Inhoud
Les 1: introductie.......................................................................................................................................................4
Psychopathologie vanuit het herstelperspectief..................................................................................................4
Verslaving en verslavingszorg...............................................................................................................................4
Situering............................................................................................................................................................4
les 2: Productinformatie alcohol..............................................................................................................................5
ver..........................................................................................................................................................................6
De impact van alcohol...........................................................................................................................................6
Alcohol: de werking...............................................................................................................................................7
Risico’s korte termijn.............................................................................................................................................7
Risico’s op lange termijn.......................................................................................................................................7
Alcohol: risico’s vruchtbaarheid en zwangerschap...............................................................................................8
FAS: foetaal alcohol syndroom..........................................................................................................................8
Uitgangspunten.....................................................................................................................................................8
Nieuwe evidentie?.................................................................................................................................................8
Bingedrinking.....................................................................................................................................................9
Het verslavingsproces.......................................................................................................................................9
Les 3: visies op verslaving en problematisch middelengebruik..............................................................................10
Verschillende modellen.......................................................................................................................................10
Verslaving als hersenziekte.................................................................................................................................11
Het effect van verslavende stoffen op de hersenen.......................................................................................11
Visies: het duale procesmodel............................................................................................................................12
Waarom is een verslaving moeilijk te doorbreken? – paard en ruitermetafoor................................................13
Gewoonten moeilijk te doorbreken................................................................................................................13
Visies....................................................................................................................................................................15
Gedragsverslaving...............................................................................................................................................15
Gokstoornis.....................................................................................................................................................16
determinanten en risicofactoren....................................................................................................................17
Vergelijking met middelenafhankelijkheid.........................................................................................................18
DSM-5 criteria gokstoornis..................................................................................................................................18
Screening: south oaks gambling screen SOGS....................................................................................................18
Internetverslaving...................................................................................................................................................18
Seksverslaving.........................................................................................................................................................19
Relatie seksueel gedrag en middelengebruik.........................................................................................................19
les 4: Drugs en wetgeving.......................................................................................................................................20
Bruggen naar hulpverlening................................................................................................................................21
1
, Assessment..........................................................................................................................................................21
Screening.........................................................................................................................................................21
Semigestructureerd interview........................................................................................................................22
Dissociatieve processen en dubbele persoonlijkheid.....................................................................................22
Alcohol en cognitieve stoornissen......................................................................................................................23
Achteruitgang door excessief alcoholgebruik.................................................................................................24
Delier – dementie – depressie............................................................................................................................25
Restgroep........................................................................................................................................................25
Abstinentie (= onthouden) bij alcoholafhankelijkheid....................................................................................25
Belang NPO in het kader van behandeling......................................................................................................26
LES 5: dubbele diagnose..........................................................................................................................................26
Ondersteuning van familieleden.........................................................................................................................27
Organisatie van de verslavingszorg.....................................................................................................................28
Preventie.............................................................................................................................................................28
Intensiteit van de hulpverlening.........................................................................................................................29
Online hulpverlening...........................................................................................................................................31
Bevindingen alcoholhulp.................................................................................................................................31
Effectieve interventies bij PM.............................................................................................................................31
De fasen van verandering................................................................................................................................32
Terugvalpreventiemodel.................................................................................................................................32
Medicamenteuze interventies........................................................................................................................33
Neuromodulatie..............................................................................................................................................33
De suïcidale cliënt....................................................................................................................................................34
Misverstanden.....................................................................................................................................................34
Uitgangspunten van suïcidepreventie................................................................................................................34
Suïcidaal gedrag: terminologie............................................................................................................................34
Zelf verwondend gedrag (ZVG)/ automutilatie...................................................................................................35
Symptomen van zelfverwonding.....................................................................................................................35
aanvangsleeftijd..............................................................................................................................................35
zelfbeschadigingssyndroom DSM-5 sectie III..................................................................................................35
Ontstaan fase 5 van Erikson...........................................................................................................................36
Verklaringen van suïcidaal gedrag......................................................................................................................36
Het beloop van het suïcidaal proces...................................................................................................................37
Basisprincipes in de hulpverlening aan suïcidale personen................................................................................37
Contact maken................................................................................................................................................38
Bevorderen van veiligheid...............................................................................................................................38
Betrekken van naasten....................................................................................................................................38
2
, Continuïteit van de zorg..................................................................................................................................38
Detectie: signalen herkennen.............................................................................................................................38
Suïcidaliteit bespreekbaar maken.......................................................................................................................39
Omgaan met weerstand......................................................................................................................................39
Stroomdiagram detectie – risicotaxatie..........................................................................................................40
Risicoformulering............................................................................................................................................40
Interventies.........................................................................................................................................................41
Richtlijnen voor een behandelplan.................................................................................................................41
Evidence based interventies...........................................................................................................................42
Na een suïcidepoging..........................................................................................................................................43
Een zorgpad als leidraad.................................................................................................................................43
Ondersteunende tools en diensten................................................................................................................43
Na een suïcide: een stappenplan........................................................................................................................43
Psychologische autopsie.................................................................................................................................44
Aandachtspunten voor het eerste gesprek met de familie............................................................................44
Het rouwproces van nabestaanden................................................................................................................44
Individuele verschillen in het rouwproces......................................................................................................44
De hulpverlener als nabestaande....................................................................................................................45
Gezondheidszorgwetgeving................................................................................................................................45
Beroepsgeheim...............................................................................................................................................45
Psychose en psychosezorg......................................................................................................................................46
Kantekeningen.....................................................................................................................................................46
Analyse van beloopstudies..................................................................................................................................47
Prevalentie van psychotische fenomenen in de algemene bevolking............................................................47
Algemene behandelingsprincipes...................................................................................................................47
Psychodiagnostiek bij psychotische symptomatologie.......................................................................................47
Belang vroegdetectie......................................................................................................................................47
Meetinstrumenten detectie UHR-patiënten...................................................................................................48
Implicaties psychodiagnostisch onderzoek.....................................................................................................48
Cognitieve evaluatie: cognitieve functies.......................................................................................................49
Algemene behandelprincipes..........................................................................................................................49
Zelfverwonding........................................................................................................................................................56
Definitie...............................................................................................................................................................56
Diagnostische kenmerken...................................................................................................................................56
Etiologie en pathogenese....................................................................................................................................56
Diagnostisch onderzoek......................................................................................................................................56
Proces van zelfverwonding.................................................................................................................................56
3
, Zelfbeschadigingssyndroom................................................................................................................................57
Behandeling en begeleiding................................................................................................................................57
Basisregels begeleiding...................................................................................................................................57
LES 1: INTRODUCTIE
PSYCHOPATHOLOGIE VANUIT HET HERSTELPERSPECTIEF
Herstel is een intens persoonlijk, uniek proces van verandering in iemands houding, waarden, gevoelens,
doelen, vaardigheden en/of rollen. Het is een manier van leven, van het leiden van een bevredigend, hoopvol
en zinvol leven met de beperkingen die de psychische klachten met zich meebrengen
SITUERING
- Behoort tot de meest voorkomende mentale aandoeningen (vaak in combinatie met angst en
depressie)
- Verslavingszorg bestaat uit verschillende vormen van preventie en hulpverlening en is gericht op
verschillende groepen specialisme
- Het totaal aantal personen dat uiteindelijk in behandeling komt, is beperkt
Waar of niet waar? W NW
Blowen tast de vruchtbaarheid aan zowel bij de man als bij de vrouw
Als je bij het inademen de rook langer vasthoudt, wordt er meer THC opgenomen
Cannabisgebruik kan bij gezonde personen een psychose uitlokken
Zodra hasj en wiet uitgewerkt is, is het niet meer aantoonbaar
Het effect van speed is dat je een grotere eetlust krijgt
Speed werd oorspronkelijk ontwikkeld als medicijn
Een alcoholprobleem is erfelijk
Het psychisch effect van ketamine is dat je je zweverig voelt en het lijkt alsof je geest en lichaam
niet meer met elkaar verbonden zijn
Enkel mensen zonder ervaring met GHB riskeren ‘out’ te gaan
Oudere mensen zijn gevoeliger voor slaap-en kalmeermiddelen
4
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