Counseling Techniques and Approaches in Substance Abuse Treatment, Exams of Psychology

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IC&RC written exam 141 Questions with

Answers 2024

What is the essential first step in determining the possible causes of addiction for the person and the most appropriate treatment modality for his and her needs? ✔ Assessment A client tells a counselor that she is unhappy with the way her treatment is progressing. The counselor should: ✔ discuss these concerns with the client and make necessary changes in treatment goals. A common error that counselors make when conducting an assessment is: ✔ Moving to quickly from data collection to treatment planning. A female client reports that she has some concerns about the relationship between her husband and her 14-year-old daughter from a previous marriage. She reports that her husband and daughter frequently argue, that her daughter refuses to take direction from stepfather, mid that her daughter regularly complains about her stepfathers "faults" and describes how her biological Father is better. The MOST relevant professional to whom a referral should be made is a: ✔ Marriage and family therapist A key factor for counselors to consider is that in a counseling relationship, the club has differential power. One of the best safeguards is: ✔ to be alert to and understand the power of relationship. A pretreatment period is frequently the result of waiting lists or client reluctance to become fully engaged in primary treatment. what might be a danger of this pretreatment period? ✔ Clients may lose interest in treatment According to Marlatt's model of the relapse process, which of the following statements is not true?

• clients should be taught skills for anticipating, avoiding, and coping with their personal high-risk situations
• clients should be taught constructive responses to cope with lapses when they do occur
• clients should be helped to recognize that one or more temporary lapses are likely to occur and are permitted.
• any positive expectations that clients have about drug use should be countered with reminders about the lows that follow the highs and about the long term negative consequences of substance abuse.

✔ clients should be helped to recognize that one or more temporary lapses are likely to occur and are permitted. According to the DSM-4, all of the following are criteria for psychoactive substance dependence Except:

• substance often on larger amounts than the person intended
• marked lack of initiative, interest or energy
• frequent intoxication when expected to fulfill major role obligations
• one or more unsuccessful efforts to cut down substance use. ✔ Lack of initiative, interest or energy All of the following are goals of person-centered therapy EXCEPT:
• teaches clients to formulate and carry out plans to change their behavior
• focusing on the person I steam of the presenting problem.
• assisting clients in enhancing their coping skills.
• individualizing the treatment plan ✔ teaches clients to formulate and carry out plans to change their behavior Bob is a case manager in an intensive inpatient treatment facility. He recently was assigned a client, Mary, who presents not only with alcoholism but has also been diagnosed with AIDS. To assist Mary in her treatment and recovery needs, Bob would probably need to have knowledge of all the following areas EXCEPT:
• AIDS epidemiology and transmission routes
• the diseases clinical progression
• new medication used in treatment regimens
• available social services for AIDS clients ✔ new medication used in treatment regimens Therapeutic communities differ from Synanon because: ✔ These communities try to return clients to society. During the screening , a critical task that the counselor has is to: ✔ Establish rapport with the client During the assessment process, your alcohol and tranquilizer abusing client reveals a history of self-destructiveness when frustrated am inability to replay impulses. The MOST appropriate assessment battery in this case is: ✔ The Beck depression Scale, MAST test, and MMPI The primary purpose of the screening process is to: ✔ Determine ones appropriateness and eligibility for admission. Effective case management for persons in need of multiple services requires: ✔ Monitoring, feedback, and evaluation of services.

In determining whether a chemically dependent patient should be treated in an inpatient or outpatient program, all of the following should be considered EXCEPT:

• whether the pt has a Hx of sobriety during the last several years
• whether the pts job and family are likely to give him another chance if this treatment fails.
• whether the pt has family support for sobriety
• whether the pt has a Hx of failed treatment on an OP or IP basis. ✔ whether the pts job and family are likely to give him another chance if this treatment fails. Alcohol decreases resistance to HIV infection by: ✔ Compromising T-cell functions It is crucial for the case manager to be aware of what may inhibit minorities' participation in the SA treatment continuum. Suppose that you are a case manager, working in and OP program with a Somali client. AA is an integral part of your program, yet you are aware of the fact that while "accepting one's powerlessness" is a central tenet of the 12- step self help programs, members of oppressed groups may not accept it, given their own societal powerlessness. What would be the best thing to do in such a case? ✔ Be sensitive to such cultural differences and seek out other recovery resources that are relevant to the individuals values. It is important to understand clients and their expectations for Counseling. Clients coming in for treatment carry with them both helpful and harmful expectations. Which of the following is a harmful client expectation?
• "This counselor is a stranger, but maybe I can learn to trust her"
• "My counselor will direct me to do what I need to do, and everything will be OK"
• "My counselor will be a resource that I can use to resolve my problems"
• "The counselors main concern and responsibility is to help me achieve my goals and objectives" ✔ My counselor will direct me to do what I need to do, and everything will be OK" Joe is a 27-year old addict who has begun counseling, but has not yet been able To give up using drugs. During one session, he tells his counselor that he is beginning to feel that "it is useless to try to stop," and that " sometimes life isn't worth living." The counselor is concerned that Joe could be suicidal. The counselor should: ✔ Assess joes potential for suicide by asking him about his intent, and evaluating high risk factors. If the orientation process is neglected or incomplete a client may: ✔ Have incorrect information and I unanswered questions about the program. ___________ is one of case managements hallmark characteristics ✔ Advocacy

When language is a barrier to treatment planning, this situation can be overcome by: ✔ Employing an interpreter The first contact that a potential client would have with an agency would likely b for the purpose of: ✔ Screening The MOST significant barrier to effective treatment for alcohol and other drug abuse for single parents is lack of: ✔ Child care services. Sarah, a counselor in a drug treatment center, grew up in an alcoholic home and still has strained relationships. Which statement best describes Sarah's situation?

• she can expect her unresolved conflict to rise to the surface because of her work in the treatment center
• she can resolve her personal pain by working professionally with addicted family units in a treatment center
• she may be more comfortable with her clients because she is familiar with their behavior
• she may have unfinished business with her parents ✔ she can expect her unresolved conflict to rise to the surface because of her work in the treatment center You are asked to see a client in the emergency room for consultation. The nursing notes read: pupils dilated; goose flesh; lacrimation; muscle jerks; flu syndrome; vomiting; diarrhea; nervousness; yawning; and severe anxiety. You conclude that the client is withdrawing from: ✔ Opioids. The organization founded as an alternative to programs with spiritual overtones, whose publication is called "The Small Book," is: ✔ Rational Recovery Effective communication occurs in groups when: ✔ Message senders use " I " statements A single mother with three young children enters your clinic and begins to discuss her current drug use. She tells You that she hasn't been home for several days and has left the 8 year old in charge. What do you do? ✔ Contact CPS to report the incident. One of the counselors task is to guide the client in relating and communicating in specific terms, rather than in general or abstract terms. That characteristic or ability is called?

✔ Concreteness One of the earliest models for case management services in the criminal justice system was created in 1972, when the White House launched a demonstration program know as; ✔ (TASC) Treatment Alternates to Street Crime Ralph is a recovering alcoholic. He has been sober for several months, and has managed to find gainful employment and re-establishes family relationships. He is in a 12-Step program as well as individual counseling. One day, he arrives to a counseling session quite upset. He reveals that he had a "slip" and drank a beer at a party. He did not get drunk, but feels terribly remorseful and has promised himself that he will not do it again. ✔ The counselor should talk to Ralph about the implications of dangerous situations like this, but assure him that it is possible to continue his recovery process. Record keeping is an important part of the counseling process. What best reflects the type of information which should be kept in a clients record? ✔ Information about consultations, diagnosis, treatment, prognosis, and progress. Stress inoculation focuses primarily on: ✔ Increasing copibg skills Providing the client with information regarding program rules, and infractions that can lead to discharge, normally occurs during the: ✔ orientation. Which of the following is NOT a commonly used technique for crisis intervention? ✔ behavior Immediately refer the client to an agency to help change the situation simple The CAGE test is a simple assessment that is administered to individuals with a drinking problem. The questions on this test refer to: ✔ cutting down on drinking, feeling annoyed and guilty, and dealing with hangovers. The focus of intervention in the criminal justice system is first to: ✔ incarceration a change. protect the health, safety, and welfare of the public. the goal of Al-Anon is: ✔ to provide a fellowship and support for individuals in relationships with alcoholics. Which of the following modes of sexual transmission provides the LOWEST risk of HIV transmission? ✔ Female to female

Counselors rely heavily on the work of developmental theorists as they attempt to stimulate clients to initiate relevant growth. According to Erickson, one of the leaders in developmental theory, the task to be accomplished in adulthood is: ✔ Intimacy vs. Isolation. The description of the client's rights typically occurs during the: ✔ orientation. a. a client's fears and denial. b. confidentiality c. information gathering. d. treatment planning. ✔ treatment planning. Comprehensive client documentation: ✔ facilitates communication and enhances accountability. Relapse prevention efforts are aimed at: ✔ identifying high-risk situations and learning alternative coping skills. Before therapy or counseling begins, clients may be given information about the treatment they will receive, as well as possible risks involved. This process is known as: a. self-disclosure. b. releasing information. c. protecting confidentiality. d. obtaining informed consent to treatment. ✔ obtaining informed consent to treatment. Which statement BEST describes how a counselor can avoid professional burnout? ✔ work hours Attend to health through adequate sleep, an exercise program, and proper diet. A cocaine-dependent client admits being fired from his job for absenteeism, losing his home and car by defaulting on his loans, and associating only with peers who use cocaine. He states that he does not require residential treatment because his problem is not serious enough. He further states that he has lost his house and car because his wife didn't work enough hours. Which defense mechanisms is this client displaying? a. Projection, denial, and displacement b. Denial, minimalization, and rationalization c. Sublimination, displacement, and compensation d. Identification, minimization, and sublimination ✔ Denial, minimalization, and rationalization

A client says to you, "I am getting to like you very much and l'd like us to get a lot closer." You should first: ✔ talk openly about transference issues. The initial stage of crisis intervention involves: ✔ determining the problem. The measurement of progress toward treatment plan goals is best assessed by: ✔ reviewing documentation in progress notes. significant others. The PRIMARY purpose of a professional code of ethics is to: ✔ serve as a guide in helping clients while behaving in a fair way to colleagues. The PRIMARY purpose of professional standards of practice is to: ✔ help programs qualify for Medicaid and other third-party reimbursement. The tendency of the family to try and maintain balance is called: ✔ homeostasis. Of the following statements made by a client in a group, which would MOST warrant documentation in the client's progress notes? a. "I'm finding the support from this group to be very helpful." b. "Getting caught for drunk driving was a mixed blessing." C. "Ever since I stopped drinking, my emotional swings have been quite intense." d. "Let's change the subject. Did anyone see the game last night?" ✔ "Ever since I stopped drinking, my emotional swings have been quite intense." Your client, Eric, discloses to the group that he is homosexual. Another shifts in his seat and changes the subject, talking member of the group about a superficial incident that happened earlier in the day. The facilitator's MOST appropriate response would be to: ✔ ask questions which facilitate a group response to Eric's disclosure and elicit more feeling content from Eric. a. Valium b. Halcion. c. Trazodone. d. Xanax ✔ Trazodone. A major method of reinforcing the therapeutic alliance and spirit of collaboration between the client and the counselor is: a. including the client's family members in counseling. b. setting mutually-established goals. c. going to 12-step meetings with the client. d. offering to make home visits. ✔ setting mutually-established goals.

A mental status exam does NOT assess: a. educational level. b. appearance. c. speech. d. thought processes. ✔ educational level. The provision of information concerning alcohol and other drug abuse and the available services and resources, is termed: ✔ client education. When making a referral you should do all of the following EXCEPT: a. share what you know about the referral agency with your client. b. follow through with the referral agency to ensure you get your referral fee. c. offer to make the initial contact in order to ensure that the client sees the right person. d. Have the client sign a release of confidentiality form before following through with the referral. ✔ follow through with the referral agency to ensure you get your referral fee. Which situation requires a client's informed consent?

• A counselor refers a client back to the referring source at completion of treatment
• A counselor discusses a client's case with another counselor in the
• A counselor discusses a client's case with the counselor's supervisor treatment facility
• A client reports recent child abuse ✔ A client reports recent child abuse Significant others should be involved in the treatment process: ✔ from the client's first contact with the treatment center. The NIDA-financed Drug Abuse Reporting Program found that: ✔ therapeutic communities do reduce drug use relative to untreated clients or those who are simply detoxified and released. Your dually-diagnosed client, stabilized on medication for his psychiatric disorder, decides he wants to quit smoking. You should: ✔ consult with his physician regarding nicotine/medication interaction. Which of the following is a cognitive-based therapy, which is designed to confront a client's irrational thinking? ✔ Rational-Emotive Therapy Because addiction affects so many facets of the addicted person's life, ___________ promotes recovery and enables the substance abuse client to fully integrate into society as a healthy, substance-free individual.

✔ a comprehensive continuum of services A "Release of Information" form must include, the client's name, address, date of birth, and ✔ The purpose of the release of information When a client discloses suicidal thoughts, the counselor's first step is to: ✔ assess the degree of risk restlessness, irritability, anxiety, agitation, tremor, elevated heart rate, increased blood pressure, decreased appetite, nausea, and vomiting are signs and symptoms for assessing ✔ Alcohol withdrawl Identifying the client's problems and needs, strengths and weaknesses is the primary focus when ✔ Conducting an assessment Which of the following is the BEST indicator if an individual is physically dependent upon alcohol or another drug? a. The amount consumed daily b. The length in years of heavy drinking or drug use c. The presence of withdrawal symptoms d. The frequency of memory blackouts ✔ The presence of withdrawal symptoms In a crisis interview with a client, you are most concerned with ✔ focusing questions about the present situation and the client's means of coping with the stress. Which statement about the grief process is TRUE? ✔ Guilt and anger are painful emotions that are part of grieving Your client has been advised by his sponsor to discontinue a needed antidepressant medication. You believe this advice to be premature and possibly harmful. What action should you take as a first step? a. Obtain your client's authorization and contact the sponsor to discuss the situation further b. Have the client discontinue involvement in AA until antidepressant medication is no longer needed c. Encourage your client to ignore the sponsor's advice and continue the medication d. Encourage your client to look for another, more understanding sponsor ✔ Obtain your client's authorization and contact the sponsor to discuss the situation further

You are having difficulty with a client early on in the case. The BEST thin for you to do is: ✔ seek out supervision with a colleague or supervisor. While taking an alcohol drug history, which of the following is a good clue to alcohol dependency? ✔ Increased tolerance and withdrawal symptoms when abstinence is attempted You have assessed your client and determined that he is a problem drinker. He insists that the reason he drinks is because of his wife's behavior. Your initial objective should be to help him: ✔ take responsibility for his behavior In order to fill gaps in services to minority clients, communities should include all of the following EXCEPT: a. education and training. b. diagnosis and intervention. c. segregated treatment programs. d. integrated treatment programs with cultural programming.. ✔ Segregated treatment programs. An irresistible impulse is called a(an): ✔ compulsion. What are theveffects of alcohol abuse on the body? ✔ malnutrition canoccur in drinkers who eat well-balanced diets. the second stage of liver deterioration can be reversed and vitamin B6 deficiency The interpersonal style in which a member of a minority group has made conscious or subconscious decision to reject the general attitudes, behaviors, customs, rituals, and stereotypic behaviors associated with his/her own minority group to assimilate into the mainstream white culture is known as: ✔ the Acculturated Interpersonal Style. Brian is a 15-year old boy who has been admitted to a program for chemical dependency. He has a history of running away from home, erratic performance in school, and has been arrested twice for petty theft. In assessing Brian, the counselor should first consider which of the following before making a treatment recommendation? ✔ Brian's familial relationships and social milieu Despite vast personality differences, virtually all substance abusers experience: ✔ remorse, self-hatred, and shame. The therapeutic reasoning for self-disclosure in group counseling is to: ✔ facilitate the growth of the group by relating to client or group issues.

Barbiturates can be sub-classified into groups based upon: ✔ the speed of the onset and duration of the effects. Heroin is an example of a(an): ✔ semi-synthetic narcotic. There are several psychological and sociological differences between male and female alcohol abusers. Which of the following BEST describes one of those differences? ✔ Women more often than men will cite a traumatic event that precipitated their drinking. Which statement MOST accurately describes the relationship between Alcoholics Anonymous and the professional treatment community? ✔ A partnership between AA and the professional community was repeatedly emphasized by the founders of AA. Which of the following patterns of drinking is accurately associated with the term "alcoholism"? ✔ The inability to control the amount one drinks Which of the following is MOST helpful for counselors in defining their professional roles for counseling clients? ✔ An ethical code of conduct "Referral" pertains to: a. assisting a client to utilize the support systems and community resources available. b. meeting with other professionals for discussions and planning. c. providing drug and alcohol information to clients. d. attending an A.A. or N.A. meeting with a client. ✔ a. assisting a client to utilize the support systems and community resources available. Assisting the client with needs generally thought to be outside the realm of substance abuse treatment, provideing the client a single point of contact for multiple health and social services systems, and flexible, community-based, and client-oriented are used by treatment professionals when utilizing ... ✔ Case Management Pointing out parallels between a client's interpersonal relationships and client/counselor interaction serves to focus awareness on ✔ the "here and now." If a client appears to be in denial due to discrepancies stated during an intake interview, which of the following statements by the counselor would be MOST appropriate?

a. "I'm not sure I understand. Let me check this out" b. "First you tell me one thing, then another. Which is really the truth?" c. "There's a lot of confusion in your story" d. "Addiction fosters denial" ✔ "I'm not sure I understand. Let me check this out" The branch of pharmacology that deals with the biological, biochemical, and physical characteristics of natural drugs is: ✔ Pharmacognosy. The term "late-onset" as it applies to chemical dependency refers to: ✔ elderly people who develop chemical dependency late in life. Written consent to release client information is required EXCEPT when the release is to the client's: ✔ spouse who participates in joint counseling sessions. Some populations suffer greater rates of addiction than others. The Native American population, for example, have addiction rates of: ✔ >50%. The BEST way of dealing with individual needs in a group is to: a. use the group process to share mutual concerns. b. see the client for individual counseling outside of group. c. conduct one-on-one sessions in the group. d. not allow monopolizing by members in group. ✔ use the group process to share mutual concerns. Assessment, according to the behavioral approach, involves: ✔ specification of the problematic behavior and collection of baseline data Concise and accurate reporting is necessary in order to: ✔ ensure continuity of client care. clinical In order to provide clients with updated information concerning addiction and recovery, the counselor must: ✔ stay well-informed and aware of recent developments in the field. teach classes Relating with in house and other professionals to assure comprehensive quality care for the client best describes the process of: ✔ consultation. A mutually-agreed-upon treatment plan should include: ✔ clear expectations, specific goals, and methods of achievement.

Which of the following statements about dysfunctional families is TRUE? ✔ The divorce rate in dysfunctional families is highest after recovery has been initiated. The quality of counseling is directly related to the counselor's ability to: ✔ Formulate and carry out realistic personal and professional goals A client says that his wife has vowed to leave him if he resumes drinking. The best response by the counselor would be: ✔ "she's really serious about your sobriety" Which self help group would be most appropriate for a mother whose drug and alcohol-abusing son is causing her distress? a. Alateen b. ACOA c. Al-Anon d. A.A. ✔ Al-Anon The treatment plan is developed based on information collected during: ✔ the assessment. You begin working with a drinking alcoholic who recently had eight months of sobriety. He asks how he can stay sober. You respond by: ✔ asking him what worked before. Which term refers to a client's projecting past emotional attitudes onto the counselor? ✔ Transference Which of the following responses would be helpful in establishing a therapeutic relationship with a client? ✔ "Let's talk about each of our expectations for counseling" Good case management requires the integration of services within a treatment plan. With this in mind, which of the following is TRUE? a. The counselor should involved in the client's treatment. coordinate regular meetings with all professionals present. b. Good integration of services requires team meetings with the client c. Once the treatment plan is written, the use of other services is determined and will remain unchanged. d. With a well-integrated team of professionals, progress notes will alone determine how the treatment plan is being the case manager's review of followed. ✔ The counselor should involved in the client's treatment. coordinate regular meetings with all professionals present. A reward is something given for a special behavior, whereas positive reinforcement is:

✔ something specifically designed to increase the occurrence of a particular behavior A 42-year-old male has just completed intake admission forms and is considered appropriate and eligible for treatment. Which step should occur next? ✔ The counselor should provide the client with an overview describing the goal, objectives, rules, and obligations of the problem. Personality disorders are: ✔ maladaptive ways of perceiving, thinking, and relating. While the overall national suicide rate has increased slightly but consistently in recent years, disproportionate increases have occurred among: ✔ females and the young. If Seconal is taken in combination with one of the following drugs, it leads to a "potentiation" of effect. Which drug will cause this effect? ✔ Alcohol Morning drinking is not an uncommon occurrence with alcoholics. Which of the following is NOT a true statement? a. Morning drinking will reduce the symptoms of withdrawal b. Morning drinking will keep the alcoholic's blood alcohol level from dropping. c. Morning drinking will lessen the need for alcohol during the remainder of the day d. Morning drinking reduces anxiety that effects the alcoholic's ability to start the day ✔ Morning drinking will lessen the need for alcohol during the remainder of the day To assist them in handling termination issues, effective counselors use appropriate levels of: a. counter-transference. b. investigation. c. self-disclosure. d. role-playing. ✔ self-disclosure. Which of the following is a TRUE statement? a. Alcohol accounts for one-half of the ten leading causes of death in the Native American population b. Cultural issues no longer play a role in alcoholism rates with the Native American population. c. Past efforts to treat the Native American alcoholic have proven highly successful. d. Revia has proven to be a popular intervention in the effective treatment of Native American populations. ✔ Alcohol accounts for one-half of the ten leading causes of death in the Native American population

During a session you notice that the client is getting progressively more agitated. You suspect a potential for violence unless something is done immediately. Your BEST course of action would be to: ✔ call for assistance. After a counselor has made a summary statement, the most important thing the counselor should do is ______________. ✔ remain quite for a time to allow the client to consider the summarized material. Bipolar mood disorder is distinguished from major depression by: ✔ at least one episode of mania. In a dysfunctional family system, the traditional role which the spouse plays is referred to as: ✔ the Primary Enabler. Frequent client reaction during the termination phase of counseling ✔ acting out behavior The completion of various forms, including releases of information, financial, and consent for treatment, happens during the client's: ✔ intake "Our meetings will consist of four 50 minute sessions at 10 a.m.. each Wednesday" is an example of a counselor _______________ with a client. ✔ Setting limits One goal of an effective aftercare program is: a. to enhance a client's emotional rehabilitation. b. to minimize the client's use of denial. c. to support the gains made in treatment. d. to assign sponsors to clients. ✔ to support the gains made in treatment. According to the American Society of Addiction Medicine (ASAM), which of the following is NOT one of the five categories of primary treatment? a. Early intervention b. Detoxification services c. Intensive outpatient or partial hospitalization d. Residential or inpatient services ✔ Detox services Regarding a "seropositive" result, which of the following is NOT a meaning of HIV antibody test results?

a. The person has the AIDS virus b. HIV infection occurred at some point in the past c. The person is infectious and will remain so for life d. The HIV infection has been in the system long enough to produce antibodies ✔ The person has the AIDS virus Client files should be readily accessible to: ✔ only those persons directly involved in providing clinical services. Which of the following issues must always be considered when consulting with out-of- agency professionals? a. Confidentiality b. Documentation of client problems c. The client's aftercare plan d. The level of commitment of the client to follow through ✔ Confidentiality The process of termination should begin: ✔ at the onset of therapy. euphoria. high levels of verbal output. pressured speech. Are symptoms of ✔ The manic phase of bipolar mood disorder Disulfiram (Antabuse) ✔ causes unpleasant reactions when combined with alcohol. Naltrexone (ReVia) ✔ reduces cravings for alcohol and prevents pleasurable effects caused by drinking. Acamprosate (Campral) ✔ curbs cravings for alcohol. Vivitrol (Naltrexone) ✔ extended release IM used to prevent alcohol relapse