Quadrants of Care
Which quadrant level would you see a client working in private practice?
Quadrant 1
Which stage is the person unaware that a problem exists?
Precontemplation
Which treatment/recovery plans are most effective for clients with co-occurring SUD and ADHD?
Sequential - SUD treated prior to mental health disorder, segregation of services, safety reasons
Integrated - Connect/conceptualize presenting issue, identifying how both disorders impact each other
What is important when assessing individuals with co-occurring depressive and SUDs?
To not jump to conclusions about the nature or cause of the depression, to keep an open mind and attitude of flexibility.
What are some of the reasons bipolar disorders are the most missed and misdiagnosed disorders?
Accurate diagnosis not received until symptoms have occurred a decade or more
When co-occurring substance use disorders cloud the diagnostic picture
Co-occurring mental disorders and personality disorders
Commonly seeking treatment when they are in a depressed phase of the illness
What type of service would someone with a mild substance use issue (m) and a sever mental illness (S) be seeking?
Inpatient detox, rehab facilities, intensive outpatient, outpatient substance use programs with co-occurring focus
Which stage does the client need to reinvest in recovery and put plans into motion that will get them back on track?
Relapse/Recycle
What does CBT/cognitive training address?
Distorted patterns of thinking.
Works with impulses and bx.
Helps to develop long-range goals vs. short term gratification, in connection to the misuse of drugs and alcohol.
Name the 3 screening tools that can be valuable to use in both initial assessment and ongoing treatment of depression.
Beck Depression Inventory-II
Hamilton Rating Scale for Depression
Patient Health Questionnaire 9 (PHQ-9)
Name 3 symptoms of a manic episode.
Pg. 158
Which service do quadrants IV and II have in common?
Case management
What is one thought/goal from the Action stage of change?
Today, I'm not going to drink.
I moved out when he was at work am staying safe at a safe house.
I've started CBT for my bulimia, and I might take medication, as well.
Which populations can abuse stimulant medications, such as Adderall, Dexedrine, and Ritalin?
High school and college students (favored for euphoric effects and ability to work longer)
Those looking to lose weight, as well as those with eating disorders for appetite suppressant
Long-distance truck drivers to ward off fatigue
Name the 5 forms of treatment that can be used to treat Depressive Disorders and SUDs.
Psychosocial Treatments - CBT, interpersonal psychotherapy, psychodynamic psychotherapy
Pharmacology - antidepressants used appropriately
ECT - for those with severe depression and have not responded to multiple medication trials
TMS
Vagus Nerve Stimulation
What are the 5 parts of the integrated clinical approach for bipolar disorder and SUDs?
1. Thorough clinical assessment
2. Patient education about both
3. Including important supports in treatment
4. Evidence-based psychotherapies for bipolar disorder - IGT, FFT
5. Other psychotherapies - CBT, REBT, DBT - adapted to incorporate both issues relevant to SUDs and bipolar disorder