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Substance Abuse Treatment and Family Therapy (Revised)

Substance Abuse Treatment and Family Therapy

1. In family therapy, geographically distant family members can play an important role in substance abuse treatment and need to be brought into the therapeutic process despite geographical distance.

A. True

B. False


2. Which of the following may be considered family for the purposes of therapy?

A. Anyone who is instrumental in providing support.

B. Anyone who is instrumental in maintaining the household.

C. Anyone who is instrumental in providing financial resources.

D. All of the above.


3. Which of the following is the main purpose for family therapy in substance abuse treatment?

A. It seeks to use family’s strengths and resources to help find or develop ways to live without substances of abuse.

B. It ameliorates the impact of chemical dependency on both the IP and the family.

C. Both (A) and (B) are main purposes for family therapy in substance abuse treatment.

D. None of the above.


4. Home-based therapy breaks from the traditional clinical setting, reasoning that joining the family where it lives can help overcome shame, stigma, and resistance.

A. True

B. False


5. Which of the following family therapy models, used as the base for treatment and specific interventions for substance abuse, is based on the idea that maladaptive behaviors, including substance use and abuse, are reinforced through family interactions?

A. The family systems model

B. Cognitive-behavioral approaches

C. The family disease model

D. Multidimensional family therapy


6. Family therapy answers which of the following questions?

A. Why should children or adolescents be involved in the treatment of a parent who abuses substances?

B. What impact does a parent abusing substances have on his or her children?

C. How does adolescent substance abuse impact adults?

D. All of the above.


7. Whether a child or adult is the family member who uses substances, the entire family system needs to change, not just the IP.

A. True

B. False


8. Family therapy helps:

A. The family make interpersonal, intrapersonal, and environmental changes affecting the person using alcohol or drugs.

B. The nonusing members to work together more effectively and to define personal goals for therapy beyond a vague notion of improved family functioning.

C. All family members understand what is occurring.

D. All of the above.


9. The single most potent risk factor of future maladaption, predisposition to substance use, and psychological difficulties is:

A. A parent’s substance-abusing behavior.

B. A sibling’s substance-abusing behavior.

C. Heavy peer pressure to use and abuse drugs.

D. All of the above.


10. Chronic diseases and substance abuse share all of the following similarities, except for:

A. They are long-standing and progressive.

B. They often result from behavioral choices.

C. They are treatable and curable.

D. They have high probability of relapse.


11. Family therapy may be especially effective for someone whose drug use has caused significant organic brain damage.

A. True

B. False


12. Family therapy treatments for substance abuse must be designed to be relatively brief and to target aspects of the family’s environment that may be maintaining the drug abuse symptomatology.

A. True

B. False


13. The need for cultural competence implies that a therapist must belong to the same cultural group as the client family.

A. True

B. False


14. Which of the following levels of recovery is a time when clients must cope with problems revolving around the cessation of substance use?

A. Dry abstinence

B. Sobriety / early recovery

C. Advanced recovery

D. Adjustment to sobriety


15. Family therapy should only be used when one family member is not being terrorized by another.

A. True

B. False


Impact of Substance Abuse on Families

16. In families with the _____ characteristic pattern of interaction, the only way to get attention or enliven the situation is to create a crisis.

A. Parental inconsistency

B. Negativism

C. Miscarried expression of anger

D. Unrealistic parental expectations


17. All of the following apply to a person with no immediate family, except for:

A. Family therapy should not automatically be ruled out.

B. A single person who abuses substances may continue to have an impact on distant family members who may be willing to take part in family therapy.

C. Just as important as how family members interact with each other, is how many family members are present.

D. If family members come from a distance, intensive session of more than 2 hours may be needed and helpful.


18. Codependent people are thought to have all of the following patterns of behavior, except for:

A. They are controlling because they believe that others are incapable of taking care of themselves.

B. Although they typically have high self-esteem they have a tendency to deny their own feelings.

C. They are excessively compliant, compromising their own values and integrity to avoid rejection or anger.

D. They often react in an oversensitive manner, as they are often hypervigilant to disruption, troubles, or disappointments.


19. Sibling relationships characterized by _____ can protect adolescents against substance abuse.

A. Mutual attachment

B. Nurturance

C. Lack of conflict

D. All of the above


20. In many families that include adolescents who abuse substances, at least one parent also abuses substances.

A. True

B. False


Approaches to Therapy

21. In substance abuse treatment, all of the following apply to denial, except for:

A. It is a deliberate, willful act on the part of the person who is abusing substances.

B. It is a common reaction of people with substance use disorders who, when confronted with the existence of those disorders, deny that they have a substance abuse problem.

C. It is a complex reaction that is the product of psychological and physiological factors, especially those concerned with memory and the influence of euphoria produced by the substance of abuse.

D. All of the above apply to denial.


22. Even if clinicians treat individual clients, or their families, at their actual stage of readiness or level of motivation to change, they will still encounter significant client resistance due to the disease of addiction.

A. True

B. False


23. Feminist and cultural family therapists caution that by ignoring the power differentials within and between cultures, therapists can potentially harm the client and family.

A. True

B. False


24. While the specific barriers the provider will encounter will vary for clients in different treatment settings, which of the following is an essential topic to review for appropriate interventions?

A. Family motivation / influence

B. Balance of hierarchal power

C. General willingness for the family and its members to change

D. All of the above


25. Along the same idea as 12-Step programs, it is desirable to cast a person abusing substances as a totally powerless entity.

A. True

B. False


26. Research has shown the confrontational approach with substance abusing clients to be the most effective method for getting clients to overcome denial.

A. True

B. False


27. All of the following are goals of behavioral contracting therapy, except for:

A. Identify and address the family’s problems as family problems.

B. Help everyone in the family achieve appropriate responsibility for self and decrease inappropriate responsibility for others.

C. Develop a substance-free environment.

D. Help families cope with the emotional distress that the removal of substance abuse can cause.


28. The initial goal of multisystemic therapy is to:

A. Engage family members and, if necessary, to identify barriers to engagement and develop strategies for overcoming those barriers.

B. Understand specific problems in a real-world context.

C. Examine the strengths and needs of each system and their relationship to the identified problem.

D. Address risk and protective factors as they impact the family from a range of sources.


29. Which of the following is a strategy or technique under the Wegscheider-Cruse’s theory?

A. Educate every family member about the disease.

B. Break through the family’s denial.

C. Confront any crisis.

D. All of the above.


30. When boundaries are too weak, family members can become psychologically and emotionally enmeshed and lose their ability to act as individuals.

A. True

B. False


31. Families that have members who abuse substances are more likely to show an excess of flexibility, rather than a lack of flexibility.

A. True

B. False


32. One of the basic techniques of structural family therapy is to:

A. Identify and adjust to the family’s way of relating to each other, which will make resistance less likely.

B. Show respect to each person by virtue of their family role.

C. Mark boundaries so that each member of the family can be responsible for him- or herself while respecting the individuality of others.

D. All of the above.


33. One of the ways to make respectful individuation possible is to make the family aware when a family member:

A. Speaks about, rather than to, another person who is present.

B. Speaks for others, instead of letting them speak for themselves.

C. Sends nonverbal cues to influence or stop another person from speaking.

D. All of the above.


Integrated Models for Treating Family Members

34. All of the following are practical advantages of the integrated models for the treatment providers, except for:

A. Reduced resistance

B. Intergenerational impact

C. Flexibility in treatment planning

D. Flexibility in treatment approach


35. To determine a counselor’s level of involvement with a specific family, which factor must be considered?

A. The counselor’s level of experience.

B. The counselor’s level of comfort.

C. Both (A) and (B).

D. None of the above.


36. All of the following models have demonstrated effectiveness in treating substance use disorders, except for:

A. Solution-focused brief therapy

B. Structural / strategic family therapy

C. Multidimensional family therapy

D. Multisystemic therapy


37. All of the following apply to multiple family therapy, except for:

A. All family members, including those who are currently abusing drugs or alcohol are included.

B. Families sit together in a circle, with several therapists interspersed among the group.

C. After the purpose of the meeting is described and the need for open communication is stressed, one family’s situation is discussed for about an hour.

D. Three or four families are the subject for each session, although all the families participate in the discussion.


38. The counselor can use which of the following techniques to facilitate behavioral change within a family to support abstinence from substance use?

A. Contingency contracting

B. Skills training

C. Cognitive restructuring

D. All of the above


39. The goal of family / larger systems therapy is to empower the family in its dealings with larger systems, which begins when the counselor designates:

A. What larger systems affects the family.

B. The family as the major expert on the family.

C. What agencies and agency subsystems regularly interact with family members.

D. How the family is moved from one larger system to another.


40. Bowen family systems therapists believe that all family dysfunctions, including substance abuse, come from ineffective management of the _____ in a family system.

A. Roles

B. Hierarchy

C. Anxiety

D. All of the above


41. It is believed that the Bowen family systems therapy is a good match for clients with substance use disorders who have immigrated to this country because it emphasizes the intergenerational transmission of anxiety and the effects of trauma that are passed down through generations.

A. True

B. False


42. Solution-focused brief therapy focuses on an extensive description of the problem with emphasis on understanding the development of the problem in the past or its maintenance in the present.

A. True

B. False


43. The most important feature of the miracle question is:

A. Its transfer of power to clients.

B. Its ability to help the client imagine what life would be like if their problems were solved.

C. The hope of change it gives to clients.

D. The preview of the benefits of change for clients.


Specific Populations

44. When a child is abusing substances, which of the following is probably the most useful approach?

A. Network and family / larger system therapy

B. Multifamily therapy

C. Single family therapy

D. All of the above


45. Play therapy refers to all of the following, except:

A. The use of toys, games, puppets, and models.

B. Playful interactions in therapy.

C. Role playing.

D. Structured and often non-verbal processes.


46. Substance use in the teen years is associated with:

A. Conduct disorders

B. Oppositional disorders

C. Eating disorders

D. All of the above


47. In general, treatment is less effective and the prognosis less optimistic for people with later-onset substance disorders.

A. True

B. False


48. One of the biggest psychosocial differentials between men and women who abuse substances is stigma.

A. True

B. False


49. A recurring theme in the lives of women with substance use disorders is:

A. A lack of healthy relationships.

B. A history of trauma.

C. The death of a spouse or child.

D. All of the above.


50. A particular treatment issue relevant to women is:

A. Shame

B. Trauma

C. Control over her life

D. All of the above


51. Which of the following is the single most important element in working with African-American families?

A. The personal connection between family members.

B. The personal connection between family and therapist.

C. Offering an educational orientation about treatment, alcohol, and other drugs.

D. All of the above.


52. Some single-parent families have a parental child who helps the mother take care of other children, particularly while the mother is working.  The existence of a parental child indicates dysfunction.

A. True

B. False


53. Which of the following is a component of the core construct among Hispanic and other ethnic-minority cultures known as familialism / familismo?

A. Perceived obligations toward helping family members.

B. Reliance on support from family members.

C. The use of family members as behavioral and attitudinal referents.

D. All of the above.


54. Hispanics / Latinos may perceive therapy interventions as incompetent or misguided if they openly encourage young people to speak their mind or tell parents what they really think.

A. True

B. False


55. Despite the diversity among the Asian subgroups, Asian immigrants and refugees share all of the following traits, except for:

A. Deference to authority

B. Emotional inhibition

C. Disregard for specific roles

D. Hierarchical families


56. Family therapy with Asian Americans is least likely to include younger generations.

A. True

B. False


57. Which of the following factors that cause conflict within Asian families is attributable to acculturation?

A. Women receiving increased status.

B. Children no longer demonstrating the highest regard for their elders.

C. Older family members losing their preeminence as the keepers of tradition.

D. All of the above.


58. It is recommended that therapists delve into the ethic differences between the American Indian family and the therapist in a direct manner.

A. True

B. False


59. Speaking with an American Indian as a human being, rather than as an “Indian,” will help to build trust.

A. True

B. False


60. When working with American Indians, it is suggested that therapists not take notes at the beginning of therapy as it can be taken as a sign that they are not listening.

A. True

B. False


61. The therapist should do each of the following when working with American-Indian clients, except for:

A. The therapist should include only the nuclear family members due to the privacy nature of American-Indian families.

B. The therapist should present suggestions in a slow and calm manner, indicating attention to clients’ time-oriented approach.

C. The therapist should determine whether all family members belong to the same tribe, as intertribal issues could be a source of conflict.

D. The therapist should allow family members to be involved in directing the process of therapy.


62. One of the overriding goals of treatment for people with disabilities is that they:

A. Focus on the choices at their disposal.

B. Gain and maintain self-awareness about their functional limitations and capacities, as well as their substance use disorders.

C. Learn social skills that are missing because of substance use disorders and disability-related problems.

D. Become educated about their legal rights to accessible environments and services as well as employment.


63. The key to successfully delivering therapeutic services in rural communities is:

A. Balancing the need to effect family change on a macro level with the equally important need of maintaining confidentiality.

B. Being willing to do in-home family therapy.

C. Gaining acceptance from the community and client population.

D. Working with faith-based, community, and spiritual groups.


Policy and Program Issues

64. Collecting data about the client’s family serves which of the following purposes?

A. It yields a more thorough, and perhaps more accurate, family history.

B. It presents an opportunity to confirm and clarify information on the client.

C. It can provide insight into the context where substance abuse most often occurs and where it may have started or accelerated.

D. All of the above.


65. Staff should be careful about asking for details in a way that may be experienced by the client as an interrogation.

A. True

B. False


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