Directions: In sections where there is True of False questions please bold your answer choice:
Section 1 (Substance)
- Provide me with a short overview of substance use disorders:
Substance use disorders affect an individual’s brain and behavior, resulting in the inability to manage the use of a substance. Over time, one may need to consume more of the substance to attain a state of euphoria. This could potentially result in the user quickly becoming dependent on the substance.
If the substance use develops into an addiction, this might make it increasingly difficult to reduce one’s drug use. It is probable that attempting to reduce your drug use can cause you to feel physically ill with withdrawal symptoms (withdrawal symptoms). If one wish to overcome and maintain control of their drug addiction, they may need the help of a doctor, family members, friends, support groups, or an organized treatment program.
Addiction to drugs, like many other mental health difficulties, can be triggered by a multitude of factors. Aspects like the environment. There is a substantial link between a person’s exposure to their family’s thoughts and attitudes and their exposure to a drug-using peer group. Genetics once you’ve started taking a medication, inherited (genetic) characteristics can either halt or speed up the progression of the condition. The conviction that you must use the drug on a daily or even multiple-day basis is one of the indicators or behaviors of addiction. A strong desire to take the drug that completely obliterates all other thoughts. The amount of medicine required to get the same effect grows over time. Because the medicine was used in higher doses and for longer periods of time than anticipated, having a supply on hand is critical. Also one continues to spend money on the drug even if one cannot afford it. Inability to fulfill tasks at home or at work, or to fully participate in social or recreational activities as a result of drug use.
- Intoxication is considered substance induced
T F
- Is withdrawal only limited to substance use?
T F
- What is tolerance:
Tolerance is essentially how much of a substance an individual can consume before they begin to feel the side effects, or some other effect, of the substance. Tolerance changes over time and varies from person to person and based on an individuals’ past experiences and repeated use with the substance. In any event, tolerance occurs when someone no longer responds to a particular substance in the way they did at first. This means that they now need to consume or take more of the drug in order to achieve the desired effect or “high” that they crave.
It should be noted that there are 3 types of tolerance. Acute tolerance is when it builds over a short period of time, chronic tolerance is when someone’s body and brain adapt to the effects of the drug over a prolonged period, and learned tolerance occurs from exposure to addictive substances, like alcohol.
Though sometimes used interchangeably, tolerance and dependence are not the same. Dependence occurs when a person stops using a drug and they go through withdrawal.
- What are some important factors that a clinician needs to know when working with someone with tobacco issues?
First, the clinician should speak with the client candidly about the extent and reasoning for the tobacco use. The clinician should hopefully be able to assess whether the client seems ready to quit. This is important because a clinician advising a client with tobacco issues to quit only works if it is done properly and with care. For example, guiding them on proper coping mechanisms without relying on tobacco or cigarettes. It should be a gradual progression, as instant quitting will not likely prove beneficial.
Section II (Sexual Dysfunction)
- Define delayed ejaculation and some issues related to it
Delayed ejaculation occurs when it takes an extended period of sexual stimulation for a male to achieve a sexual climax and ejaculate. In some cases, a male is unable to ejaculate at all. Depending on the male’s circumstances, this can be either a temporary or lifelong condition. However, it is also normal for men to have delayed ejaculation on occasion. It only becomes problematic when it is an ongoing issue and causes stress for you and/or your partner.
Delayed ejaculation can occur because of certain underlying chronic health conditions, surgeries, and medications. In some cases, it can be attributed to some combination of physical and psychological concerns.
- Is delayed ejaculation and erectile disorder the same:
T F
- Define the term female orgasmic disorder:
Female orgasmic disorder is simply when a female experiences difficulty achieving an orgasm. That is, it is a delay in achieving an orgasm (sexual climax). In this way, it bears resemblance to a male’s delayed ejaculation condition in that they both involve difficulty or a delay in reaching their sexual climax.
For women specifically though, it occurs either when the orgasm is infrequent or less pleasurable despite sufficient sexual stimulation and sexual arousal. This is an important criterion because there are other reasons why a woman may be unable to achieve sexual climax, such as insufficient arousal or stimulation. Female orgasmic disorder requires a woman to still be unable to climax despite satisfactory sexual activity.
- Define the term male hypoactive sexual desire disorder:
Hypoactive sexual desire disorder in men are persistent deficient sexual or erotic, thoughts, feelings, or desires. This lessened desire for sexual activity persist for at least six months and cause significant distress. Although it was previously a non-gender specific disorder, it is now only counted for in men by the DSM-5 because sexual problems for women were combined into a single disorder.
To sum, it is when a male has inhibited sexual feelings, thoughts, or desires.
- How would you work with a client that suffers from premature early ejaculation issues?
Premature early ejaculation issues come with unique psychological concerns and issues for the male afflicted with it. Consequently, psychological treatment for men and couples with PE should address issues of self-esteem, performance anxiety, and interpersonal conflict. The challenge, however, is that it is difficult to ascertain which specific psychotherapy strategies are most effect for these issues. There are few studies, but those that exist suggest psychological intervention could be beneficial at resolving the underlying issues.
Beyond psychological interventions, topics anesthetics are also sometimes used. I would stress patience because it might take some time to find the right combination of treatment that works best for the patient. For example, it might include some combination of behavioral techniques, topical anesthetics, counselling sessions, and maybe medications. It is important to reassure the patient that this is not anything to worry about, because it commonly affects men.
Short answer portion of the EXAM
- How would you work with an individual that suffers from gender dysphoria as an adolescent?
In this case, it is important to ensure that the patient’s mental health, quality of life, and sense of self-worth are upheld and treated with respect. It is important to ensure that individuals with gender dysphoria feel more confident in expressing their gender identity in relationships, education, and in the workplace.
Therapy can be used to help in this instance, such as by helping integrate one’s gender identification into their everyday life and embracing who they are. It could also help identifying and addressing the psychological and emotional consequences of stress. Depending on the patient’s desires, consultation by a specialist with expertise in transgender and intersex health would be recommended prior to hormone and/or surgical treatment of gender dysphoria.
- What is the criteria for gender dysphoria in adults?
According to the DSM-5, gender dysphoria occurs when an adolescent or adult experiences an incongruence between their expressed gender and the gender they were assigned at birth. These feelings need to persist consistently for a minimum of 6 months although, depending on age, some clinicians may wait a little longer to meet this determination. Further criteria for gender dysphoria include:
- Incongruence between their expressed gender and their biological sex characteristics (primary/secondary sex characteristics), and a consistent desire to rid oneself of their primary or secondary sex characteristics because of this incongruence
- A desire for one’s primary and secondary sex characteristics to be that of the opposite gender, or some other gender apart from what they were assigned at birth
- A desire to identify and be treated as the opposite gender, or some other gender apart from what they were assigned at birth
- What are the environmental factors that males experience with gender dysphoria?
Gender dysphoria can negatively affect one’s life, since they can be preoccupied with being of a different gender than that to which one was assigned at birth. People who struggle with gender dysphoria may have increased absenteeism or withdrawal from social events, because they feel afraid of dressing in a manner consistent with the gender they identify as. In other words, they may feel peer pressure to dress in a manner consistent with their assigned sex for fear of being bullied. Relationship problems are also possible, as are anxiety, depression, self-harm, and eating disorders. These concerns typically stem from discrimination and the stigma, further complicated by the lack of access to health and mental health care from providers who are experts in helping individuals with gender dysphoria.
- What is reactive attachment disorder
Reactive attachment disorder is when a young child is unable to form a healthy emotional bond with their primary caregivers, normally their parents. As a result, they are less likely to interact with other people in their lives because of their negative experiences with adults in their early years. Oftentimes, these children appear mostly unhappy, irritable, sad or scared while interacting with their primary caregivers.
Though relatively uncommon, it is serious because attachment is the deep, trusting connection a child should develop with their parents. This connection, or attachment, is normally encoded into the young child’s brain in their early years as they develop. This promotes the child’s future development.
- Provide me with the diagnostic criteria for PTSD
According to the DSM-5, the diagnostic criteria for PTSD is comprised of eight different components, as described below:
- Criterion A:
- Exposed to at least one kind of stressor, whether through direct exposure or witnessing a trauma
- Criterion B:
- The trauma introduces in your life consistently, such as through nightmares, flashbacks, persistent emotional distress and physical reactivity
- Criterion C:
- The individual avoids any trauma-related stimuli, which could be thoughts or physical reminders of anything relating to the traumatic incident
- Criterion D:
- Negative thoughts or feelings that occurred directly after the trauma
- Criterion E:
- Trauma-related reactivity that began or worsened directly after the trauma, such as aggression, irritability, risky behavior, hypervigilance, difficulty concentrating
- Criterion F:
- Symptoms occurring for over 1 month
- Criterion G:
- Symptoms create a sense of distress or impairment for the afflicted individual
- Criterion H:
- Symptoms not related to some other underlying illness, substance use, or medication being taken
- Can children 6 years and younger be diagnosed with PTSD and if so, how would you work with?
Yes, children under 6 years can be diagnosed with PTSD. However, there is a somewhat different type of criteria for children in this age range. This can occur as a result of adverse childhood experiences, such as sexual abuse, school violence (such as school shootings), natural disasters, and life-threatening illnesses.
Some common signs of PTSD in children include loss of appetite, difficulty concentrating, nightmares, fearfulness, and isolation from family and friends. Though a lot of the PTSD criterion established for adults apply to children under 6, the specific behaviours tend to be age-specific. For example, behavioural changes in young children might be crying or screaming a lot.
In working with a child with PTSD, it is important to be mindful of the child’s relative age and the profound ways the trauma impacts them. Thus, it is imperative that the child be treated by a clinician who is properly qualified to work with children given their particular vulnerability. Cognitive behavioural therapy (CBT) is likely the treatment method best used for children, which typically involves psychoeducation for both parent and child, skills-building to deal with what the child is experiencing, and then gradually revisiting the trauma. At each step, it is important for the parents to be involved.
- What is acute stress disorder?
Acute stress disorder can occur after someone has experienced or witnessed some deeply traumatic event. Unlike PTSD, acute stress disorder is often a short-term condition and does not often require significant treatment (even though some may benefit from it). It can occur following natural disasters, assaults, car accidents, the sudden death of a loved one, or even receiving a life-threatening diagnosis. Overall, it occurs following some unexpected life event that is traumatizing to the afflicted individual.
