Draw up a new contract with the client.
Talk to the client about possible denial.
Create new goals and objectives, and suggest alternate forms of therapy.
Discuss these concerns with the client and make necessary changes in treatment goals.
Asking too many questions.
Moving too quickly from data collection to treatment planning.
Focusing on strengths and weaknesses.
Processing the data collected from the client.
Licensed professional counselor.
Marriage and family therapist.
To be alert to and understand the power relationship.
To utilize the differential power to motivate the client.
To realize the importance of this power in client interventions.
To use differential power to get the client to try new behaviors.
The pretreatment period may be when clients lose interest in treatment.
A client may receive enough help so as not to need the services of the program or agency.
Successful pretreatment may result in a client needing services that an agency doesn't have, thus losing the potential admission.
There is really no danger with pretreatment - recovery will require much more programming than pretreatment can offer.
Clients should be taught skills for anticipating, avoiding, and coping with their personal high-risk situations.
Clients should be taught constructive responses to cope with lapses when they do occur.
Clients should be helped to recognize that one or more temporary lapses are likely to occur and are permitted.
Any positive expectations that clients have about drug use should be countered with reminders about the lows that follow the highs and about the long-term negative consequences of substance abuse.
Substance often taken in larger amounts than the person intended.
Marked lack of initiative, interest or energy.
Frequent intoxication when expected to fulfill major role obligations.
One or more unsuccessful efforts to cut down substance use.
Teaching clients to formulate and carry out plans to change their behavior.
Focusing on the person instead of the presenting problem.
Assisting clients in enhancing their coping skills.
Individualizing the treatment plan.
AIDS epidemiology and transmission routes.
The disease's clinical progression.
New medication used in treatment regimens.
Available social services for AIDS clients.
These communities try to return clients to society.
These communities are based on individual psychotherapy rather than group encounter.
These communities keep the patients busy rather than engaging in contemplative thought.
These communities rely on professional psychologists rather than former addicts or abusers.
Complete a mental status exam.
Engage the client's family in treatment.
Develop a treatment plan.
Establish rapport with the client.
The Beck Depression Scale , the MAST test, and the MMPI.
The Beck Depression Scale the MAST test, and the Stanford-Binet.
The MAST test, the Strong-Campbell, and the Stanford-Binet.
The MMPI, the Strong-Campbell, and the Stanford-Binet.
Develop a treatment plan.
Have the client sign appropriate documents.
Determine one's appropriateness and eligibility for admission.
Identify the client's strengths and weaknesses.
Monitoring, feedback, and evaluation of services.
Frequent face-to-face contact with the client.
Collaboration with family members.
Careful matching with appropriate 12-step groups.
Whether the patient has a history of sobriety during the last several years.
Whether the patient's job and family are likely to give him another chance if this treatment fails.
Whether the patient has family support for sobriety.
Whether the patient has a history of failed treatment on an outpatient or inpatient basis.
Compromising T-cell functions.
Impairing frontal cortical functions.
Increasing serotonin levels in the synaptic gap.
Decreasing cardiopulmonary functioning.
Ask the client to participate, never-the-less, and suggest he simply "do his best" when dealing with the issue of powerlessness.
Let the client know that participation in AA is mandatory, and that if he doesn't participate, he could be discharged for "noncompliance."
Be sensitive to such cultural differences and seek out other recovery resources that are relevant to the individual's values.
Seek out another Somali who is in a local AA group and ask the he or she sponsor your client.
"This counselor is a stranger, but maybe I can learn to trust her."
"My counselor will direct me to do what I need to do, and everything will be OK."
"My counselor will be a resource that I can use to resolve my problems."
"The counselor's main concern and responsibility is to help me achieve my goals and objectives."
Assess Joe's potential for suicide without directly asking him about suicide plans, but assess his high-risk factors.
Assess Joe's potential for suicide by asking him about his intent, and evaluating high risk factors.
Determine if Joe has a gun or other weapon.
Initiate involuntary hospitalization procedures.
Remain in denial about his/her addiction.
Have incorrect information and unanswered questions about the program.
Need to be referred to an outside agency.
Need additional education about addiction.
Employing an interpreter.
Training the counselor in cultural sensitivity.
Requiring the client to utilize a family member as an interpreter.
Getting the client a language tutor.
Child care services.
Primary health care.
Sarah can expect her unresolved conflicts to rise to the surface because of her work in the treatment center.
Sarah can resolve her personal pain by working professionally with addicted family units in a treatment center.
Sarah may be more comfortable with her clients because she is familiar with their behavior.
Sarah may have unfinished business with her parents.
Secular Organization for Sobriety.
Men and Women for Sobriety.
Message receivers hear "you" messages.
Message receivers do not speak.
Message senders use third-person pronouns.
Message senders use "I" messages.
Contact child protective services to report this incident.
Explain to her the limits of confidentiality regarding drug use.
Admit her for treatment and arrange childcare services.
Contact law enforcement to have her arrested for child abuse and neglect.
Treatment Alternatives to Street Crime (TASC).
Treatment Approaches for Criminal Offenders (TACO).
Treatment Resources for Chronic Repeat Offenders (TRCRO).
Helping Services for the Criminal Element (HSCE).
Although Ralph did have a relapse, recovery should be easier the second time around.
This constitutes a relapse, and Ralph may need to begin the recovery process all over again.
Ralph should be reassured that this behavior is permissible as long as he did not lose control and become drunk.
The counselor should talk to Ralph about the implications of dangerous situations like this, but assure him that it is possible to continue his recovery process.
The name of an attending physician, referrals made, diagnostic procedures used
Information about consultations, diagnosis, treatment, prognosis, and progress
Names of family members, emergency numbers, DSM-IV-TR diagnosis
Personal notes, insurance information, treatment notes
Increasing coping skills.
Decreasing anxious responding.
Decreasing negative thought patterns.
Group therapy sessions.
Help the client to express feelings generated by the crisis
Eliminate negative beliefs that contributed to the crisis
Assign specific behavior tasks such as spending time with people
Immediately refer the client to an agency to help change the situation
Cutting down on drinking, feeling annoyed and guilty, and dealing with hangovers.
Making a distinction between problem drinkers and alcoholics.
Craving a drink, drinking alone, feeling guilty, and employment difficulties.
Client perceptions, guilt, and "eye-openers."
Use the threat of incarceration as a motivator to change.
Protect the health, safety, and welfare of the public.
Keep the chronic, chemically dependent person off the streets.
To provide group and individual therapy for family members of alcoholics.
To provide a fellowship and support for individuals in relationships with alcoholics.
To educate family members of their risk of becoming alcoholics.
To provide families of alcoholics with the intervention necessary to prevent their substance abuse.
Male to male
Male to female
Female to female
Female to male
Trust vs. Mistrust.
Integrity vs. Despair.
Identity vs. Role Confusion.
Intimacy vs. Isolation.
A client's fears and denial.
Is best achieved when done independently from direct client care.
Facilitates communication and enhances accountability.
Is used primarily by the primary counselor.
Is a standardized process.
Developing a therapeutic relationship for sobriety and maintenance.
Changing expectations regarding the effects of intervention.
Identifying high-risk situations and learning alternative coping skills.
Discussing aspects of evaluation and treatment.
Obtaining informed consent to treatment.
Move from direct care to an administrative position.
Contact a supervisor and ask for fewer work hours.
Attend to health through adequate sleep, an exercise program, and proper diet.
Add more structure to work by using a commercial time management system.
Projection, denial, and displacement
Denial, minimization, and rationalization
Sub-limitation, displacement, and compensation
Identification, minimization, and Sub-limitation
Terminate the client's treatment and seek supervision.
Talk openly about transference issues.
Reciprocate your true feelings, but only if you are attracted to him/her.
Refer the client to another professional.
Discussing the client's plans for the future.
Helping the client adapt.
Determining the problem.
Determining a solution.
Reviewing documentation in progress notes.
Consulting with the client's significant others.
Referring the client to a professional outside your agency for an objective review.
Asking the client to write a personal evaluation of his/her own progress.
Serve as a guide in helping clients while behaving in a fair way to colleagues.
Strengthen the appearance of professionalism among addiction counselors.
Clarify the difference between acceptable and unacceptable client behavior.
Provide legal recourse and concrete consequences for unethical behavior.
Provide recognition of demonstrated competency in addictions counseling.
Ensure that each client receives equal treatment regardless of ability to pay.
Help programs qualify for Medicaid and other third-party reimbursement.
Allow unlicensed counselors to work in licensed facilities.
"I'm finding the support from this group to be very helpful."
"Getting caught for drunk driving was a mixed blessing."
"Ever since I stopped drinking, my emotional swings have been quite intense."
"Let's change the subject. Did anyone see the game last night?"
Interrupt the second speaker and remind him of the group rules.
Remind Eric that you are here to treat addiction and ask how this relates to his addiction.
Tell Eric that this disclosure is more appropriate for an individual session and you will meet with him later.
Ask questions which facilitate a group response to Eric's disclosure and elicit more feeling content from Eric.
Including the client's family members in counseling.
Setting mutually-established goals.
Going to 12-step meetings with the client.
Offering to make home visits.
Share what you know about the referral agency with your client.
Follow through with the referral agency to ensure you get your referral fee.
Offer to make the initial contact in order to ensure that the client sees the right person.
Have the client sign a release of confidentiality form before following through with the referral.
A counselor refers a client back to the referring source at completion of treatment
A counselor discusses a client's case with the counselor's supervisor
A counselor discusses a client's case with another counselor in the treatment facility
A client reports recent child abuse
When the client requests interaction.
From the client's first contact with the treatment center.
After it has been determined that the clients treatment is going well.
After it has been determined that the interaction will not interfere with the client's treatment.
Short-term therapy is more effective for drug abusers than long-term therapy.
Heroin addicts had a higher relapse rate than cocaine addicts.
Most drug abusers who enter therapeutic communities remain drug free.
Therapeutic communities do reduce drug use relative to untreated clients or those who are simply detoxified and released.
Advise him to select a quit date within the next 2 weeks.
Encourage him to use the nicotine patch or gum.
Consult with his physician regarding nicotine/medication interaction.
Suggest he cut down the number of cigarettes daily for 2 weeks before quitting.
Detoxification and stabilization
Psychological evaluation and treatment
Integration into a self-help recovery program
A comprehensive continuum of services
The client's ethnic background
A signature by a medical doctor
The purpose of the release of information
The client's social security number
Identify alternative courses of action.
Offer emotional support.
Contact emergency personnel.
Assess the degree of risk.
Restlessness, irritability, anxiety, agitation.
Tremor, elevated heart rate, increased blood pressure.
Decreased sensitivity to sounds, oversensitivity to tactile sensations.
Decreased appetite, nausea, and vomiting. ©
Identifying the client's problems and needs, strengths and weaknesses
Explaining the rules of the program
Having the client sign Release of Information forms
Confronting the client's denial
The amount consumed daily
The length in years of heavy drinking or drug use
The presence of withdrawal symptoms
The frequency of memory blackouts
The client's family dynamics.
Getting all the information that you can.
What your immediate response should be.
Focusing questions about the present situation and the client's means of coping with the stress.
Guilt and anger are painful emotions that are part of grieving
Symptoms of grief typically disappear within six months
The grieving process should be hurried so the client can resume his life
Grief is only a response to situations involving death
Obtain your client's authorization and contact the sponsor to discuss the situation further
Have the client discontinue involvement in AA until antidepressant medication is no longer needed
Encourage your client to ignore the sponsor's advice and continue the medication
Encourage your client to look for another, more understanding sponsor
Transfer the client to another counselor.
Let the relationship develop and try to work it out.
Challenge the client about his/her resistance to treatment.
Seek out supervision with a colleague or supervisor.
Increased tolerance and withdrawal symptoms when abstinence is attempted
Continued use despite experiencing problems that result from drinking
Recurring incidents of driving under the influence
Depression and lethargy
Get his wife into counseling with him.
Take responsibility for his behavior.
Develop a more positive perception of himself.
Effect a behavioral intervention.
Education and training.
Diagnosis and intervention.
Segregated treatment programs.
Integrated treatment programs with cultural programming..
Malnutrition can occur in drinkers who eat well-balanced diets.
Stimulation of the brain's frontal lobe can occur.
The second stage of liver deterioration can be reversed.
A vitamin B6 deficiency can occur.
The Acculturated Interpersonal Style.
The Bi-Cultural Interpersonal Style.
The Culturally-Immersed Interpersonal Style.
The Traditional Interpersonal Style.
Brian's goals in life
Brian's social resources
If Brian really needs the program
Brian's familial relationships and social milieu
Denial, surrender, and acceptance.
Self-hatred, anger, and guilt.
Remorse, self-hatred, and shame.
Shame, euphoric recall, and relapse.
Provide the group members with insight into the counselor's background.
Convince group members that the counselor has more life experiences than they do.
Demonstrate how to react when other group members disclose personal information.
Facilitate the growth of the group by relating to client or group issues.
How they are used.
When they were discovered.
Their medical and non-medical use.
The speed of the onset and duration of the effects.
Women more often than men will cite a traumatic event that precipitated their drinking.
Female alcoholics are more likely to be sociopathic and male alcoholics are more likely to have affective problems.
Female alcoholics are less frequently characterized as feeling depressed and guilty than male alcoholics.
Women move more slowly from the early stages to the later stages of abusive drinking than men.
AA policy clearly states that recovery can often be frustrated by contact with professionals.
AA has made no statements for or against the professional treatment community.
There are inherent conflicts between AA and the professional treatment community which are unlikely to be resolved.
A partnership between AA and the professional community was repeatedly emphasized by the founders of AA.
A lack of tolerance for alcohol
Frequent short periods of sobriety
The inability to control the amount one drinks
Light drinking EXCEPT on weekends
An understanding of self-help groups
An ethical code of conduct
An advanced degree
Assisting a client to utilize the support systems and community resources available.
Meeting with other professionals for discussions and planning.
Providing drug and alcohol information to clients.
Attending an A.A. or N.A. meeting with a client.
Assist the client with needs generally thought to be outside the realm of substance abuse treatment.
Provide the client a single point of contact for multiple health and social services systems.
Advocate for the treatment center's approach to care.
Be flexible, community-based, and client-oriented.
The "here and now."
The client's weaknesses in communication.
The counselor's feelings about the relationship.
The unique qualities of the client/counselor relationship.
"I'm not sure I understand. Let me check this out"
"First you tell me one thing, then another. Which is really the truth?"
"There's a lot of confusion in your story"
"Addiction fosters denial"
Adolescents who avoid use till their late teen years.
Women who don't begin use till after marriage.
Elderly people who develop chemical dependency late in life.
Alcoholics who develop medical complications after years of exposure to alcohol.
Spouse who participates in joint counseling sessions.
Employer when confirmation of attendance is needed for continued employment.
Attorney when verification of admission status ¡s needed for a court hearing.
Physician when information on medications prescribed in treatment is requested.
Use the group process to share mutual concerns.
See the client for individual counseling outside of group.
Conduct one-on-one sessions in the group.
Not allow monopolizing by members in group.
Taking a client history and specifying problematic behavior.
Specification of the problematic behavior and collection of baseline data.
Identification of the problematic behavior and evaluation of the client's motivation to change.
Specification of the problematic behavior and evaluation of the client's motivation to change.
Assist in client education.
Ensure continuity of client care.
Promote team work among the clinical staff.
Identify client strengths and weaknesses.
Regularly attend A.A. and/or N.A. meetings.
Stay well-informed and aware of recent developments in the field.
Teach classes about these topics.
Assume that the client will ask for what he/she needs.
A detailed explanation of goals and objectives.
More than one goal established by the counselor.
A well-developed outline for the discharge summary.
Clear expectations, specific goals, and methods of achievement.
The family cannot get well until the dependent person seeks help.
The children in a dysfunctional family can be protected from the problems cause by chemical dependency.
The divorce rate in dysfunctional families is highest after recovery has been initiated.
Family problems develop in the later phases of the addiction process.
Formulate and carry out realistic personal and professional goals.
Interpret the deeper meaning of problems.
Analyze client problems.
Convince clients to change.
"she seems to be over-reacting"
"does she usually threaten you?"
"sounds like she needs Al-Anon"
"she's really serious about your sobriety"
Getting him to gradually cut down on his drinking.
Encouraging him to change sponsors.
Referring him for additional treatment.
Asking him what worked before.
"What's the matter with you? Why didn't you just take care of the problem yourself?"
"Let's get right to the point. You've got a drinking problem"
"Let's talk about each of our expectations for counseling"
"Let me tell you what you need to stay sober"
The counselor should coordinate regular meetings with all professionals involved in the client's treatment.
Good integration of services requires team meetings with the client present.
Once the treatment plan is written, the use of other services ¡s determined and will remain unchanged.
With a well-integrated team of professionals, the case manager's review of progress notes will alone determine how the treatment plan ¡s being followed.
A mutual reward to reinforce behavior by the same amount.
Something specifically designed to increase the occurrence of a particular behavior.
The process of observing behavior of others.
A type of learning in which behaviors are increased as the result of the consequences.
A licensed physician should conduct a physical examination of the client.
The client should complete psychological tests to be used ¡n the evaluation.
The counselor should conduct an initial family therapy session in order to address problems caused by the client's use.
The counselor should provide the client with an overview describing the goal, objectives, rules, and obligations of the program.
Reactions to stress.
Episodic in nature.
Maladaptive ways of perceiving, thinking, and relating.
Females and the elderly.
Females and the young.
Males and the elderly.
Males and the young.
Morning drinking will reduce the symptoms of withdrawal
Morning drinking will keep the alcoholic's blood alcohol level from dropping.
Morning drinking will lessen the need for alcohol during the remainder of the day
Morning drinking reduces anxiety that effects the alcoholic's ability to start the day
Alcohol accounts for one-half of the ten leading causes of death in the' Native American population.
Cultural issues no longer play a role in alcoholism rates with the Native American population.
Past efforts to treat the Native American alcoholic have proven highly successful.
Revia has proven to be a popular intervention in the effective treatment of Native American populations.
Summarize the inappropriateness of the client's feelings.
Confront the client's behavior.
Instruct the client in relaxation techniques.
Call for assistance.
Remain quite for a time to allow the client to consider the summarized material.
Document the summary as soon as possible as part of the treatment plan.
Recommend that the client discuss the session with his/her sponsor.
Terminate the session immediately.
At least one episode of mania.
Evidence of earlier cyclothymia.
Evidence of earlier dysthymia.
Chronic forms of depression.
The Primary Enabler.
Acting out behavior.
Lack of trust.
"We're here to discuss your alcohol problem - I don't want to talk about your marriage"
"Counseling is a very unstructured process - anything goes"
"Our meetings will consist of four 50 minute sessions at 10 a.m. each Wednesday"
"What's important is that I help you. I'll counsel you no matter what"
To enhance a client's emotional rehabilitation.
To minimize the client's use of denial.
To support the gains made in treatment.
To assign sponsors to clients.
Intensive outpatient or partial hospitalization
Residential or inpatient services
The person has the AIDS virus
HIV infection occurred at some point in the past
The person is infectious and will remain so for life
The HIV infection has been in the system long enough to produce antibodies
All staff of the facility.
The agency board of directors.
Only those persons directly involved in providing clinical services.
Documentation of client problems
The client's aftercare plan
The level of commitment of the client to follow through
When the client appears to have gained all that he or she can from therapy.
At the point specified in the therapeutic contract.
At the onset of therapy.
When the client brings it up.
High levels of verbal output.
The client was deeply in debt because of his credit card use
The client's wife had left him because of his physical abuse of her
The client wanted to leave treatment because of his work schedule
The client did not want to attend AA meetings in the càmmunity
The counselor and client were planning to carpool to aftercare
The client's motivation was questionable because he was forced into treatment.
The counselor minimized the client's employment problem
The counselor made a referral which was not directly related to the alcohol problem.
There were no physical complications and the client was motivated
The client was court-ordered and had the ability to pay for services
The client was intelligent and highly motivated
The client lived close by and was gainfully employed
The client was assigned a primary counselor
An initial assessment was completed
The client was admitted to the program
The client signed all required consent forms
The counselor sought the advice of his clinical supervisor regarding the client's finances
The counselor scheduled an appointment with a credit counseling agency
The counselor arranged for the client to change his work schedule
The counselor helped the client find an AA meeting and sponsor
The counselor formulated appropriate short term goals for the client
The counselor identified and ranked the client's problems needing resolution
The counselor worked with the client in establishing the client's treatment goals
The client's treatment goals were expressed in measurable behavioral terms
The client admitting all of his legal problems were alcohol related
The client's denial of use of prescription medication
The client's report of increased use of alcohol and occasional memory loss
The client's conviction for his second DUI offense
The client was provided an estimate of the cost of his treatment
The client' rights were explained to him
The client was provided a copy of the programs goals and objectives
The client was provided information about schedule times for meetings
Acceptance of a referral from the client's Probation Officer
Setting up an appointment for the client to visit a credit counseling agency
Assisting the client with transportation to AA meetings upon discharge
Seeking the advice of his clinical supervisor about the client's financial problems
The counselor helping the client change his work schedule
The counselor helping the client complete all required insurance and consent forms
The counselor admitting the client into the program
The counselor completed a progress note for the client's chart
The counselor referring the client to the credit counseling agency.
The counselor helping the client stay in treatment by accepting a change in his work schedule.
The scheduling of an appointment for the client to talk to a college admissions counselor to encourage the client to continue his education.
The counselor documenting the client's tour of the facility and general orientation.
The client was not informed of his rights and responsibilities at the startof: his treatment.
The client was not informed of his legal responsibilities and obligations related to his DUI.
The client was not informed of community recovery resources available to him upon discharge
The client was not offered the opportunity to participate in weekend family education seminars