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    Drug Abuse

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    Lei Koyou
    This document discusses counseling technology and substance abuse counseling. It covers 6 patterns counselors can use to engage clients, types of drug abuse like stimulants, opioids and hallucinogens. It also discusses diagnosing substance use disorders based on criteria like withdrawal symptoms. The assessment process involves screening for co-occurring disorders, determining the severity of mental health and substance use issues, and the appropriate level of care.

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    Drug Abuse

    Uploaded by

    Lei Koyou
    48 views23 pages
    This document discusses counseling technology and substance abuse counseling. It covers 6 patterns counselors can use to engage clients, types of drug abuse like stimulants, opioids and hallucinogens. It also discusses diagnosing substance use disorders based on criteria like withdrawal symptoms. The assessment process involves screening for co-occurring disorders, determining the severity of mental health and substance use issues, and the appropriate level of care.

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    This document discusses counseling technology and substance abuse counseling. It covers 6 patterns counselors can use to engage clients, types of drug abuse like stimulants, opioids and hallucinogens. It also discusses diagnosing substance use disorders based on criteria like withdrawal symptoms. The assessment process involves screening for co-occurring disorders, determining the severity of mental health and substance use issues, and the appropriate level of care.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    48 views23 pages

    Drug Abuse

    Uploaded by

    Lei Koyou
    This document discusses counseling technology and substance abuse counseling. It covers 6 patterns counselors can use to engage clients, types of drug abuse like stimulants, opioids and hallucinogens. It also discusses diagnosing substance use disorders based on criteria like withdrawal symptoms. The assessment process involves screening for co-occurring disorders, determining the severity of mental health and substance use issues, and the appropriate level of care.

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    © All Rights Reserved
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    of 23

    A REPORT IN

    COUNSELING TECHNOLOGY
    Presented by SHIELA MILLARES

    • Counselor Readiness for Engagement


    with Client
    • Types of Drug Abuse
    • Diagnosis of Substance Abuse
    • Assessment of Substance Abuse
    COUNSELOR READINESS FOR
    ENGAGEMENT WITH CLIENT
    Are you feeling nervous about starting to counseling? Counseling is more
    than a basket of techniques, questions, and home assignments. It is
    important to have knowledge of the techniques and interventions that can be
    used in session, whatever approaches or techniques to be used, new
    counsel also need to develop the courage of just "being" with clients. This
    post the question: How ready are you to engage with your client?

    A counsel must connect with a client and form enough trust for them to talk
    to so that you can help them? In the next slides, I will discuss the SIX
    PATTERNS used by a counsel to plan strategies to better engage with the
    client. These patterns ready the counselor to engage with the clients to earn
    their trust to opens up and cooperates to the counsel;
    1. MAKE SURE THE FOCUS IS ON THE CLIENT
    The beginning, middle and end of every session should be about
    the client’s thoughts, feelings and actions. Keep the spotlight on
    the client.
     
    2. WALK THE LINE BETWEEN PUSHY AND CODDLING
    Clients need to know you accept them and respect their right to
    make their own decisions.

    3. STAY CONFIDENTIAL
    Trust is the most valuable facet of the counselor/client
    partnership. Without trust, the client won’t be comfortable
    opening up to let you listen and begin the journey to health and
    healing.
    4. ASK FOR CLARIFICATION
    Work hard to understand the client; for example ask what family
    means and who is theirs.
     
    5. PRACTICE YOUR QUESTIONS
    A counselor should ask open-ended questions to assess more
    detail from the discussion.
     
    6. STRUCTURE THE SESSION
    Sessions will vary depending on the theory of counseling you are
    using. Some counselors use protocols with clear guidelines for
    what comes first, second and so on
    4. ASK FOR CLARIFICATION
    Work hard to understand the client; for example ask what family
    means and who is theirs.
     
    5. PRACTICE YOUR QUESTIONS
    A counselor should ask open-ended questions to assess more
    detail from the discussion.
     
    6. STRUCTURE THE SESSION
    Sessions will vary depending on the theory of counseling you are
    using. Some counselors use protocols with clear guidelines for
    what comes first, second and so on
    DRUG ABUSE
    Drug abuse or substance abuse refers to the use of certain
    chemicals for the purpose of creating pleasurable effects on the
    brain. Specifically, the signs, symptoms, and effects of one’s
    substance use disorder will be dependent on how much he or
    she is using, how often he or she uses, and if he or she is using
    alongside other addictive substances.

    All drugs are not created equal. In fact, some drugs have the
    potential to be deadlier than others based on how they are
    developed, what they contain, and how potent they are. In this
    report, I will discuss the most common types of drug abuse.
    TYPES OF DRUG ABUSE
    STIMULANT ABUSE
    Stimulants are substances that cause physical and psychological
    functions to speed up. Individuals that abuse stimulants tend to
    experience a major boost in energy, euphoria, and a powerful sense of
    grandiosity.

    COCAINE ABUSE
    This substance, which is a derivative of the coca plant, comes in white
    powder form and is usually snorted. Someone abusing cocaine will
    experience an energetic, euphoric high for about 20 minutes before it
    wears off.
    ADDERALL ABUSE
    When taken as prescribed, Adderall can increase focus and
    attention. However, when it is abused, Adderall triggers a boost of
    energy and hyperfocus, which can last hours. Abusing this
    prescription drug excessively can lead to cardiac complications up
    to and including heart attack.

    METH ABUSE
    Known on the streets as “trash” or “garbage”, meth is an extremely
    toxic stimulant that has a pseudoephedrine base, which is the
    primary ingredient that triggers stimulant effects. Individuals
    abusing meth will experience intense euphoric highs and equally
    as depressed lows.
    OPIOID ABUSE
    Opioids can be naturally occurring or synthetic but are all equally
    as addictive. Continual opioid abuse can result in vital organ
    damage or failure, respiratory problems, and overdose.

    HEROIN ABUSE
    Today, heroin is the kingpin of opioids. When heroin is abused,
    individuals obtain a pleasurable high that reduces or eliminates
    their physical and/or psychological distress. Heroin is usually
    smoked or injected.

    HALLUCINOGENS
    Someone who is under the influence of a hallucinogen can behave
    in a manner that is possibly dangerous or even deadly.
    PRESCRIPTION PAINKILLERS
    When taken as prescribed, each one of these painkillers can pose
    a significant medical benefit, however when abused, they can be
    deadly. These medications can be smoked, snorted, swallowed, or
    injected.

    SEDATIVE ABUSE
    Sedatives such as benzodiazepines are primarily used to treat
    anxiety disorders such as panic attacks, phobias, and obsessive-
    compulsive disorder. They are very popular substances of abuse
    due to the feelings of detachment and relaxation that they
    produce.
    XANAX, ATIVAN, AND VALIUM
    Xanax, Ativan, and Valium are benzodiazepines that work to calm
    the mind and body. Unfortunately, when benzodiazepines like
    these are abused, individuals are at risk for experiencing
    excessive sleepiness, drowsiness, and respiratory depression.

    ECSTASY ABUSE
    When ecstasy is abused, individuals experience delusions and
    hallucinations that can be both visual and auditory. Those who are
    under the influence explain being on ecstasy as being in a state of
    complete euphoria.
    DIAGNOSIS OF SUBSTANCE
    USE
    Blood, urine or other lab tests are used to assess drug use,
    but they're not a diagnostic test for addiction. However,
    these tests may be used for monitoring treatment and
    recovery. The American Psychiatric Association diagnoses
    the severity of Substance Use Disorders by identifying the
    presence of problematic patterns using the following criteria:

    AMOUNT - Take the substance in larger amounts and for


    longer than intended
    CONTROL - Want to cut down or quit but are unable to

    TIME - Spend large amounts of time obtaining the substance

    CRAVINGS - Experience cravings or strong desires to use the


    substance

    OBLIGATIONS - Repeatedly unable to carry out major


    obligations at work, school or home due to substance use

    SOCIAL - Continuing to use the substance despite persistent or


    recurring social or interpersonal problems or harm to
    relationships
    ACTIVITIES - Stopping or reducing important social,
    occupational or recreational activities due to substance use.

    HAZARD - Continually using the substance in physically


    hazardous situations such as driving under the influence

    HARM - Consistently using the substance, despite knowledge of


    the substance causing persistent or recurrent physical or
    psychological problems

    TOLERANCE - Building a tolerance – the need for markedly


    increased amounts of the substance to achieve the desired effect
    or a markedly diminished effect with continued use of the same
    amount of the substance
    WITHDRAWAL - Feeling withdrawal symptoms – as either a
    characteristic syndrome or when the substance is used to avoid
    withdrawal.

    In consideration of those criteria, substance abuse is


    diagnosed and classified to 3 different levels: from Mild to
    Moderate and Severe.
    THE ASSESSMENT PROCESS
    Assessment Step 1: Engage the Client
    Assessment Step 2: Identify and Contact Collaterals (Family, Friends,
    Other Providers) To Gather Additional Information
    Assessment Step 3: Screen for and Detect Co-Occurring Disorders
    Assessment Step 4: Determine Quadrant and Locus of Responsibility
    Assessment Step 5: Determine Level of Care
    Assessment Step 6: Determine Diagnosis
    Assessment Step 7: Determine Disability and Functional Impairment
    Assessment Step 8: Identify Strengths and Supports
    Assessment Step 9: Identify Cultural and Linguistic Needs and Supports
    Assessment Step 10: Identify Problem Domains
    Assessment Step 11: Determine Stage of Change
    Assessment Step 12: Plan Treatment
    Assessment Step 1: Engage the Client
    Five key concepts that underlie effective engagement during the initial
    clinical contact:
    1. universal access (“no wrong door”)
    2. empathic detachment
    3. person-centered assessment
    4. cultural sensitivity, and
    5. trauma sensitivity

    Assessment Step 2: Identify and Contact Collaterals


    (Family, Friends, Other Providers) To Gather Additional Information
    Information from collaterals is valuable particularly in evaluating the
    nature and severity of mental health symptoms when the client may be
    so impaired that he or she is unable to provide that information
    accurately.
    Assessment Step 3: Screen for and Detect Co-Occurring
    Disorders
    • All individuals presenting for substance abuse treatment should
    be screened routinely for co-occurring mental disorders.
    • All individuals presenting for treatment for a mental disorder
    should be screened routinely for any substance use disorder.

    Assessment Step 4: Determine Quadrant and Locus of


    Responsibility
    The Four Quadrants
    IV - More severe mental disorder/more severe substance disorder
    III - Less severe mental disorder/more severe substance disorder
    II - More severe mental disorder/More severe substance disorder
    I - Less severe mental disorder/less severe substance disorder
    Assessment Step 5: Determine Level of Care
    This process involves consideration of six dimensions of assessment:

    • Dimension 1:
    Acute Intoxication and/or Withdrawal Potential
    • Dimension 2:
    Biomedical Conditions and Complications
    • Dimension 3:
    Emotional, Behavioral, or Cognitive Conditions and Complications
    • Dimension 4:
    Readiness to Change
    • Dimension 5:
    Relapse, Continued Use, or Continued Problem Potential
    • Dimension 6:
    Recovery/Living Environment
    Assessment Step 6: Determine Diagnosis
    Determining the diagnosis can be a formidable clinical challenge in the
    assessment. Clinicians in both mental health services and substance
    abuse treatment settings recognize that it can be impossible to establish a
    firm diagnosis when confronted with the mixed presentation of mental
    symptoms and ongoing substance abuse. Of course, substance abuse
    contributes to the emergence or severity of mental symptoms and
    therefore confounds the diagnostic picture. Therefore, this step often
    includes dealing with confusing diagnostic presentations.

    Assessment Step 7: Determine Disability and Functional Impairment


    Assessment of current cognitive capacity, social skills, and other functional
    abilities also is necessary to determine if there are deficits that may
    require modification in the treatment protocols of relapse prevention
    efforts or recovery programs.
    Assessment Step 8: Identify Strengths and Supports
    All assessment must include some specific attention to the individual's current strengths,
    skills, and supports, both in relation to general life functioning, and in relation to his or
    her ability to manage either mental or substance use disorders.

    Assessment Step 9: Identify Cultural and Linguistic Needs and Supports


    • Not fitting into the treatment culture and conflict in treatment
    • Cultural and linguistic service barriers
    • Problems with literacy

    Assessment Step 10: Identify Problem Domains


    The ASI (Addiction Severity Index) is a tool that is used widely to identify and quantify
    addiction-related problems in multiple domains, thereby determining which domains
    require specific attention. The value of the ASI is that it permits identification of problem
    domains. It is used most effectively as a component of a comprehensive assessment. A
    comprehensive evaluation for individuals requires clarifying how each disorder interacts
    with the problems in each domain, as well as identifying contingencies that might
    promote treatment adherence for mental health and/or substance abuse treatment.
    Assessment Step 11: Determine Stage of Change
    In substance abuse treatment settings, stage of change assessment usually
    involves determination of Prochaska and DiClemente Stages of Change:
    precontemplation, contemplation, preparation, action, maintenance, and relapse
    (Prochaska and DiClemente 1992).
    • No problem and/or no interest in change (Precontemplation)
    • Might be a problem; might consider change (Contemplation)
    • Definitely a problem; getting ready to change (Preparation)
    • Actively working on changing, even if slowly (Action)
    • Has achieved stability, and is trying to maintain (Maintenance)

    Assessment Step 12: Plan Treatment


    A major goal of the screening and assessment process is to ensure the client is
    matched with appropriate treatment. Program placements and treatment
    interventions should be matched individually to the needs of each client. The
    ultimate purpose of the assessment process is to develop an appropriately
    individualized integrated treatment plan.

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