Statistics
Psychoeducation
Assessment
Treatment
Ethics
100
What are the TOP 3 most commonly used substances for adolescents?
46.4%- Alcohol
Marijuana/ Hashish- 30.5%
Cigarettes- 22.9%
100
What are five domains of risk factors for adolescent substance use and examples of each?
Personal: depressive symptoms, sensation-seeking tendencies, low-risk perception, drug use at an early age, favorable attitude towards substance use, violent and delinquent behavior, lack of social competence, low self-esteem
Family: low parental involvement or parental monitoring, family history of alcohol or drug use
School: low commitment to school, lack of school bonding, school failure/dropoutPeer: peer pressure, associating with peers who use,
100
What are some behavioral signs that caregivers might endorse to signal a potential substance use disorder?
"skipping school frequently, performing poorly in school, changing friends, and dropping activities or former interests... dangerous behavior like getting in fights or driving while impaired."
100
What forms of individual therapeutic modalities are most helpful in treating substance use in disorder in adolescents?
100
If you have a child or adolescent client who endorses using illicit substances within the course of their mental health treatment, under which circumstances can you share this information with: parent or guardian, other providers, and Child Protective Service (CPS) or law enforcement?
Typically, Federal Law CFR-42 states that SUD treatment is confidential unless appropriate consents are signed by the minor. Without consents, information can be shared when the SUD counselor perceives "substantial threat to the minor's life or well-being." Again, this is for SUD counseling that receives federal funding. Written consents are needed for all other parties.
200
Among high school seniors, what percentage report having consumed alcohol?
Roughly 67% (or 2 out of 3) report trying alcohol
Source: https://www.cdc.gov/ncbddd/fasd/features/teen-substance-use.html#first-ref
200
What are five examples of resiliency factors?
- optimism and hope
- self-efficacy
- strong self-regulation skills
- problem solving skills
- adaptability
- sense of humor
- easy temperament
- close relationships with family members
- low discord between parents
- warm and structured parenting styles
200
Which assessment focuses on primarily alcohol use?
A) SBIRT
B) DAST-10
C) AUDIT
D) CRAFFT
C) AUDIT
National Institute on Alcohol Abuse and Alcoholism, 2011AUDIT focuses on drinking patterns and alcohol-related behaviors. Research supports use of the this screening tool for adolescents ages 14 to 18, with cut points of two for identifying any alcohol problem use and three for alcohol abuse or dependence.
200
True or False: Given the developmental stage and needs of the adolescent, treatment outcomes are most successful when treatment efforts focus solely on drug use.
False: Treatment should address the needs of the whole person, rather than just focusing on his or her drug use. The best approach to treatment includes supporting the adolescent’s larger life needs, such as those related to medical, psychological, and social well-being, as well as housing, school, transportation, and legal services. Failing to address such needs simultaneously could sabotage the adolescent’s treatment success.
200
Risk assessment: In assessing for suicidal or homicidal risk, would active substance use influence your assessment? If so, under what conditions? Does this influence safety planning? If so, how?
Active substance use increases risk for suicidal or homicidal risk. If a patient is currently under the influence, has recently used, or is in active withdrawal, this should influence risk assessment and subsequent safety planning.
300
Among high school seniors, what percentage report consuming prescription medications without the necessary prescription?
Approximately 20% endorse consuming prescription medications illegally
Source: https://www.cdc.gov/ncbddd/fasd/features/teen-substance-use.html#first-ref
300
True or False: When teens begin drinking at an early age, they increase the chance of becoming addicted to or continuing to abuse substances later in life.
300
Which assessment focuses on primarily substance use?
A) DAST-10
B) AUDIT
C) CRAFFT
A) DAST-10
Centre for Addiction and Mental Health, 2006
For use with older youth and adults, this 10-item, yes/no self-report instrument was designed to provide a brief instrument for clinical screening and treatment evaluation.
Questions:
1. Have you used drugs other than those required for medical reasons?
2. Do you abuse more than one drug at a time?
3. Are you always able to stop using drugs when you want to?
4. Have you had “blackouts” or “flashbacks” as a result of drug use?
5. Do you ever feel bad or guilty about your drug use?
6. Does your spouse (or parents) ever complain about your involvement with drugs?
7. Have you neglected your family because of your use of drugs?
8. Have you engaged in illegal activities in order to obtain drugs?
9. Have you ever experienced withdrawal symptoms (felt sick) when you stopped taking drugs?
10. Have you had medical problems as a result of your drug use (e.g. memory loss, hepatitis, convulsions, bleeding, etc.)?
300
Can adolescents benefit from substance use interventions, even without a diagnosed substance use disorder or reported addiction?
Adolescents can benefit from a drug abuse intervention even if they are not addicted to a drug. For young people, any drug use (even if it seems like only “experimentation”), is cause for concern, as it exposes them to dangers from the drug and associated risky behaviors and may lead to more drug use in the future. Parents and other adults should monitor young people and not underestimate the significance of what may appear as isolated instances of drug taking.
300
If an adolescent client reports they are engaging in alcohol and substance use, and then proceeds to engage in risky behaviors, such as driving under the influence or sexual risk-taking, how would you proceed?
Depending on interpretation, this might fall under the CFR-42 limitation of threat to life or well-being, and information can be shared with caregivers. As a reminder, confidentiality and limits should always be reviewed at outset of treatment, and often throughout.
400
What percentage of high school students report using marijuana at least once?
Approximately 50% of 9th-12th graders endorse use
Source: https://www.cdc.gov/ncbddd/fasd/features/teen-substance-use.html#first-ref
400
What are the highest risk periods for drug abuse among youth?
Major transition periods. These transitions include significant changes in physical development (for example, puberty) or social situations (such as moving
or parents divorcing) when children experience heightened vulnerability for problem behaviors.
Source:
https://www.drugabuse.gov/sites/default/files/preventingdruguse_2.pdf
400
Which assessment focuses on both alcohol and substance use?
A) DAST-10
B) AUDIT
C) CRAFFT
C) CRAFFT
The Center for Adolescent Substance Abuse Research, 2009
A behavioral health screening tool for use with children under the age of 21, it consists of a series of six questions developed to screen adolescents for high risk alcohol and other drug use disorders simultaneously.
400
True or False: Self-help groups are not typically recommended as an adjunctive component of therapy for adolescents.
False: while self-help groups are not advocated in lieu of individual therapy, self-help groups can be a helpful, supportive adjunctive component to therapy.
400
If you are aware that an adolescent client is prescribed psychotropic medications as part of their treatment regime, and they also endorse active substance use, would you share such information with their psychiatric provider? If so, under what circumstances?
If the psychiatric provider is within your practice, then consents for collaboration should be executed at the beginning of treatment, but collaboration is typically expected. Otherwise, written consent is needed for community providers.
500
How many estimated adolescents and young adults have a substance use disorder (SUD)?
In 2015, in the United States, an estimated 1.3 million adolescents, aged 12 to 17, and 5.4 million young adults, aged 18 to 25, met diagnostic criteria for having a substance use disorder (SUD)
Source: https://effectivehealthcare.ahrq.gov/products/substance-use-disorders-adolescents/protocol
500
With the exception of some outliers, at what age does abuse of substances typically begin? Which substances are usually the first to be experimented with?
Studies such as the National Survey on Drug Use
and Health, reported by the Substance Abuse and Mental Health Services Administration, indicate that some children are already abusing
drugs by age 12 or 13, which likely means that some may begin even earlier. Early abuse includes such drugs as tobacco, alcohol, inhalants, marijuana,
and psychotherapeutic drugs.
Source: https://www.drugabuse.gov/sites/default/files/preventingdruguse_2.pdf
500
Case study: John, a 15-year-old cis-gender male, is referred for treatment by his parents. John's mother reports that John, once an avid soccer player and solid "B" student, has demonstrated some recent changes. John has begun to skip soccer practice, has difficulty getting up and arriving on time to school, and his grades have begun to decline. John's father reports that John appears increasingly tired, and spends more time sleeping or "lounging around on his phone." When you meet alone with John, he endorses "not caring" about much anymore, and just wanting to "sleep." John also endorses "smoking a joint, here and there" and occasionally "getting hammered" with his friends at parties, but "nothing too crazy."
What diagnoses are you considering for John (both psychiatric and substance related)? What more information might you need to accurately make this diagnosis? What assessments might you use?
Depression, Cannabis-Use Disorder, Alcohol Use Disorder
Additional information: timeline of symptom emergence (when did depressive symptoms emerge in comparison to substance use) and current use patterns, appearance of symptoms across contexts, motivation for substance use
Assessments: BDI, CRAFFT (or AUDIT & DAST-10)
500
Case study: John, a 15-year-old cis-gender male, is referred for treatment by his parents. John's mother reports that John, once an avid soccer player and solid "B" student, has demonstrated some recent changes. John has begun to skip soccer practice, has difficulty getting up and arriving on time to school, and his grades have begun to decline. John's father reports that John appears increasingly tired, and spends more time sleeping or "lounging around on his phone." When you meet alone with John, he endorses "not caring" about much anymore, and just wanting to "sleep." John also endorses "smoking a joint, here and there" and occasionally "getting hammered" with his friends at parties, but "nothing too crazy."
You speak with John's soccer coach and school counselor, who report similar concerns at school, in terms of "slipping grades" due to distraction and disengagement in the classroom, and increased absences. You are administer the BDI, in which John scores clinically significant for depressive symptoms, including recent suicidal ideation. Further interviews with John suggest he began engaging in alcohol and substance use following emergence of depressive symptoms.
In addition, John reports smoking marijuana "at least once a day" and often becoming irritable if he is unable to do so. John does report engaging in occasional alcohol use on the weekends, only when attending parties, and not exceeding two or three beers. John does not smoke and drink together, nor is he driving while under the influence.
What are current diagnostic recommendations? What additional information might you need? What would be your initial treatment recommendations?
Major Depressive Episode, Cannabis-Use Disorder, Rule Out: Alcohol Use Disorder
Additional information: ongoing assessment to determine possible additional diagnoses, such as Alcohol Use Disorder or Anxiety Disorder
Recommendations: individual therapy to address depressive concerns and minimize marijuana use (incorporate parents and possibly important others as indicated and supported by John), risk assessment and safety planning to address suicidal ideation, consultation with psychiatrist for potential medication supports, potential group therapy involvement, potential self-help involvement
500
How might ongoing medical monitoring of active substance use be influenced by age of the patient (i.e., under 18 years of age)?
Protocols of urine testing may change to accommodate for age.
Less invasive options may be prioritized.