Certified Clinical Trauma Specialist: Trauma and Addiction (2021)

Welcome to your Certified Clinical Trauma Specialist: Trauma and Addiction (2021)

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Changes in the hormones and biochemistry of the body lead to _____ changes in behavior, emotions, and thinking

Abnormal

Problematic

Predictable

Volitional

Which of the following is NOT a salutogenic asset-focused counselor characteristic?

Skilled in delivering information lengthily

Awareness of one’s own beliefs, preferences, needs and biases

Experienced in strengthening personal reliance to stressors

Ability to give a believable and reasonable rationale for information

Which of the following questions about symptoms asks about duration?

When has it stopped immediately?

When does the problem occur?

What have you discovered that increases how much it happens?

Is there anywhere the problem does not occur?

In 2010, what percentage of people had 1 ACE?

9.5%

24%

26%

41%

Which of the following is NOT a way to stimulate the vagus nerve?

Loud singing, chanting, or humming

Yoga poses (such as twists)

Inhaling longer than exhaling

Cold water immersion

How many drug overdose deaths occurred in the United States in the 12 months ending in May 2020?

53,000

68,000

79,000

81,000

According to the American Medical Association in 1957, what is “primary”?

The illness does not go away, heal spontaneously, or remit

The illness will result in death if left untreated

The illness exists in and of itself

The illness gets worse over time

What can happen when there is a large increase in noradrenalin?

Fear, withdrawal, flight

Depression, sadness

Anxiety, increased energy, mania

Anger, aggression, and hostility

Why was treatment unsuccessful for Jaime?

Overuse of trauma treatment in substance abuse facility

Shame based punitive approach

Individual support only rather than therapeutic groups

Free movement in an unlocked facility

Which of the following is NOT included in Stage 1: Preparation and Relationship Building?

Avoid sharing personal weaknesses and biases

Review pacing differences

Discuss how transitions are approached in treatment

Create as many success visuals as possible

Which of the following does NOT occur when the hot system is activated?

A reduction in language ability

Internal conditioned dialogues are suppressed

Perceptions shift to worrisome fantasies

Moral reasoning lessens or disappears

What do pathogenic approaches address?

Whole person

Lifestyle

Deficits

Prevention

What is meaningfulness according to Antonovsky’s work?

The quality of having great value or significance

The extent to which you might perceive both internal and external stimuli as being understandable in a rational way

The degree to which we might feel that there are resources at our disposal

The extent to which we feel that our lives have emotional meaning

How does binary thinking make healing and dealing effectively with trauma more complicated?

Binary thinking allows for being relational rather than being ego driven

Binary thinking is problem focused and deficits based

Binary thinking promotes intentional living rather than reactivity

Binary thinking follows the salutogenic model

Which of the following is NOT a question that one should ask themselves to promote personal growth?

How are you making sure you are growing past your upsets, failures, and/or disappointments?

What is your plan to grow tomorrow, and then the next day and the next day?

What have you done today “on purpose with a plan” to improve your character, talents, skills, and relationships?

What did you do wrong today and how will you make sure it does not happen again in the future?

What percent of participants engaging in AA would remain completely abstinent one year later?

35%

42%

56%

65%

Which of the following statements is false about using the SUD’s scale?

10 indicates no distress, no anxiety/depression, no disturbance

It is a tool for clients to measure their own level of distress

Breath techniques can be used at any notice of increase on SUDs scale

It is helpful for clients to begin practicing tools/techniques when they are on the lower end of the SUDs scale

Which template is NOT created by a child’s nervous system looking for stimulus?

Regulation patterns

Physical patterns

Emotional patterns

Cognitive patterns

What emerges when categories collapse?

Thinking on a spectrum/gradient

Moving toward relationship and connection

Difficulty in activating the ACC

Developing a belief that one must choose between polarities

Which of the following is NOT a step to interoception?

Learn to calm, relax, and reduce arousal in the limbic system

Detect what in the environment is activating the limbic shift

Practice detecting and reducing limbic shifts at higher thresholds

Recognize when a limbic shift is occurring

A trauma informed lens ___________

Looks at the person and the behavior as a problem

Encourages authoritarian control through power and force

Validates the humanity of the individual

Marginalizes and criticizes the individual

What can happen when there is reduced serotonin in the body?

An interruption in sequential memory

Loneliness, stress, alienation

A reduction in ability to reality check

Low self-esteem, hopelessness, panic attacks

What fraction of individuals with 7+ ACEs have heart disease?

1 in 14

1 in 30

1 in 7

1 in 6

What happens when cortisol is released in limbic shift?

Reduced ability to create sequential memory

Increased fear, anxiety, phobias, hallucinations, depression, agitation

Reduced healthy sleep patterns

Increased access to the impulse control center

What is a behavioral salutogenic attribute?

Alcohol and drugs

Intimacy/empathy

Meaning/purpose

Cultural identity

Which of the following is NOT expected in sympathetic dominance?

Reduced ability to express resilience and self-regulation strategies

Increased volatile, reactive behaviors

Reduction in recognizing social cues

Increase in expressing verbally and modulating emotion

What can one do to build their inner resources daily?

Rewiring the brain by focusing on pathology

Connecting to nature

Asking questions like, “what’s wrong with you?”

Practicing compassion and kindness except for in annoying circumstances

What is the limbic system responsible for?

Learning, memory, and coping with stress

Involuntary physiologic processes (e.g., heart rate, blood pressure, etc.)

Delivering oxygen and nutrients to cells

Movement and muscle contraction

What can determine how genes are turned on/off or whether some are expressed at all?

Early experiences

Number of genes transferred from parent to offspring

Presence of neurotransmitters

Development of synapses

What is an action-oriented behavior related to adaptation?

Compulsiveness

Addiction

Suicidality

Impulsivity

Which of the following is NOT one of the four R’s from SAMHSA?

Resist re-traumatization

Realize

Recognize

Reactivate

1. What is a somatic resource for the traumatic reaction of muscular hypervigilance?

Lengthening the spine

Grounding with the feet

Slowing the pace

Placing the hand over heart

Which of the following statements is false regarding epigenetics and addiction?

Chemical signatures can be temporary or permanent

Genes are turned on and off due to environmental factors

There are no genes for mental health conditions

Genes can cause addiction

What does the amygdala do?

It is involved in coordinating movement and balance

It sends and receives hormones in the body

It supports hallucinations/delusions

It relays information from the brain to the body

How can an individual avoid activating someone’s “sore spots”?

By never relying on assumptions

By always laying on additional demands

By directly asking what happened

By judging behavior, thinking, and emotions

In 2008, what was the prevalence of PTSD in SUD clients in comparison to the general population?

13x higher

13x lower

17x higher

17x lower

What is the neocortex involved with?

Abstract representation, social behavior, decision making

Converting short-term memory to long-term memory

Relaying all senses except for smell

Autonomic arousal, sensory information, body processing

Which of the following is NOT a way that an individual could be invited to engage in the social dominance game?

If the individual perceives status, power, or role is respected

If the individual perceives attention is being forced

If the individual perceives a restriction of movement and action

If the individual perceives that someone is trying to exert control

Which of the following is NOT a core feature in resilience?

Intentional applications of personal strengths

Appreciation of life except when faced with stressors

Exploring new possibilities

Relating to others, reconnecting or creating new connections

What happens when the body moves into sympathetic dominance?

Diaphragm muscles relax

Inhibited insulin production

Maintaining baseline blood pressure

Minimal or no muscle tension

How can a clinician support the recovery of people with histories of adversity?

Share vivid, descriptive examples of failure

Focus on behavior and emotion rather than environment

Start trying to intervene with “the Hulk”

Discuss real stumbling blocks and how people deal with them

What has Medicated Assisted Treatment (MAT) been shown to do?

Decrease retention in treatment

Increase criminal activity among people with substance use

Contribute to lowering a person’s risk of contracting HIV or hepatitis C

Impairs birth outcomes among women who have substance use disorders and are pregnant

Which of the following does NOT belong to Picker’s Eight Principles of Patient Centered Care?

Compliance with the clinician’s opinion

Involvement of family and friends

Coordination and integration of care

Physical comfort

How long does it take for a single dose of the fiery cocktail to metabolize?

Seconds

Minutes

Hours

It metabolizes immediately

What is a salutogenic assumption?

Avoid getting worse

Humans are inherently flawed

Reactive to treat disease

Humans are naturally healthy

What happens when the relational social engagement system is suppressed?

Stable friendships and family relationships

Poor quality attachment

Understanding of social cues

Altruistic behaviors

How can an individual motivate trauma clients?

Utilize long term goals

Decrease distress tolerance

Focus on the year rather than the week

Address avoidance with curiosity

What occurs when executive functioning can take place?

Balancing and regulating emotions

Reducing threat through aggression

Altering body tension and muscle readiness to act

Avoiding threat through flight

When the balance system (ANS) is dysregulated, it responds with ___________

Intentionality

Growth and learning

Survival strategies

Vagal brakes

What was found in the brain scan of cocaine abusers?

Increase in white matter integrity

Reduction of dopamine D2 receptors

Increase in grey matter density

Reduction of brain’s basal ganglia

What is implicit memory?

Information one consciously works to remember

An example would be recalling animals that live in the sea

The memory of everyday events

Body and tactile memory

What is a common medication to treat alcohol use disorder?

Buprenorphine

Naloxone

Disulfiram

Methadone

What can sensory integration rooms be used for?

Provide symptom tracking, instant access to support, connection with communities, daily meditations, mindfulness tools, etc.

Create dynamic, 3-D stimulus environments and allows for the recording of behavioral and physiological responses providing clinical assessment options

Help clients identify emotions, understand why they are feeling this way, and learn how to calm themselves without the use of substances

Reduce or eliminate the geographic distance causing spatial barriers for patients to receive care and treatment

Which of the following is NOT how the human body reacts to threat, toxic stress, or adversity?

Muscles tighten throughout the body

Hypothalamus activates the adrenal glands

Liver produces extra insulin resulting in low levels of glucose in the blood

Stress hormones affect the respiratory and cardiovascular systems

Which of the following is NOT associated with SUD and PTSD?

Increased physical health problems

Poorer social functioning

Lower rates of suicide attempts