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Course 5H - The Quiz



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Among professionals, 'problem drinking' is increasingly used to describe NON-dependent drinking that results in adverse consequences for the drinker. (select one)
True only when the adverse consequences are of a legal nature.
While problem drinkers are CURRENTLY experiencing adverse consequences as a result of drinking, risky drinkers consume alcohol in a pattern that puts them AT RISK FOR these adverse consequences.
True False
In this study material, therapists and health care professionals are asked to direct interventions not only to drinkers with alcohol use disorders, but also to 'problem drinkers' and 'at-risk' drinkers in families who present for treatment.
True False
FROM SCREENING AND ASSESSMENT TO ACTION: Even if we broaden the target population for alcohol-related interventions to include people with RISKY DRINKING PATTERNS and MILD TO MODERATE ALCOHOL PROBLEMS, the goals of family therapy treatment remain the same.
True False
ALCOHOL PROBLEMS - THE COUPLE AND FAMILY CONTEXT: In addition to the widely documented association between alcohol use and interpersonal violence, we know that ...
drinking problems may negatively alter marital and family functioning.
drinking problems can increase as a consequence of marital and family problems.
alcohol problems are common in couples that present for marital therapy.
marital problems are common in drinkers who present for alcohol treatment
All of the above.
_____________ features copies of exemplary instruments for both screening and problem assessment, creating a complete “Clinical Toolbox” for you to use in your practice.
Appendix A
Appendix B
Appendix C
SCREENING AND PROBLEM ASSESSMENT: When treating adults in family or conjoint therapy, who should be routinely screened for alcohol-related problems?
Adults who have evidence of organic impairment
Adults who have had domestic violence issues
All adults who present for treatment
Standardized SCREENING INSTRUMENTS such as the Michigan Alcohol Screening Test (MAST) can produce 'false positives'.
True False
THE ALCOHOL PROBLEM ASSESSMENT: Three essential domains that any alcohol assessment should cover are:
level and pattern of alcohol use
the client's potential resistance to involvement of his family in treatment
dependence symptoms and the severity of the problem
consequences of alcohol use
the 1st, 3rd, and 4th answers
Regarding BRIEF INTERVENTIONS: INITIAL DECISION-MAKING -- Once you become aware that drinking is a problem for a family, you must ask yourself a series of questions. Which question below IS NOT one that is listed in the 'Initial Decision Making' section?:
If I address the drinking, to what degree will I be able to help the family?
Should I involve the drinker or other family members in alcohol-specific specialty services instead of, or in addition to, the treatment that I provide?
Should I ask a co-worker to co-therapy this case with me, because of the risks associated with treatment of AOD issues within a family context?
If I take some of the responsibility for addressing the drinking,should I work only with the drinker for a while, or should I also continue working with other family members?
If I do continue working with the family, to what extent should the children be involved?
Deciding Whether Identified Drinking Problems Should Be Addressed: There may be reasons for NOT ADDRESSING an identified drinking problem. Some reasons include .....
Treatment may [need to] be directed to another severe or acute problem,such as child abuse or the terminal illness of a family member.
You may have a limited number of sessions or limited time during which the family is available for treatment.
You may be convinced that it would cause the family to leave treatment.
All of the above
only the first and second options above
In Figure 3 - Decision Making About Treating Drinking Problems - there is an option to provide brief feedback and make no further response.
True False
In Figure 3 - If drinking problems are central to family issues and you have some expertise, you may provide treatment
in individual treatment
in adults only treatment
in whole family treatment
All of the above
The second and third options only
With a less acute drinking problem: If the therapeutic alliance is tenuous, a direct discussion of drinking problems might strengthen the alliance by bringing a major hidden issue into the open
True False
With a less acute drinking problem: Addressing the drinking habits of one family member may undermine an already tenuous alliance.
True False
Deciding on the Timing of a Brief Intervention: With less acute drinking problems, consider the goals and progress made, from this/these perspective(s) .....
Drinking may underpin the presenting problems, such as a couple’s concerns with finances, sexual functioning, or allocation of time
Child or spousal abuse also may be linked directly to one family member’s drinking.
When drinking is closely tied to presenting problems, you should address the drinking early in the treatment.
Drinking may be addressed directly and more immediately if it is interfering with achieving treatment goals, such as lack of follow-through on homework assignments, erratic attendance, etc.
All of the above.
If drinking is linked directly to the family's or couple's presenting problems, the authors of this paper believe that BRIEF INTERVENTION techniques can be used effectively - provided that there are no acute medical, psychological, or interpersonal problems associated with drinking.
No. They believe that Brief Intervention is not effective when drinking is affecting important aspects of a family's life.
If drinking appears to be more marginally related to presenting problems and treatment is progressing smoothly, it can be addressed later in treatment.
True False
There are several positive reasons for involving the children when adult drinking issues are involved:
Children typically are acutely aware if a parent is drinking heavily.
Discussing the drinking with the children present brings what may have been a taboo topic out into the open
If there is violence in the family, asking children to discuss their parent’s drinking may prevent further violence.
All of the above
The first and second answers above
Boundary issues between parents and children may be violated in destructive ways by a full discussion of drinking issues with the children present.
True False
If you decide to bring drinking problems into the family therapy agenda, the next challenge(s) is/are to
decide upon a euphemistic way to reference the drinking problems during therapy sessions
determine how you can raise drinking issues
facilitate the family’s acceptance of drinking as a legitimate part of the therapeutic agenda.
All of the above
The second and third options only
WHICH THERAPEUTIC PRINCIPLE(S) is/are said to facilitate the successful introduction of drinking issues into the therapy? (Choose the best answer below.)
empathy and motivation
motivation, with an awareness that not everyone succeeds
empathy, motivation, and choice
empathy up to a point
In Figure 4A, we are told that it is important to let the drinker in the family know that ' talk means change'.
True False
IN FIGURE 4B, we are told that PITFALLS of raising drinking in an issue in the context of family therapy
Drinker defensiveness
Family alliance with the therapist
Family and drinker ally against the therapist
Family reacts badly to empathy toward the drinker
All of the above.
APPLYING THE GENERAL PRINCIPLES: The course tells us that, when INTRODUCING THE TOPIC OF DRINKING in family therapy, an appropriate comment might be
'I’d like to bring up a topic that we haven’t talked about too much'.
'There is something that we need to talk about, even though it might be an uncomfortable topic'
'I’ve been thinking about another issue that might be contributing to the difficulties that you’ve been having.'
'It might be important to talk a bit more about how alcohol fits into the problems you’ve been experiencing.'
The 1st, 3rd, and 4th options above.
We want to respond empathetically toward the drinker. Therefore, we should NOT ENCOURAGE the family to play the following roles: (1) Providing feedback about negative consequences resulting from drinking, or (2) objectionable behaviors observed when drinking; or (3) the results of previous change attempts.
True False
LINK DRINKING TO CLIENT GOALS AND ASPIRATIONS: Your challenge is to understand how the drinking may be playing a role in the presenting problems, and to articulate this understanding to the family
True False
Clues that the drinking might be a contributing factor in the family's failure to progress in treatment include:
Noncompliance with homework assignments
Feeling bewildered about aspects of a family’s functioning
Specific types of assignments fall apart (e.g., having a couple go out together, or discuss a problem during the evening)
All of the above
The 1st and 3rd answers above.
Feedback about the linkages between drinking and lack of progress in treatment SHOULD NOT BE USED to introduce the topic of alcohol into therapy.
True False
Such comments as, 'I’ve been concerned about that too,' or 'She’s right, we have to face this,'
are things that might be said by a family member who is trying to become your ally against the drinker.
are efforts that you must try to neutralize, in order to maintain an alliance with the family as a unit, rather than with specific family members.
Both of the above
REGARDING THE PRINCIPLE OF CHOICE: After first discussing drinking ....
you can't let the option of 'choice to discuss or not' get out of hand, if you want to make progress.
you can give the family a choice about the degree to which the topic is pursued in any one session.
MOTIVATIONAL INTERVIEWING uses which techniques?
Brief intervention in which you share your impressions about the person's drinking, summarize the negative consequences of drinking, and encourage the drinker to consider change.
An empathetic client-centered style with active reflective listening, and rolling with resistance rather than confronting resistance.
Warm, empathetic, descriptive rather than evaluative feedback - to help the drinker recognize discrepancies between his/her current circumstances vs. his personal and family goals and aspirations.
All of the above
The 2nd and 3rd answers above
Near the end of the BRIEF INTERVENTION portion of family or couples therapy, the therapist or counselor should provide organized FEEDBACK which summarizes the negative consequences of the drinker's behavior.
True False
'Positive outcomes' of the Brief Intervention approach include which outcomes below?
Ensuring that the drinker has choices and does not feel forced to select one option.
Any movement toward change EXCEPT a plan which is includes only a REDUCTION in drinking.
Stating that they accept the need for change but want to try to change on their own.
Any movement toward change
The first, third, and fourth answers above.
Given the importance of the drinker feeling that s/he has CHOICES, during a BRIEF INTERVENTION it is NOT appropriate for the counselor or therapist provide specific information about different goals and treatment options .... OR to express his or her own view of the advantages and disadvantages of each option .... OR to suggest a preferred course of action.
True False
During BRIEF INTERVENTIONS, we should discourage family members from deciding on limits about what they will tolerate, and what they plan to do should the drinking continue unchanged.
True False
If the drinker and family settle on a change strategy by the end of the brief intervention, it is unnecessary to check in and monitor success and problems in future treatment sessions, unless the family brings up drinking-related issues.
True False
Study findings support the effectiveness of Brief Interventions when the drinker is not part of the family therapy or counseling sessions - and the Interventions are the same as when the drinker is present..
True False
When performing Brief Intervention with the drinker not present, which is a true statement?
This assessment of family coping strategies sets the stage for suggested interventions.
Assessment should target global questions such as, “Is there any violence in your home?” rather than specific aggressive behaviors.
The Conflict Tactics Scale can be used to conduct a more formalized assessment of domestic violence.
All of the above
Only the first and third answers.
During Brief Intervention when the drinker is not present, your goal(s) is/are which of the following?
To learn how the family members have protected the drinker from experiencing negative consequences from drinking.
To learn how the family members have reinforced drinking..
To learn how the family members have talked with the drinker about his/her drinking behavior.
To learn how the family members have been affected themselves.
All of the above.
The usual behavior change approaches used in counseling sessions - i.e., problem-solving, role-playing new responses, and giving specific homework assignments that involve practicing new behaviors - are unlikely to be effective with a family when the drinker is not present in the sessions.
True False
LONGER-TERM APPROACHES TO ALCOHOL PROBLEMS - CHANGE THROUGH FAMILY-INVOLVED TREATMENT: Two major approaches to family-based treatment for alcohol problems have been developed and tested in controlled research — Family Systems approaches and .... (select the one which is correct)
Alcohol-Focused Behavioral Couples Therapy (ABCT)
Alcohol-Focused Behavioral Change Therapy (ABCT)
Major components of ABCT include:
Strategies to teach support for the drinker’s change efforts, reduce protection for consequences, cope with negative affect, and communicate around alcohol-related topics.
Cognitive-behavioral strategies that will help the drinker stop drinking and acquire coping skills for both drinking-specific and general life problems.
Strategies to improve the couple’s relationship by increasing positive exchanges and improving communication and problem-solving skills - including behavioral contracts between intimate partners.
All of the above
The 1st and 3rd answers
FAMILY SYSTEMS THERAPY views drinking as one aspect of the marital/family relationship and focuses on altering couple interactions that might be sustaining the drinking, as well as each partner’s views of the meaning of the drinking. Abstinence may not be required.
True False
Research suggests that FAMILY SYSTEMS approaches result in more marital happiness after treatment, fewer incidents of marital separation, and fewer incidents of domestic violence, when compared to ABCT.
True False


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