to meet the client's short term view of drinking patterns that suggest that
needs. Helps the client while in whatever substance sociocultural context can enhance or
level of treatment while also planning for related reduce risk of substance use, abuse, and
discharge and re-entry into the community. disorders is dependence.
what?
52. Rational Addictive Voice Recognition Technique
Recovery (AVRT)is what is used. It uses the principles 62. Some of dopamine receptor sites in the reward
(RR) uses of (RET) Rational Emotive Therapy, which individuals are center of the brain (which is called the
what to assist was developed by Albert Ellis. Based on more likely to mesolimbic dopamine system)
the individual Self reliance. have the gene
to become present that
aware of regulates the
thoughts that sensitivity to
support what?
drinking
behaviors
63. Staff is community members, who are rational 70. The treatment is a developmental view of the change
considered authorities, role models, facilitators, and organized into process.
guides in the self help community method. phases that
reflect what?
64. Structure the community is organized so that members
and systems see how they depend on one another; 71. WFS (Women another group with a spiritual base for
mean members learn the value of living responsibly for Sobriety) is women (b/c AA is better for men);
and respecting authority. what emphasizes the power of positive
emotions.
65. T.C. is based substance abuse is a disorder of the whole
on the idea person and that recovery is a self-help 72. What are some *Can decrease the number of platelets
that process of incremental learning toward stable other chronic (which is a major component for clotting
change in behavior, attitudes, and values of drinking heart blood) & some form of bleeding disorder
right living that are associated with side effects? occurs
maintaining abstinence. They need to learn a *AHMD (Alcoholic Heart Muscle Disease)
whole new way of being. Not all residential - heart is not pumping enough blood
drug abuse treatment programs are *Reduction of B-1 (Thiamine) vitamin,
therapeutic communities. resulting in Beriberi Heart Disease.
*Cardiac Rhythm abnormalities
66. Tertiary on stopping the progressive damage of drug
*Seasonal alcohol-induced arrhythmias
prevention use and assisting drug abusers back to a
(holidays or weekend drinking).
focuses on healthier state.
what? *Group intervention to get individual into 73. What are the Participant roles, membership feedback,
treatment components of membership as role models, collective
*Desensitize the drug user to people, place & the therapeutic formats for guiding individual change,
things that trigger use community? shared norms and values, structure and
*Use of family therapy, group therapy and systems, open communication,
residential therapeutic communities relationships
*Use of pharmacological strategies such as
74. What are the Assessment
methadone maintenance
functions of Planning
*promotion of healthier life styles
case Linking
Use of aftercare support systems, usually
management? Advocacy
utilizing 12-step programs.
Monitoring
67. Therapeutic Social learning model
75. what are the Case Finding and Pretreatment
communities
phases of the Primary Treatment
are based
treatment Aftercare
on the
continuum Disengagement
what?
concerning case
68. Three 1. Keeping out of the way & going about one's management?
approaches own life.
76. What are the six *Denial
members 2. Being the care giver, getting into
stages that *Attempts to eliminate
use in living counseling, and trying to control the situation,
occur as a *Disorganization and chaos
with a including the substance abuse.
family deals *Reorganization in spite of the problem -
substance 3. resigning to the idea that the user will
with addiction? partner focus away from user and on to
dependent always use and will never change, and
maintaining a family life in spite of the
person. continuing to maintain a facade that all is well
chemical use.
What are in the family.
*Efforts to escape (separation/divorce)
they?
*Family reorganization - when separation
69. The Identification, assessment, stabilization, occurs & family reorganizes without the
treatment rehabilitation, relapse prevention and user.
and substance substitution if necessary.
recovery
continuum
of care
incorporates
what?
77. What are three *Responsible one 89. What is the The case manager identifies clients'
coping styles as a *adjuster Brokerage/generalist needs and helps them access the
survival technique to *placater model of case necessary resources. Ongoing
deal with the reality management? monitoring is not emphasized, nor is
of what the advocacy; it is most useful when
substance there is a problem with access, not
abuse/dependence availability, of resources.
has done to the
90. What is the strength it is where the case manager
family unit
based model? supports clients in their search for
78. What are two- is a phrase used to describe a few resources. It encourages the use of
steppers? people who enter a 12 step program informal helping networks as
like AA, acknowledging they have a opposed to institutional ones. It
problem, get clean, dry out, and then involves aggressive outreach to
begin their quest to help rescue clients, helps clients develop their
others. This refers to the individual own goals, and emphasizes the role
not working through the steps & of advocacy. Some of the principles
applying them to one's life. of the strengths perspective are
encouraging client control over the
79. What happens in Intercede on behalf of the client to
search for those resources they
advocacy? obtain needed resources.
perceive as needed and viewing the
80. What happens in Identify clients' strengths, weaknesses, community as a resource and not a
assessment? and needs. barrier.
81. What happens in help clients obtain required services 91. What organic brain Alcoholic Dementia -overall decline
linking? by referring or transferring clients to syndromes occur of intellect
services in the formal care-giving when brain tissue Wernicke's disease (thiamine or B-1
systems. damage occurs as a deficiency) - can be corrected
82. What happens in Evaluate progress continuously and result of long term Korsakoff's psychosis - Deficiency B
monitoring? take action if needed drinking? Vitamin Thiamine

83. What happens in Negotiate what the client wants and 92. With sufficient Tolerance, dependence, craving and
planning? develop a plan for achieving it. quantities of alcohol, withdrawal.
the CNS adapts to
84. What is Al-Anon's to help families of alcoholics
the presence of
primary purpose?
alcohol; this
85. What is an example members of oppressed groups may adaptation brings
of counselors being not be comfortable with the 12 step about what?
culturally sensitive idea of accepting one's
93. Work is considered therapeutic and educational.
to their clients? powerlessness, given their societal
what?
powerlessness - the client should not
be linked with resources that stress
the concept of powerlessness.
WHATEVER!
86. What is korsakoff's the individual's inability to learn new
psychosis is information or remember recent
characterized by events and appears to be irreversible.
87. What is Mellanby The CNS is affected more as the
effect alcohol level is increasing compared
to when it is decreasing.
88. What is the assertive The case manager has frequent, long
community term contact with clients in their
treatment model? natural settings (e.g., home) focusing
on the practical problems of daily
living. Advocacy is emphasized.