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Course 6TBI - ToolKit for TBI - Guide 3 - Quiz 3

 

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1)
Moving to Study Guide 3 in this course: Problems with EXECUTIVE FUNCTIONS. Which below is accurate?
 
Executive functions are the cognitive processes that are responsible for regulating and managing both thinking and behavior.
The term “frontal lobe functioning” is sometimes used interchangeably with “executive functions” because so much of these activities are mediated by structures in the frontal lobes.
Difficulty with executive functioning is common as the result of both brain injury and the toxic effects of many substances including alcohol..
Problems with Executive Functions can include trouble with getting started on or finishing an activity, setting or sticking to goals, making decisions, maintaining relationships, solving problems, generating new ideas, and failing to see the big picture.
All of the above.
 
2)
A person with TBI may have problems with 'self-regulation' due to problems in frontal lobe functioning.
 
True False
 
3)
Using strategies to improve the EXECUTIVE FUNCTIONING of clients with co-occurring SUD and TBI is intended to do what?
 
identify triggers and personal situations that often precede problematic actions
develop routines and strategies that will halt impulsivity, prompt thinking, and overcome difficulty
give up and work on something else when mistakes occur.
know how to use the Goal Management Training approach - Set Goal, Plan, Do, Review, Revise
all but the third answer
 
4)
In the vignette about Gerry, the 'bottom line' lesson for counselors is ....
 
Progress may be slow in assessing the needs of dual diagnosis SUD-TBI clients - e.g., distinguishing between poor motivation and frontal lobe damage.
To understand what is actually going on in a client's cognitive response to therapy, seek more information beyond the initial personal and medical history.
From expanded medical history, decide if the individual could benefit from meta-cognitive strategies to enhance executive functions..
Avoid pressing for historical details about medical history that the client believes are now irrelevant or too personal.
All but the fourth option.
 
5)
Programming for individuals with concurrent SUD disorders and brain injury needs to take a long-term perspective—anticipating that interventions will take longer than for individuals with less complex difficulties.
 
True False
 
6)
People who are aware of the difficulties they are having with frontal lobe cognition are less likely to require environmental support to achieve their goals.
 
True False
 
7)
Intervention for co-occurring SUD-TBI is best conceptualized as OCCURRING IN PHASES. The first phase in working with people with concurrent SUD and TBI is _________.
 
focus on changes in behavior that reduce harm, support a healthy and engaged lifestyle, and may result in reducing substance use.
work on tasks that directly compete with substance use
prepare for referral to a structured treatment program for further intervention
engagement
 
8)
When offering group therapy to individuals with TBI, there is no need to include additional strategies beyond those that you use during their individual sessions.
 
True False
 
9)
For those with TBI who do participate in GROUP THERAPY, what adaptations are recommended?
 
Use a consistent format for group sessions: provide a brief summary of the previous group, outline the goal for the current session, provide a brief summary of the current session and the goal for the next.
Make individualized attendance plans for those who will be attending, including items such as transportation routes and departure times.
Use name tags and build in time for breaks.
Limit groups to no more than ten participants.
All but the fourth option.
 
10)
Outreach: Many clients with brain injury will require a more assertive approach to care, which may include meeting clients in the community (home-based services).
 
True False
 
11)
Substance use after brain injury can have the following effect:
 
Delayed recovery from brain injury
Self-medicating as a coping strategy
Less impulsivity
Worsening issues with balance, walking, communicating, and thinking (concentration and memory)
All but the third option.
 
12)
Ways to respond in many given situations is no longer automatic following a TBI. A major part of therapy is developing 'scripts' with the client to re-learn behaviors and responses in specific situations.
 
A 'script' (that describes a strategy for a specific situation) is developed and reviewed with the client in sessions.
The client is taught to recognize where and when a particular behavior might be useful, using helpful clues.
The client is encouraged to use scripts in a functional way, with gradually fading clues.
All of the above
 
13)
Moving to Motivational Interviewing (MI): MI is important part of the SUD treatment protocol. However, because of brain injury deficits—including memory problems, problems staying on track, etc—Motivational Interviewing must be ADAPTED for those with co-occurring SUD and brain injury. What is NOT a way to ADAPT Motivational Interviewing?
 
Summaries should be frequent, brief, and provided through notes or diagrams that are created in a collaborative way.
Sessions should begin with a review of previous summaries, and counselors should directly influence the course of the conversation by reminding clients of the topic at hand.
Ask open-ended questions, to allow for creativity and spontaneous conversation.
Use written notes, menus of topics, and visual cues to set a clear agenda for sessions.
 
14)
In Motivational Interviewing with co-occurring SUD and TBI, the therapist may need to directly influence the course of the conversation in ways that differ from traditional therapy. What are ways to do this?
 
Remind clients of the topic at hand
Ask permission to be more directive. For example, 'We both want to make the best use of our time together.'
'If we get off track, how can I let you know? Can we use this agenda to keep us focused?'
Use summaries extensively, orally and in writing - prior to session, at end of session, and prior to the following session.
All of the above.
 
15)
END OF THIS COURSE: ADAPTATIONS TO COUNSELING SKILLS, including Motivational Interviewing, to accommodate brain injury: SUMMARIES of plans and session content should be frequent, brief, and provided in more than one way—using notes or diagrams that are created in a collaborative way. Sessions should begin with a review of the previous session and goals for the current session.
 
True False
 

 

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