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Enhancing Motivation and Change in Substance Abuse Treatment
Chapters 1, 2, 3, 8 & 9
Chapter 1 Conceptualizing Motivation and Change
1. Motivation: is a key to change, is multidimensional, is dynamic and _____.
A. can be emotional
B. can be modified
C. can be challenged
2. Critical life events often stimulate the motivation to change.
3. Research has shown that motivation enhancing approaches are associated with greater participation in treatment and _______________________.
A. positive treatment outcomes
B. negative outcomes
C. motivation outcomes.
4. Some of the benefits of employing motivational enhancement techniques include:
A. Inspiring motivation to change
B. Engaging and retaining clients in treatment
C. improving treatment outcomes
D. All of the above
E. Only A & C
5. The spiritual model of addiction is one of the most influential in America, largely because of:
A. Spiritual leaders
B. The Church
C. 12 step programs
6. Because substance-related problems are seen as occurring in interactive relations with families groups and communities, alterations in policies, laws and norms are ___________________.
A. part of the problem
B. part of the change process
C. part of the status quo
7. The field of addiction is evolving toward more comprehensive understanding of substance misuse and abuse, earlier views of addiction no longer persist in treatment.
8. The term confrontation can reflect the assumption that denial and other defense mechanisms must be aggressively ____________________.
A. broken through and torn down
C. dismissed and ignored
9. The treatment field has historically focused on the deficits and limitations of clients, there is a greater emphasis today on identifying, enhancing and using clients strengths and competencies.
10. Therapeutic partnership: The clinician who uses motivational strategies establishes a therapeutic alliance with the client and ____________ and change strategies.
A. the clinician
B. the goals of the clinician
C. elicits goals
11. Treatment goals include a broad range of biopsychosocial measures, such as reduction in substance use, improvement in health and phychosocial functioning, improvement in employment stability and reduction in _______.
A. using activities
B. negative behaviors
C. criminal justice activities
12. Change occurs in the natural environment, among all people, in relation to many behaviors and without professional intervention.
13. The change process has been conceptualized as a sequence of stages through which people typically progress as they __________________.
A. think about initiate and maintain new behaviors
B. stop using
C. find new activities
14. There are four stages of change
15. At the point of contemplation, they may seek relevant information, reevaluate their substance use behaviors, or seed help to support the _____.
A. their beliefs
B. possibility of changing behaviors
C. their using
16. The multidimensional nature of motivation is captured in part in the popular phrase that a person is ______________________________.
A. ready, willing and able to change
B. ready to believe it, think it and be it.
C. fake it until you make it.
17. Motivation interviewing was originally developed to work with problem alcohol drinkers at early stages of readiness and was conceived as a way of initiating treatment.
Chapter 2 Motivation & Intervention
18. Using the transtheoretical perspective…seeks to assist in moving from the early stage of change to ________________________.
A. willingness or ready to change
B. determination or action
C. seeing the possibilities.
19. FRAMES: stands for: Feedback, Responsibility, Advice Empathic and ____
C. self- efficacy
20. A Motivational approach allows clients to be active rather than passive by insisting that the choose their treatment and ____________________.
A. stay clean and sober
B. take responsibility for change
C. work through their issues
21. The Realistic Model of Change points out that difficulties and set backs can be __________ as learning experiences, not failures.
22. Simple acts of giving gentle advise can promote positive behavioral change.
23. The PIE’s approach
24. Flexible Pacing: Every client moves through the stages of change in their own pace.
25. “Special Application” of motivational approaches have been or are currently being explored with diabetic patients, for pain management, in coronary heart disease rehabilitation, for HIV risk reduction, with sex offenders, with pregnant alcohol drinkers, with severely alcohol-impaired veterans, with persons who have eating disorders and with individuals with coexisting substance use and psychiatric disorders.
26. Another sensitive are in matching the clients with the clinician, although the literature suggests that warmth, empathy, and genuine respect are more important in building a therapeutic partnership than professional training or experience, nevertheless, program can identify those clinician who may be optimally suited because of _____ to work with clients from specific populations.
A. cultural identification, language or similar background
B. cultural identification, speech without regard to background
C. cultural beliefs, language and an understanding of background
27. Brief interventions have been used effectively with in substance abuse treatment settings with persons seeking assistance, by placed on waiting lists, as a motivational prelude to engagement and participation in more intensive treatment and as a first attempt to ___________________.
A. control negative behaviors
B. facilitate behavior change with little additional clinical attention
C. accept the process of change
28. Motivational interviewing is a counseling style based on the following assumption(s):
A. the client leads the content
B. the alliance between you and your client is collaborative partnership to which you each bring important expertise
C. the counselor bring parallel expriences
29. Principles of Motivational Interviewing
– Express Empathy through reflective listening
– Develop discrepancy between clients goals & values and current behavior
– Adjust to client resistance
– Support self-efficacy and optimism
A. avoid argument and direct confrontation
B. reflect clients behaviors
C. re-state clients statements
30. Rolling with resistance: One strategy for adapting to clients resistance is to side with the negative by restating the client’s words.
31. Opening strategies for Early Sessions:
– Ask open ended questions
– Listen Reflectively
– Elicit self-motivational statements
C. accepting change
Chapter 8 Measuring Components of Client Motivation
32. Ways of measuring Motivation Self efficacy – Readiness to Change – Motivational for suing substance- Goals and Values and ______________.
A. making a client counselor connection
B. developing new behaviors
C. decisional balancing
33. “Would you like to reduce or quite drinking if you could do so easily” is one of the four questions in the Readiness to change questions.
34. Decisional balancing: The general benefits of the behavior and also of changing it – are weighed against the cost, allowing clients to appraise the impact of their behavior and:
A. make more informed choices regarding changing it
B. make correct discussions regarding changing it
C. make proper choices regarding changing it
Chapter 9 Integrating Motivational Approaches Into Treatment Programs
35. A review of the Cost-effectiveness of treatment for alcohol use disorders concluded that brief motivational counseling ranked among the most effective treatment modalities, based on weighted evidence from rigorous clinical trials.
36. Often, there is a relatively short period of time in which you, the clinician, can make a
A. beneficial impact
37. The application of motivational intervention with African-American clients has been ___________ trough the contextualization of personal substance use within a historical and societal reality.
38. Many motivation-enhancing activities can take place in group therapy that cannot be done in
A. regular sessions
B. individual treatment
C. extended treatment
39. In group therapy, all clients act as ____________ by helping each other.
C. Agents of change
40. In group therapy, particularly using motivational techniques and strategies, clients struggle with the group environment
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